IL-37与慢性阻塞性肺疾病急性加重患者免疫功能及预后的关系研究  

Relationship between IL-37 and Immune Function and Prognosis in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

作　　者：黄清平 林芳崇 王日兴[1] 符超 HUANG Qingping;LIN Fangchong;WANG Rixing;FU Chao(Department of Emergency,the Second Affiliated Hospital of Hainan Medical University,Haikou 570311,China)

机构地区：[1]海南医学院第二附属医院急诊科,海南省海口市570311

出　　处：《实用心脑肺血管病杂志》2023年第7期22-26,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：海南省卫生计生行业科研项目(20A2000375)。

摘　　要：目的探讨IL-37与慢性阻塞性肺疾病急性加重(AECOPD)患者免疫功能及预后的关系。方法选取2020年10月至2022年6月于海南医学院第二附属医院住院的AECOPD患者204例,按出院时预后情况将患者分为好转组(n=163)和恶化组(n=41)。比较两组临床资料〔年龄、性别、BMI、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、第1秒用力呼气容积(FEV_(1))、FEV_(1)/用力肺活量(FVC)〕、IL-37与免疫功能指标。采用Pearson相关分析探讨AECOPD患者入院第1天IL-37与免疫功能指标的相关性。采用多因素Logistic回归分析探讨AECOPD患者预后的影响因素。绘制ROC曲线以评估入院第1天IL-37对AECOPD患者预后恶化的预测价值。结果好转组FEV_(1)、FEV_(1)/FVC高于恶化组(P<0.05)。恶化组入院第7天IL-37、CD_(8)^(+)T淋巴细胞百分比分别高于本组入院第1天,CD_(4)^(+)/CD_(8)^(+)T淋巴细胞比值低于本组入院第1天(P<0.05);好转组入院第7天IL-37、CD_(8)^(+)T淋巴细胞百分比分别低于本组入院第1天,CD_(4)^(+)/CD_(8)^(+)T淋巴细胞比值高于本组入院第1天(P<0.05);恶化组入院第1天和入院第7天IL-37、CD_(8)^(+)T淋巴细胞比值高于好转组,CD_(4)^(+)/CD_(8)^(+)T淋巴细胞比值低于好转组(P<0.05)。Pearson相关分析结果显示,AECOPD患者入院第1天IL-37与CD_(8)^(+)T淋巴细胞百分比呈正相关(r=0.782,P<0.001),与CD_(4)^(+)/CD_(8)^(+)T淋巴细胞比值呈负相关(r=-0.693,P=0.012)。多因素Logistic回归分析结果显示,IL-37、CD_(8)^(+)T淋巴细胞百分比、CD_(4)^(+)/CD_(8)^(+)T淋巴细胞比值是AECOPD患者预后恶化的独立影响因素(P<0.05)。ROC曲线分析结果显示,入院第1天IL-37预测AECOPD患者预后恶化的AUC为0.813〔95%CI(0.745,0.881)〕,最佳截断值为121.5 ng/L,灵敏度为84.3%,特异度为78.6%。结论AECOPD患者入院第1天IL-37与免疫功能相关,其是AECOPD患者预后恶化的影响因素,且对AECOPD患者预后恶化有一定预测价值。Objective To explore the relationship between IL-37 and immune function and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 204 patients with AECOPD admitted to the Second Affiliated Hospital of Hainan Medical University from October 2020 to June 2022 were selected.According to the prognosis at discharge,the patients were divided into the improvement group(n=163)and the deterioration group(n=41).Clinical data[age,sex,BMI,arterial partial oxygen pressure(PaO_(2)),arterial partial carbon dioxide pressure(PaCO_(2)),forced expiratory volume in one second(FEV_(1)),FEV_(1)/forced vital capacity(FVC)],IL-37 and immune function indexes were compared between the two groups.Pearson correlation analysis was used to investigate the correlation between IL-37 and immune function indexes in AECOPD patients on the 1st day of admission.Multivariate Logistic regression analysis was used to investigate the influencing factors of prognosis of patients with AECOPD.ROC curve was drawn to investigate the predictive value of IL-37 on the 1st day of admission for prognosis deterioration in patients with AECOPD.Results FEV_(1) and FEV_(1)/FVC in improvement group were higher than those in deterioration group(P<0.05).IL-37 and percentage of CD_(8)^(+)T lymphocytes in the worsening group on the 7th day of admission were higher than those on the 1st day of admission,while CD_(4)^(+)/CD_(8)^(+)T lymphocyte ratio was lower than that on the 1st day of admission(P<0.05).IL-37 and percentage of CD_(8)^(+)T lymphocytes in the improvement group on the 7th day of admission were lower than those on the 1st day of admission,while CD_(4)^(+)/CD_(8)^(+)T lymphocyte ratio was higher than that on the 1st day of admission(P<0.05).And the IL-37 and percentage of CD_(8)^(+)T lymphocytes in the worsening group on the first and seventh days of admission were higher than those in the improvement group,CD_(4)^(+)/CD_(8)^(+)T lymphocyte ratio was lower than that in the improvement group(P<0.05).Pea

关 键 词：肺疾病 慢性阻塞性 慢性阻塞性肺疾病急性加重 白介素37 免疫功能 预后 

分 类 号：R563.9[医药卫生—呼吸系统]