血浆中生长分化因子-15在慢性阻塞性肺疾病中的表达和临床应用价值  

The serum GDF-15 level in patients with COPD and its clinical value in the diagnosis of COPD in the stable stage and in acute exacerbation stage

作　　者：李磊[1] 倪正义 汤中文[1] 周密[1] 

机构地区：[1]武汉市医疗救治中心外一科,430000

出　　处：《实用医学杂志》2017年第15期2443-2447,共5页The Journal of Practical Medicine

摘　　要：目的探讨血浆中生长分化因子-15(GDF-15)在慢性阻塞性肺疾病(COPD)中稳定期和急性恶化期的浓度及其在诊断稳定期和急性恶化期的临床应用价值。方法回顾性分析2015-2016年我院诊断的COPD患者58例,其中COPD稳定期和急性恶化期各29例,并选取同期在我院门诊就诊年龄、性别、体质指数相匹配的健康体检者29例为对照组。对比分析各组血浆中GDF-15、C-反应蛋白(CRP)浓度。采用Spearman相关分析研究COPD稳定期和急性恶化期GDF-15和CRP间的相关性,并比较GDF-15和CRP在区分COPD急性恶化期和稳定期的诊断效能。结果 COPD稳定期患者血浆中GDF-15浓度较对照组显著增加,COPD急性恶化期较稳定期GDF-15浓度显著增加。COPD稳定期患者中,GDF-15和CRP浓度呈正相关(r=0.776,P<0.001),COPD急性恶化期,GDF-15和CRP浓度呈正相关(r=0.877,P<0.001)。GDF-15对COPD急性恶化期诊断AUC为0.783(95%CI:0.666~0.900,P<0.001),诊断准确率为69%。CRP对COPD急性恶化期诊断AUC为0.686(95%CI:0.549~0.823,P<0.01),诊断准确率为59%。结论 COPD患者血浆中GDF-15浓度较健康的对照人群显著增加,在稳定期和急性恶化期COPD患者中,血浆中GDF-15和CRP均具有高度的相关性,GDF-15在诊断COPD患者稳定期和急性恶化期的准确率较CRP更高。Objective To investigate the level of plasma GDF-15 in patients with COPD and its clinical value in the diagnosis of COPD in the stable stage and in acute exacerbation stage.Methods From 2015 to 2016,58 cases of patients with COPD were enrolled,including COPD patients in the stable stage and in acute exacerbation stage.29 cases of COPD patients diagnosed in our hospital were enrolled in the experimental group,and 29 cases of age-,gender and body mass index-matched healthy people were enrolled in the control group.Compared and analyzed the blood cell count,determination of plasma GDF-15 and C-reactive protein were performed and analyzed.Spearman correlation analysis was conducted to compare levels of GDF-15 and C-reactive protein between patients with the stable stage of COPD and those with acute exacerbation stage of COPD.The diagnostic efficacy was compared between GDF-15 and C-reactive protein in differentiatingthe COPD in acute exacerbation period and in the stable period.Results Level of GDF-15 in the stable COPD patients was significantly increased compared with that in the control group.The plasma GDF-15 level was significantly increased in acute exacerbation COPD patients compared to patient with the stable COPD(P<0.001).For the stable COPD patients,GDF-15 level and C-reactive protein level was positively correlated(r=0.776,P<0.001).In acute exacerbation COPD patients,GDF-15 level and C-reactive protein level was positively correlated(r=0.877,P<0.001).The ROC curves showed that the GDF-15 level on the diagnosis of acute exacerbation COPD patients with an AUC was 0.783(95% CI,0.666~0.900,P<0.001)and with the diagnostic accuracy was 69%.C-reactive protein in the acute exacerbation of AUC diagnosis of COPD was 0.686(95% CI:0.549~0.823,P<0.01)and the diagnostic accuracy rate was 59%.Conclusion The plasma level of GDF-15 was significantly increased in COPD patients compared with people in the healthy control group.Plasma GDF-15 and C-reactive protein were highly correlated in the stable stage of COPD patients a

关 键 词：分化生长因子-15 C-反应蛋白 急性恶化期 COPD 临床诊断 

分 类 号：R563.9[医药卫生—呼吸系统]