GDF-15对COPD患者严重程度评估及再次入院的诊断价值分析  

Analysis of the diagnostic value of GDF-15 in the severity assessment and readmission of COPD patients

作　　者：魏小婉 鲁美霞 楚荷莹[1] WEI Xiaowan;LU Meixia;CHU Heying(Department of Respiratory and Critical Care Medicine,First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学第一附属医院呼吸与危重症医学科一,河南郑州450052

出　　处：《检验医学与临床》2022年第17期2331-2335,共5页Laboratory Medicine and Clinic

基　　金：河南省高等学校重点科研项目(19A320065)。

摘　　要：目的探讨血清生长分化因子-15(GDF-15)水平在慢性阻塞性肺疾病(COPD)患者中的临床意义。方法选取2020年8-10月该院COPD急性加重期(AECOPD)患者28例为AECOPD组,稳定期COPD患者15例为稳定期COPD组和体检健康者26例为对照组。采用酶联免疫吸附试验检测GDF-15水平,并对AECOPD患者进行为期1年的随访。采用受试者工作特征(ROC)曲线评估GDF-15水平对AECOPD患者再次入院的诊断价值。结果与对照组比较,稳定期COPD组和AECOPD组患者GDF-15水平升高(P<0.05),且AECOPD组患者GDF-15水平高于稳定期COPD组(P<0.05)。COPD患者GDF-15水平与COPD评估测试问卷(CAT)评分、C-反应蛋白、降钙素原均呈正相关(P<0.05)。AECOPD患者GDF-15水平与住院时长呈正相关(P<0.05)。ROC曲线结果表明,GDF-15诊断AECOPD患者再次入院的最佳临界值为51.34 pg/mL,曲线下面积为0.718,灵敏度和特异度分别为69.23%、86.67%。再次入院患者GDF-15水平明显高于未再次入院者(P<0.05)。结论GDF-15水平与COPD的严重程度和全身炎症反应有关。此外,GDF-15对AECOPD患者再次入院具有一定的诊断价值。Objective To investigate the clinical significance of serum growth differentiation factor-15(GDF-15)levels in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 28 patients with acute exacerbation of COPD(AECOPD)in this hospital from August to October 2020 were selected as the AECOPD group,15 patients with stable COPD were selected as the stable COPD group,and 26 healthy subjects were selected as the control group.Enzyme linked immunosorbent assay was used to detect the level of GDF-15,and AECOPD patients were followed up for 1 year.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of GDF-15 level in patients with AECOPD who had acute exacerbation and readmission.Results Compared with the control group,the levels of GDF-15 in the stable COPD group and AECOPD group were increased(P<0.05),and the GDF-15 level in the AECOPD group was higher than that stable COPD group(P<0.05).The level of GDF-15 in COPD patients was positively correlated with COPD assessment test questionnaire(CAT)score,C-reactive protein,and procalcitonin(P<0.05).GDF-15 was positively correlated with the length of hospital stay in AECOPD patients(P<0.05).The ROC curve results showed that the optimal cut-off value of GDF-15 for the diagnosis of AECOPD patients readmission was 51.34 pg/mL,the area under the curve was 0.718,and the sensitivity and specificity were 69.23%and 86.67%,respectively.The level of GDF-15 in readmission patients was significantly higher than that in non-rehospitalized patients(P<0.05).Conclusion The level of GDF-15 is related to the severity of COPD and systemic inflammatory response.In addition,GDF-15 has certain diagnostic value for readmission of AECOPD patients.

关 键 词：生长分化因子-15 慢性阻塞性肺病 慢性阻塞性肺疾病急性加重期 再次入院 

分 类 号：R563.9[医药卫生—呼吸系统]