sTREM-1联合CC16对老年AECOPD患者预后不良的预测效能  

Prognostic Value of sTREM-1 Combined with CC16 in Elderly Patients with Chronic Obstructive Pulmonary Disease

作　　者：魏丹 陈娟 WEI Dan;CHEN Juan(Department of Respiratory No.215 Hospital of Shaanxi nuclear industry,Xianyang Shaanxi 712000)

机构地区：[1]陕西省核工业二一五医院呼吸科,陕西咸阳712000

出　　处：《医学临床研究》2021年第10期1504-1507,1511,共5页Journal of Clinical Research

摘　　要：【目的】探讨可溶性髓系细胞触发受体-1(sTREM-1)联合Clara细胞分泌蛋白(CC16)对老年慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)患者预后不良的预测效能。【方法】选取2019年2月至2020年3月在本院诊治的206例COPD患者,其中AECOPD患者108例(A组),稳定期COPD患者98例(B组),另外选择同一时间段在本院进行体检的95例健康志愿者(C组)。对比三组血清sTREM-1、CC16水平;统计AECOPD患者预后不良发生情况,并依据预后情况分为预后不良组和预后良好组;对比预后不良组和预后良好组临床资料;Logistic回归分析AECOPD患者预后的影响因素;制作受试者工作特征曲(ROC),分析sTREM-1联合CC16对老年AECOPD患者预后不良的预测效能。【结果】A组、B组sTREM-1水平均明显高于C组(P<0.05),CC16水平均明显低于C组(P<0.05);A组sTREM-1水平明显高于B组(P<0.05),CC16水平明显低于B组(P<0.05)。AECOPD患者中预后不良发生率为25.93%(28/108);预后不良组机械通气时间、降钙素原(PCT)、C反应蛋白(CRP)、sTREM-l水平显著高于预后良好组(P<0.05),预后不良组肺活量(FVC)、第一秒用力呼气容积(FEV1)、CC16水平则显著低于预后良好组(P<0.05)。Logistic回归显示CRP、sTREM-1、CC16均为AECOPD患者预后不良的影响因素(P<0.05);ROC分析显示,sTREM-l、CC16水平预测老年AECOPD患者预后不良的最佳截断点分别为161.25 ng/L、65.83μg/L。sTEEM-1、CC16两者联合的特异度为96.25%,显著高于血清sTEEM-1、CC16水平单独进行评估的特异度,且sTREM-1、CC16两者联合预测老年AECOPD患者预后不良的曲线下面积(AUC)为0.923,高于血清sTREM-l、CC16水平单独预测的AUC(P<0.05)。【结论】STREM-1联合CC16预测老年AECOPD患者预后不良的预测效能较高,可用于对老年AECOPD患者预后不良的预测。【Objective】To investigate the predictive effect of soluble myeloid cell trigger receptor-1(sTREM-1)combined with Clara cell secretory protein(CC16)on poor prognosis in elderly patients with a-cute exacerbation of chronic obstructive pulmonary disease(COPD).【Methods】A total of 206 patients with COPD treated in our hospital from February 2019 to March 2020 was selected,including 108 patients with a-cute exacerbation of COPD(AECOPD)(group A)and 98 patients with stable COPD(group B).In addition,95 healthy volunteers(Group C)who underwent physical examination in our hospital at the same time were selected.The levels of serum sTREM-1 and CC16 in the three groups were compared;The incidence of poor prognosis in AECOPD patients was counted and divided into poor prognosis group and good prognosis group according to the prognosis;The clinical data of poor prognosis group and good prognosis group were compared;Logistic regression analysis was used to analyze the prognostic factors of AECOPD patients;The receiver operating characteristic curve(ROC)was made to analyze the predictive efficacy of sTREM-1 combined with CC16 in the poor prognosis of elderly AECOPD patients.【Results】The level of sTREM-1 in the group A and the group B was significantly higher than that in then group (P<0.05),and the level of CC16 was significantly lower than that in the group (P<0.05);The level of sTREM-1 in the group A was significantly higher than that in the group B(P<0.05),and the level of CC16 was significantly lower than that in the group B(P<0.05);The incidence of poor prognosis in AECOPD patients was 25.93%(28/108);The mechanical ventilation time,procalcitonin(PCT),C-reactive protein(CRP)and sTREM-1 levels in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05),while the vital capacity(FVC),forced expiratory volume in the first second(FEV1)and CC16 levels in the poor prognosis group were significantly lower than those in the good prognosis group(P<0.05);Logistic regression showed that

关 键 词：肺疾病 慢性阻塞性 急性病 膜糖蛋白类/血液 子宫珠蛋白/血液 预后 老年人 

分 类 号：R563[医药卫生—呼吸系统]