摘要
目的 探讨血清可溶性生长刺激表达基因2蛋白(sST2)联合中性粒细胞数(NEU)、C反应蛋白(CRP)检测对预测慢性阻塞性肺疾病急性加重期(AECOPD)患者不良预后的临床价值。方法 选择2022年5—8月本院收治的100例慢性阻塞性肺疾病(COPD)患者为研究对象,其中70例为COPD急性加重期,30例为COPD稳定期,选择同期体检且年龄和性别相匹配的健康体检者30例为对照组。采用方差分析比较不同组间sST2、NEU、CRP的水平;Spearman分析sST2、NEU、CRP与AECOPD临床分级的相关性;记录AECOPD患者出院后6个月内不良事件的发生情况,通过受试者工作特征(ROC)曲线评估sST2、NEU、CRP检测对AECOPD患者不良预后的预测效能,Cox回归分析AECOPD患者不良预后的相关风险因素。结果 AECOPD组sST2、NEU、CRP水平高于COPD稳定组和对照组,COPD稳定组sST2、NEU、CRP水平高于对照组(P<0.05);sST2、NEU、CRP水平随AECOPD患者临床分级的增加而升高,与AECOPD临床分级呈正相关,差异均有统计学意义(P<0.01);sST2、NEU、CRP对AECOPD患者6个月发生不良预后有较高的预测价值(AUCROC=0.861、0.674、0.729,P<0.05),最佳截断点分别为108.30 ng/mL、8.94×10^(9)/L、72.90 mg/L,且三项联合检测的预测价值最高(AUCROC=0.907,敏感性为95.5%,P<0.05);sST2>108.30ng/mL是AECOPD患者出院后6个月内发生不良预后的独立风险因素。结论 血清sST2、NEU、CRP可反映AECOPD病情严重程度,联合检测对预测AECOPD不良预后具有一定的临床价值。
Objective To investigate the clinical value of serum soluble growth-stimulating expression gene 2 protein(sST2)combined with neutrophil count(NEU)and C-reactive protein(CRP)in predicting the poor prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 100 patients with chronic obstructive pulmonary disease(COPD)who were admitted to the first affiliated hospital of Bengbu Medical College from May to August 2022 were selected as the research objects,with 70 cases in the acute exacerbation stage of COPD and 30 cases in the stable stage of COPD.Thirty healthy subjects who underwent physical examination during the same period matched in age and gender were served as the control group.ANOVA was used to compare the levels of sST2,NEU,and CRP among different groups;Spearman analysis was used to analyze the correlation between sST2,NEU,and CRP and the clinical grade of AECOPD;The occurrence of adverse events within 6 months after discharge of AECOPD patients was recorded,and receiver operating characteristic(ROC)curve were used to evaluate the predictive efficacy of sST2,NEU,and CRP detection on the poor prognosis of AECOPD patients,and Cox regression analysis was used to analyze the related risk factors for poor prognosis of AECOPD patients.Results The levels of sST2,NEU,and CRP in the AECOPD group were higher than those in the stable COPD group and the control group,and the levels of sST2,NEU,and CRP in the stable COPD group were higher than those in the control group(P<0.05).The levels of sST2,NEU,and CRP increased with the clinical grade of AECOPD patients increased,and they were positively correlated with AECOPD grading,the differences were statistically significant(P<0.01).sST2,NEU,and CRP have a high predictive value for the poor prognosis of AECOPD patients at 6 months(AUC ROC=0.861,0.674,0.729,P<0.05),the best cut-off points were 108.30 ng/mL,8.94×10^(9)/L,and 72.90 mg/L,and the combined detection of the three items had the highest predictive value(AUC ROC=0.907,sensitivity 95.5%,P<0.05);sST2 over108.30ng/mL was an independent risk factor for poor prognosis in AECOPD patients within 6 months after discharge.Conclusions Serum sST2,NEU,and CRP can reflect the severity of AECOPD,and combined detection has certain clinical value in predicting the poor prognosis of AECOPD.
作者
李明远
王凤超
朱佳蕊
Li Mingyuan;Wang Fengchao;Zhu Jiarui(Department of Clinical Laboratory,the First Affiliated Hospital of Bengbu Medical University,Bengbu,Anhui 233000,China)
出处
《齐齐哈尔医学院学报》
2023年第21期2017-2021,共5页
Journal of Qiqihar Medical University
基金
安徽省重点科研平台开放课题(KLICD-2022-D1)。
关键词
慢性阻塞性肺疾病急性加重期
可溶性生长刺激表达基因2蛋白
中性粒细胞
C反应蛋白
不良预后
Acute exacerbation of chronic obstructive pulmonary disease
Soluble growth-stimulatory expressed gene 2 protein
Neutrophils
C-reactive protein
Poor prognosis
作者简介
通信作者:王凤超,Email:llmmyy1019@126.com。
