急性加重期特发性间质性肺炎患者血清CD59、Gremlin-1表达及与近期预后的相关性  

The expression of serum CD59 and Gremlin-1 in patients with acute exacerbation of idiopathic interstitial pneumonia and their correlation with recent prognosis

作　　者：符艳 金朝晖[1] 王伟[1] 闵锐 肖雪飞 Fu Yan;Jin Chaohui;Wang Wei;Min Rui;Xiao Xuefei(Department of Respiratory Medicine,The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan,410000,China)

机构地区：[1]湖南中医药大学第一附属医院呼吸内科,长沙410000

出　　处：《疑难病杂志》2023年第12期1262-1267,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：湖南省自然科学基金资助项目(2019JJ50425)。

摘　　要：目的研究急性加重期特发性间质性肺炎(IIP)患者血清CD59、Gremlin-1水平及其与近期预后的相关性。方法选取2020年3月—2022年2月湖南中医药大学第一附属医院呼吸内科诊治的急性加重期IIP患者90例为研究对象(急性加重期组),以同期诊治的稳定期IIP患者60例为稳定期组,以同期体检的健康者60例为健康对照组。根据急性加重期IIP患者随访3个月生存情况,分为生存亚组(n=59)和死亡亚组(n=31)。酶联免疫吸附实验检测血清CD59、Gremlin-1水平。Pearson相关分析急性加重期IIP患者血清CD59、Gremlin-1与临床指标的相关性。多因素Logistic回归分析影响急性加重期IIP患者死亡预后的因素。受试者工作特征曲线分析血清CD59、Gremlin-1对急性加重期IIP患者死亡预后的预测价值。结果急性加重期组血清CD59、Gremlin-1高于稳定期组和健康对照组(t=30.916、47.431,34.379、54.420,P均<0.001)。死亡亚组患者ESR、HRCT评分,血清CD59、Gremlin-1明显高于生存亚组(t/P=2.580/0.012、4.546/<0.001、26.388/<0.001、20.842/<0.001)。急性加重期IIP患者血清CD59、Gremlin-1水平与ESR、HRCT评分呈正相关(r=0.621、0.736、0.705、0.689,P均<0.001)。HRCT评分、CD59、Gremlin-1是高影响急性加重期IIP患者死亡预后的危险因素[OR(95%CI)=1.589(1.258~2.006),1.593(1.252~2.028),1.733(1.249~2.404)]。HRCT评分,血清CD59、Gremlin-1及联合检测评估急性加重期IIP患者预后的AUC分别为0.807、0.779、0.752、0.867,以联合检测的AUC最大(Z=5.183、4.349、5.127,P均<0.001)。结论急性加重期IIP患者血清CD59、Gremlin-1水平升高,是影响急性加重期IIP患者死亡预后的影响因素,HRCT评分、血清CD59、Gremlin-1联合检测对急性加重期IIP患者死亡预后具有较高的评估价值。Objective To study the serum levels of CD59 and Gremlin-1 in patients with acute exacerbation of idiopathic interstitial pneumonia(IIP)and their correlation with recent prognosis.Method Ninety patients with acute exacerbation stage IIP diagnosed and treated in the Respiratory Department of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from March 2020 to February 2022 were selected as the research subjects(acute exacerbation stage group).60 stable stage IIP patients diagnosed and treated at the same time were selected as the stable stage group,and 60 healthy individuals examined at the same time were selected as the healthy control group.According to the 3-month follow-up survival status of patients with acute exacerbation stage IIP,they were divided into survival subgroup(n=59)and death subgroup(n=31).Enzyme linked immunosorbent assay was used to detect serum levels of CD59 and Gremlin-1.Pearson correlation analysis of the correlation between serum CD59,Gremlin-1 and clinical indicators in patients with acute exacerbation of IIP.Multivariate logistic regression analysis of factors affecting the prognosis of death in patients with acute exacerbation of IIP.The predictive value of serum CD59 and Gremlin-1 in predicting the prognosis of death in patients with acute exacerbation of IIP by analyzing the working characteristic curve of subjects.Results The levels of serum CD59 and Gremlin-1 in the acute exacerbation group were higher than those in the stable stage group and the healthy control group(t=30.916,47.431,34.379,54.420,P<0.001).The ESR and HRCT scores,serum CD59 and Gremlin-1 levels in the death subgroup were significantly higher than those in the survival subgroup(t/P=2.580/0.012、4.546/<0.001、26.388/<0.001、20.842/<0.001).The levels of serum CD59 and Gremlin-1 in patients with acute exacerbation of IIP were positively correlated with ESR and HRCT scores(r=0.621,0.736,0.705,0.689,all P<0.001).HRCT score,CD59,and Gremlin-1 are high risk factors for mortality prognosis i

关 键 词：特发性间质性肺炎 急性加重期 CD59 Gremlin-1 预后 

分 类 号：R563.13[医药卫生—呼吸系统]