热休克蛋白27对慢性阻塞性肺疾病急性加重住院患者预后的预测作用  

Prediction of heat shock protein 27 on prognosis of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：王立芹[1] 李书阅[1] 蒋云书 董亮亮[1] Wang Liqin;Li Shuyue;Jiang Yunshu;Dong Liangliang(Department of Respiratory Medicine,Liaocheng Second People′s Hospital,Liaocheng 252600,China)

机构地区：[1]聊城市第二人民医院呼吸内科,252600

出　　处：《国际呼吸杂志》2020年第20期1556-1561,共6页International Journal of Respiration

摘　　要：目的探究热休克蛋白27对慢性阻塞性肺疾病急性加重(AECOPD)住院患者预后的预测作用。方法以2014年6月至2016年11月在聊城市第二人民医院接受治疗的AECOPD患者246例为研究对象进行回顾性分析。根据入院时热休克蛋白27(HSP27)浓度分为2组,其中HSP27≥3098 ng/L组68例,HSP27<3098 ng/L组178例。采用酶联免疫吸附法检测血浆心肌肌钙蛋白T(高敏)(cTnT)和N末端脑钠肽前体(NT-proBNP)及HSP27浓度。所有患者出院后随访3年,观察的终点是全因死亡率。生存分析采用Kaplan-Meier曲线法和Cox回归模型。结果HSP27≥3098 ng/L AECOPD患者CPR、cTnT、NT-proBNP水平显著升高(P<0.05)。与HSP27<3098 ng/L AECOPD患者比较,HSP27≥3098 ng/L AECOPD患者入院时和出院时HSP27水平显著升高(P<0.05)。与入院时比较,HSP27≥3098 ng/L AECOPD患者出院时和出院后180 d HSP27水平显著降低(P<0.05)。Kaplan-Meier生存曲线结果示,HSP27≥3098 ng/L AECOPD患者死亡风险显著升高(P<0.05),中位生存时间为836 d。多变量Cox比例风险分析示,HSP27与AECOPD患者90 d、180 d、1年全因死亡率风险增加显著相关(P<0.05),与AECOPD患者3年全因死亡率风险增加无显著相关性(P>0.05)。结论血清HSP27浓度可能预测COPD急性加重后短期生存率,但不能作为3年长期全因死亡率的独立预测因子。Objective To investigate the predictive effect of heat shock protein 27(HSP27)on the prognosis of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 246 patients with AECOPD who were treated in Liaocheng Second People′s Hospital from June 2014 to November 2016 were taken as the study subjects.According to the HSP27 concentration at the time of admission,the patients were divided into two groups,including 68 patients in the HSP27≥3098 ng/L group and 178 patients in the HSP27<3098 ng/L group.Plasma myocardial troponin T(high sensitivity)(cTnT)and N-terminal brain natriuretic peptide precursor(NT-proBNP)and HSP27 were detected by enzyme-linked immunosorbent assay.All patients were followed up for 3 years after discharge.The end point of observation was all-cause mortality.Survival analysis was performed using Kaplan-Meier curve method and Cox regression model.Results The levels of CPR,cTnT and NT-proBNP in AECOPD patients with HSP27≥3098 ng/L were significantly increased(P<0.05).Compared with patients with HSP27<3098 ng/L AECOPD,patients with HSP27≥3098 ng/L AECOPD had significantly increased HSP27 levels at admission and discharge(P<0.05).Compared with the time of admission,patients with HSP27≥3098 ng/L AECOPD had significantly lower levels of HSP27 at discharge and 180 days after discharge(P<0.05).Kaplan-Meier survival curve results showed that patients with HSP27≥3098 ng/L AECOPD had a significantly increased risk of death(P<0.05),and the median survival time was 836 days.Multivariate Cox proportional hazard analysis showed that HSP27 was significantly associated with an increase in all-cause mortality risk in patients with AECOPD at 90 days,180 days,and 1 year(P<0.05),and was not significantly associated with an increased 3-year all-cause mortality risk in AECOPD patients(P>0.05).Conclusions Serum HSP27 concentration may predict short-term survival rate after exacerbation of COPD,but it cannot be used as an independent predictor of long-t

关 键 词：肺疾病 慢性阻塞性 热休克蛋白27 急性加重 生物标志物 

分 类 号：R563.9[医药卫生—呼吸系统]