特发性间质性肺炎急性加重期患者血清decorin、SDC-4水平测定的意义  

Significance of serum decorin and SDC-4 levels in patients with acute exacerbation stage idiopathic interstitial pneumonia

作　　者：宋然[1] 王利娴[2] 郭瑞霞[1] 王晓君[1] 刘健[3] SONG Ran;WANG Lixian;GUO Ruixia;WANG Xiaojun;LIU Jian(Department of Respiratory and Critical Medical Second Ward,Handan First Hospital of Hebei Province,Handan,Hebei 056000,China;Department of Clinical Laboratory,Handan First Hospital of Hebei Province,Handan,Hebei 056000,China;Department of Cardiac Surgery,Handan Central Hospital of Hebei Province,Handan,Hebei 056008,China)

机构地区：[1]河北省邯郸市第一医院呼吸与危重症医学科二病区,河北邯郸056000 [2]河北省邯郸市第一医院检验科,河北邯郸056000 [3]河北省邯郸市中心医院心外科,河北邯郸056008

出　　处：《国际检验医学杂志》2021年第23期2876-2880,共5页International Journal of Laboratory Medicine

基　　金：河北省2020年度医学科学研究课题计划(20200474)。

摘　　要：目的探讨特发性间质性肺炎(IIP)急性加重期患者血清核心蛋白多糖(decorin)、多配体蛋白聚糖-4(SDC-4)水平与预后的关系及其预测价值。方法收集2016年2月至2019年11月该院收治的124例IIP急性加重期患者作为观察组,另选择同期该院收治的124例IIP临床稳定期患者作为对照组,比较两组患者血清decorin、SDC-4水平,根据观察组患者预后情况将其分为存活组(69例)和死亡组(55例),比较存活组和死亡组的临床资料及血清decorin、SDC-4水平,分析IIP急性加重期患者预后的影响因素,采用受试者工作特征曲线评估血清decorin、SDC-4对IIP急性加重期患者预后的预测价值。结果与对照组比较,观察组患者血清decorin水平明显升高,SDC-4水平明显下降,差异均有统计学意义(P<0.05)。与存活组比较,死亡组患者血清decorin水平明显升高,SDC-4水平明显下降,第1秒用力呼气容积(FEV1)和最大自主分钟通气量(MVV)均明显下降,差异均有统计学意义(P<0.05)。血清decorin水平≥12.70μmol/L是IIP急性加重期患者预后的危险因素(OR=1.696,P<0.05);SDC-4水平≥10.70μmol/L、FEV1≥38.57%和MVV≥59.19 L是IIP急性加重期患者预后的保护因素(OR=0.739、0.529、0.492,P<0.05)。血清decorin联合SDC-4检测诊断IIP急性加重期患者预后的曲线下面积为0.852,灵敏度、特异度分别为87.23%、86.71%,明显高于血清decorin、SDC-4单独检测。结论IIP急性加重期患者血清decorin水平升高及SDC-4水平下降与IIP急性加重期患者不良预后相关,二者联合检测可作为临床辅助评估IIP急性加重期患者预后的有效指标。Objective To explore the relationship between serum core protein polysaccharide(decorin)and polyligand proteoglycan-4(SDC-4)levels in patients with idiopathic interstitial pneumonia(IIP)in the acute exacerbation stage and prognosis,and its predictive value.Methods A total of 124 patients with acute exacerbation stage IIP admitted to the hospital from February 2016 to November 2019 were collected as the observation group,and 124 patients with clinically stable stage IIP admitted to the hospital during the same period were selected as the control group.The serum decorin and SDC-4 levels of the two groups of patients were compared.According to the prognosis of the observation group,they were divided into the survival group(69 cases)and the death group(55 cases).Compared the clinical data,serum decorin and SDC-4 levels of survival group and death group.The factors affecting the prognosis of patients with acute exacerbation stage IIP were analyzed,and the receiver operating characteristic curve was used to evaluate the predictive value of serum decorin and SDC-4 on the prognosis of patients with acute exacerbation stage IIP.Results Compared with control group,the serum decorin level in observation group was significantly increased,and the SDC-4 level was significantly decreased,and the difference was statistically significant(P<0.05).Compared with survival group,the serum decorin level of the patients in death group was significantly increased,the SDC-4 level was significantly decreased,and the forced expiratory volume in the first second(FEV1)and the maximum voluntary minute ventilation(MVV)were significantly decreased,and the differences were statistically significant(P<0.05).Serum decorin level≥12.70μmol/L was a risk factor for the prognosis of patients with acute exacerbation stage IIP(OR=1.696,P<0.05);SDC-4 level≥10.70μmol/L,FEV1≥38.57%and MVV≥59.19 L were protective factors for the prognosis of patients with exacerbation stage IIP(OR=0.739,0.529,0.492,P<0.05).The area under the curve for the detection

关 键 词：核心蛋白多糖 多配体蛋白聚糖-4 特发性间质性肺炎 急性加重期 预后 

分 类 号：R563.13[医药卫生—呼吸系统] R446.1[医药卫生—内科学]