血清DcR3对COPD急性加重期患者预后评估的应用价值  

The value of serum DcR3 in prognosis assessment of COPD patients in acute exacerbation stage

作　　者：刘雯 费维伦 梁春阳 杜斌斌 LIU Wen;FEI Weilun;LIANG Chunyang;DU Binbin(Clinical Laboratory,Feidong County People's Hospital,Hefei Anhui 230001,China)

机构地区：[1]肥东县人民医院检验科,安徽合肥230001

出　　处：《中国急救复苏与灾害医学杂志》2022年第2期225-229,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：安徽省自然科学基金青年项目(编号:1608085QH210)。

摘　　要：目的检测慢性阻塞性肺疾病(COPD)急性加重期患者血清诱导受体3(DcR3)水平,并探讨其对患者预后评估的应用价值。方法选取2018年2月—2020年2月肥东县人民医院收治的COPD患者163例,其中急性加重期患者83例,缓解期患者80例。根据COPD急性加重期患者预后情况分为存活组(n=68)和死亡组(n=15)。采用酶联免疫吸附法(ELISA)测定受试者血清DcR3、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平;采用血气分析仪检测COPD患者动脉二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2));采用肺功能测定仪检测第1秒用力呼吸容积占预计值百分比(FEV1%pred)、第1秒用力呼吸容积占用力肺活量比值(FEV1/FVC);采用Pear⁃son法分析COPD急性加重期患者血清DcR3水平与IL-8、TNF-α以及PaCO_(2)、PaO_(2)的关系;应用COX回归分析影响COPD急性加重期患者不良预后的危险因素;采用受试者工作特征(ROC)曲线评价血清DcR3水平对COPD急性加重期患者预后不良的诊断价值。结果与COPD缓解期组比较,COPD急性加重期组患者血清DcR3、IL-8、TNF-α水平显著升高(P<0.05);COPD急性加重期患者中,死亡组患者血清DcR3、IL-8、TNF-α水平明显高于存活组患者(P<0.05)。Pearson法分析显示,COPD急性加重期患者血清DcR3水平与IL-8、TNF-α、PaCO_(2)水平均呈正相关(P<0.05),与PaO_(2)呈负相关(P<0.05)。COX分析显示,血清DcR3、IL-8、TNF-α水平高是COPD急性加重期组患者不良预后的独立危险因素(P<0.05);ROC曲线分析结果显示,血清DcR3水平预测COPD急性加重期患者死亡的曲线下面积为0.885。结论COPD急性加重期患者血清DcR3水平异常高表达,是COPD急性加重期患者预后不良的危险因素,对COPD急性加重期患者预后不良有一定诊断价值。Objective To investigate the value of serum decoy receptor 3(DcR3)in assessment of prognosis for patients with chronic obstructive pulmoriary disease(COPD)in acute exacerbation.Methods 63 patients with COPD treated in our hospital from February 2018 to February 2020 were selected,including 83 patients in acute exacerbation stage and 80 patients in remission stage.According to the prognosis of patients with acute exacerbation of COPD,they were divided into survival group(n=68)and death group(n=15).The levels of serum DcR3,interleukin-8(IL-8)and tumor necrosis factorα(TNF-α)were measured by enzyme-linked immunosorbent assay(ELISA);Blood gas analyzer was used to detect the arterial carbon dioxide partial pressure(PaCO_(2))and arterial blood oxygen partial pressure(PaO_(2)),and lung function tester was used to detect the percentage of the forced breathing volume in the first second(FEV1%pred)and the forced breathing in the first second volume occupancy vital capacity ratio(FEV1/FVC).Pearson method was used to analyze the relationship of serum DcR3 level with the levels of IL-8,TNF-α,PaCO_(2),and PaO_(2).COX regression analysis was used to analyze the risk factors of adverse prognosis.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of serum DcR3 level for poor prognosis.Results The levels of serum DcR3,IL-8 and TNF-αin the acute exacerbation group were significantly higher than those in the remission group(P<0.05);in patients with acute exacerbation of COPD,the levels of DcR3,IL-8 and TNF-αin the death group were significantly higher than those in the survival group(P<0.05).Pearson analysis showed that serum DcR3 level was positively correlated with IL 8,TNF-α,PaCO_(2) levels(P<0.05),and negatively correlated with PaO_(2) level(P<0.05).COX analysis showed that high levels of serum DcR3,IL-8 and TNF-αwere independent risk factors for poor prognosis in patients with acute exacerbation of COPD(P<0.05),ROC curve analysis showed that the area under curve of serum DcR3 level in p

关 键 词：慢阻肺急性加重期 慢阻肺缓解期 血清诱导受体3 预后 

分 类 号：R563[医药卫生—呼吸系统]