血清CXCL9和SFRP1在AECOPD合并肺栓塞患者中的表达及对预后的影响  

Expression of serum levels of CXCL9 and SFRP1 in patients with AECOPD complicated with pulmonary embolism and their influence on prognosis

作　　者：苏振磊[1] 杨万春 韩天龙 SU Zhenlei;YANG Wanchun;HAN Tianlong(Department of Emergency,Red Star Hospital of the 13th Division of Xinjiang Production and Construction Corps,Hami 839000,China)

机构地区：[1]新疆生产建设兵团第十三师红星医院急诊科,839000

出　　处：《天津医药》2023年第4期427-431,共5页Tianjin Medical Journal

摘　　要：目的 探讨血清CXC趋化因子配体9(CXCL9)和分泌型卷曲相关蛋白1(SFRP1)在慢性阻塞性肺疾病急性加重期(AECOPD)合并肺栓塞(PE)患者中的表达水平及其对预后的预测价值。方法 56例AECOPD合并PE患者为病例组,并收集同期的80例单纯AECOPD患者为对照组。采用酶联免疫吸附试验检测各组血清CXCL9、SFRP1水平。采用Logistic回归模型分析AECOPD发生PE的影响因素,绘制受试者工作特征(ROC)曲线评估血清CXCL9、SFRP1对AECOPD患者PE的预测价值,采用COX比例风险回归模型分析血清CXCL9、SFRP1对不良预后的影响。结果 与对照组比较,病例组AECOPD病程较长,血清CXCL9、SFRP1水平升高(P<0.05)。较长AECOPD病程(OR=1.420,95%CI:1.246~1.620)和较高CXCL9(OR=1.835,95%CI:1.502~2.241)、SFRP1(OR=1.608,95%CI:1.351~1.914)水平是AECOPD患者发生PE的独立危险因素。血清CXCL9、SFRP1均可预测AECOPD患者PE发生风险,指标联合预测价值更大。血清CXCL9、SFRP1与PESI分级呈正相关(rs分别为0.752和0.716,P<0.05)。较高水平的血清CXCL9(HR=1.374,95%CI:1.184~1.595)以及SFRP1(HR=1.186,95%CI:1.329~1.542)是PE患者死亡的独立危险因素。结论 血清CXCL9、SFRP1异常升高是AECOPD患者发生PE的危险因素,并且与PE病情严重程度以及预后密切相关。Objective To explore expression levels of serum C-X-C chemokine ligand 9(CXCL9)and secretory frizzled-associated protein 1(SFRP1)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with pulmonary embolism(PE)and their prognostic value.Methods Fifty-six AECOPD patients with PE were collected as the case group,and 80 patients with AECOPD in the same period were selected as the control group.The serum CXCL9 and SFRP1 levels were detected by enzyme-linked immunosorbent assay.Logistic regression curve was drawn to evaluate the predictive value of serum CXCL9 and SFRP1 on PE in AECOPD patients. COX proportionalrisk regression model was used to analyze the influencing factors of serum CXCL9 and SFRP1 on poor prognosis. ResultsThe course of AECOPD was longer in the case group than that in the control group, and the serum CXCL9 and SFRP1 levelswere higher than those in the control group (P<0.05). Long AECOPD course (OR=1.420,95%CI:1.246-1.620), higherCXCL9 (OR=1.835,95%CI:1.502-2.241) and SFRP1 (OR=1.608,95%CI:1.351-1.914) were independent risk factors forPE in AECOPD patients. Serum levels of CXCL9 and SFRP1 can predict the risk of PE in AECOPD patients, and thepredictive value of combination of two indicators was more better. Serum CXCL9 and SFRP1 levels were positivelyassociated with PESI grade (rs=0.752, 0.716;P<0.05). Higher serum levels of CXCL9 (HR=1.374, 95%CI:1.184-1.595) andSFRP1 (HR=1.186,95%CI:1.329-1.542) were independent risk factors for death in AECOPD patients with PE.Conclusion The abnormal increased serum levels of CXCL9 and SFRP1 are risk factors for PE in AECOPD patients,which is closely related to the severity and prognosis of PE.

关 键 词：肺疾病 慢性阻塞性 急性病 肺栓塞 CXC趋化因子配体9 分泌型卷曲相关蛋白1 

分 类 号：R563.5[医药卫生—呼吸系统]