血清25-(OH)D_(3)、LTB4、FKN联合检测对慢阻肺急性加重期患者预后的临床价值研究  

Clinical value of combined detection of serum 25-(OH)D_(3),LTB4 and FKN in prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：徐蕾 王海霞 XU Lei;WANG Haixia(Department of Pulmonary and Critical Care Medicine,Suzhou Science&Technology Town Hospital,Suzhou,Jiangsu 215000,China)

机构地区：[1]苏州科技城医院呼吸与危重症医学科,江苏苏州215000

出　　处：《临床肺科杂志》2023年第10期1531-1535,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨血清25羟基维生素D_(3)[25-(OH)D_(3)]、白三烯B4(LTB4)、不规则趋化因子(FKN)联合检测对慢性阻塞性肺疾病急性加重期(AECOPD)患者预后的预测价值。方法选取2019年1月至2022年1月本院收治的AECOPD患者106例,根据患者预后情况分为预后不良组38例和预后良好组68例。治疗前对AECOPD患者进行血气分析;酶联免疫吸附法(ELISA)测定血清LTB4、FKN水平,电化学发光免疫分析仪测定血清25-(OH)D_(3)水平。Logistic回归分析AECOPD患者预后不良的影响因素。采用受试者工作特征(ROC)曲线分析25-(OH)D_(3)、LTB4、FKN联合检测对AECOPD患者预后不良的预测价值。结果与预后良好组相比,预后不良组血氧分压(PaO_(2))较低(P<0.001),血清中25-(OH)D_(3)水平较低(P<0.001),二氧化碳分压(PaCO_(2))较高(P<0.001),血清中LTB4、FKN水平较高(P<0.001)。经Logistic回归分析显示,LTB4、FKN水平是AECOPD患者预后不良的危险因素(P<0.05),25-(OH)D_(3)是AECOPD患者预后不良的保护因素(P<0.05)。ROC曲线结果显示,25-(OH)D_(3)、LTB4、FKN水平预测AECOPD患者预后不良的曲线下面积(AUC)分别为0.915、0.881、0.845,敏感度分别为89.50%、92.10%、92.10%,特异度分别为77.90%、75.00%、70.60%;25-(OH)D_(3)、LTB4、FKN联合预测AECOPD患者预后不良的AUC为0.965,敏感度为84.20%,特异度为94.10%。结论预后不良的AECOPD患者血清25-(OH)D_(3)水平明显降低,血清LTB4、FKN水平明显升高,25-(OH)D_(3)、LTB4、FKN对评价AECOPD患者临床预后有重要指导价值。Objective investigate the prognostic value of combined detection of serum 25 hydroxyvitamin D_(3)[25-(OH)D_(3)],leukotriene B4(LTB4)and fractalkin(FKN)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 106 AECOPD patients admitted to our hospital from January 2019 to January 2022 were selected.According to the prognosis,they were divided into the poor prognosis group(38 cases)and the good prognosis group(68 cases).Blood gas analysis was performed for AECOPD patients before treatment.Their serum LTB4 and FKN levels were measured by enzyme-linked immunosorbent assay(ELISA),and serum 25-(OH)D_(3)level was measured by electrochemiluminescence immunoassay.Logistic regression analysis was used to analyze the influencing factors of poor prognosis in AECOPD patients.The predictive value of combined detection of 25-(OH)D_(3),LTB4 and FKN for poor prognosis of AECOPD patients was analyzed by ROC curve.Results Compared with the good prognosis group,the poor prognosis group had lower PaO_(2)(P<0.001),lower serum 25-(OH)D_(3)(P<0.001),higher PaCO_(2)(P<0.001),and higher serum LTB4 and FKN(P<0.001).Logistic regression analysis showed that LTB4 and FKN levels were risk factors for poor prognosis of AECOPD patients(P<0.05),and 25-(OH)D_(3)was a protective factor for poor prognosis of AECOPD patients(P<0.05).ROC curve results showed that the area under the curve(AUC)of 25-(OH)D_(3),LTB4 and FKN levels in predicting poor prognosis of AECOPD patients was 0.915,0.881 and 0.845,respectively,the sensitivity was 89.50%,92.10%and 92.10%respectively,and the specificity was 77.90%,75.00%and 70.60%respectively.The AUC of the combination of 25-(OH)D_(3),LTB4 and FKN in predicting poor prognosis of AECOPD patients was 0.965,with sensitivity of 84.20%and specificity of 94.10%.Conclusion The serum 25-(OH)D_(3)level in AECOPD patients with poor prognosis is obviously reduced,the serum LTB4 and FKN levels are obviously increased,25-(OH)D_(3),LTB4,and FKN have important guiding value in evaluat

关 键 词：慢性阻塞性肺疾病急性加重期 不规则趋化因子 白三烯B4 25羟基维生素D_(3) 预后 

分 类 号：R563.9[医药卫生—呼吸系统]