慢性阻塞性肺疾病患者急性加重影响因素及血清分泌型卷曲相关蛋白1和Clara细胞分泌蛋白对其预测价值  

Influencing factors of AECOPD and predictive value of serum SFRP1 and CC16 for AECOPD

作　　者：周旭东 吴吉星 夏杰[2] ZHOU Xudong;WU Jixing;XIA Jie(Department of General Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院普外科,湖北武汉430030 [2]华中科技大学同济医学院附属同济医院呼吸与危重症医学科,湖北武汉430030

出　　处：《陕西医学杂志》2023年第9期1168-1171,1176,共5页Shaanxi Medical Journal

基　　金：国家自然科学基金资助项目(81700042)。

摘　　要：目的:探讨慢性阻塞性肺疾病(COPD)患者急性加重的影响因素,以及血清分泌型卷曲相关蛋白1(SFRP1)和Clara细胞分泌蛋白(CC16)对急性加重慢性阻塞性肺疾病(AECOPD)的预测价值。方法:选取COPD患者198例为研究对象,根据出院后3个月复诊是否发生AECOPD分为稳定期COPD组(102例)和AECOPD组(96例)。比较两组患者性别、年龄、体重指数(BMI)、是否吸烟、既往病史(糖尿病、高血压、肺心病和冠心病等)、病程等一般资料。比较两组患者C反应蛋白(CRP)、白细胞(WBC)、中性粒细胞(NEU)、淋巴细胞(LYM)、血小板(PLT)、纤维蛋白原(FIB)、白蛋白(ALB)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、纤维蛋白原/白蛋白比值(FAR)、血清SFRP1和CC16水平。采用Logistic回归分析发生AECOPD的影响因素。采用受试者工作特征(ROC)曲线分析血清SFRP1和CC16对AECOPD发生的预测价值。结果:两组患者性别、年龄、BMI、是否吸烟、既往病史(高血压、糖尿病、肺心病和冠心病)以及病程比较差异无统计学意义(均P>0.05)。AECOPD组CRP、WBC、NEU、LYM、PLT、ALB、FIB、NLR、PLR、FAR、SFRP1和CC16水平高于稳定期COPD组(均P<0.05)。Logistic回归分析结果显示,NLR>3.53、PLR>120、FAR>3.5、SFRP1>4.8 ng/ml以及CC16>260 ng/ml是COPD患者发生AECOPD的独立危险因素(均P<0.05)。血清SFRP1和CC16对COPD患者发生AECOPD具有一定的预测价值,且两者联合的预测价值更高。结论:NLR、PLR、FAR、SFRP1及CC16是COPD患者发生AECOPD的独立影响因素。SFRP1联合CC16对COPD患者发生AECOPD的预测价值较高。Objective:To investigate the influencing factors of acute exacerbation of chronic obstructive pulmonary disease(COPD),and the predictive value of serum secreted frizzled-related protein 1(SFRP1)and Clara cell secretory protein(CC16)for acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 198 COPD patients were selected as the research objects.The group was divided into stable COPD group(102 cases)and AECOPD group(96 cases)according to whether AECOPD occurred at the follow-up visit 3 months after discharge.The general data of gender,age,BMI,smoking,past medical history(diabetes,hypertension,pulmonary heart disease,coronary heart disease,etc.),and course of disease were compared between the two groups.The levels of CRP,WBC,NEU,LYM,PLT,FIB,ALB,NLR,PLR,FAR and serum SFRP1 and CC16 levels were compared between the two groups.Logistic regression was used to analyze the influencing factors of AECOPD.ROC curve was used to analyze the predictive value of serum SFRP1 and CC16 for AECOPD.Results:There were no significant differences in gender,age,BMI,smoking,past medical history(hypertension,diabetes,pulmonary heart disease and coronary heart disease)and disease duration between the two groups(all P>0.05).The levels of CRP,WBC,NEU,LYM,PLT,ALB,FIB,NLR,PLR,FAR,SFRP1 and CC16 in the AECOPD group were higher than those in the stable COPD group(all P<0.05).Logistic regression analysis showed that NLR>3.53,PLR>120,FAR>3.5,SFRP1>4.8 ng/ml and CC16>260 ng/ml were independent risk factors for AECOPD in COPD patients(all P<0.05).Serum SFRP1 and CC16 had certain predictive value for the occurrence of AECOPD in COPD patients,and the predictive value of the combination of the two was higher.Conclusion:NLR,PLR,FAR,SFRP1 and CC16 are independent influencing factors for AECOPD in COPD patients.SFRP1 combined with CC16 has a high predictive value for AECOPD in COPD patients.

关 键 词：慢性阻塞性肺疾病 急性加重慢性阻塞性肺疾病 分泌型卷曲相关蛋白1 CLARA细胞分泌蛋白 预测价值 

分 类 号：R563.9[医药卫生—呼吸系统]