COPD急性加重期患者血清DcR3、TLR4、EOS的表达及预后相关分析  

Serum DcR3,TLR4,EOS expression and prognostic correlation analysis during acute exacerbations of COPD

作　　者：汪皙雯 梁佳美 吴雅萍 WANG Xiwen;LIANG Jiamei;WU Yaping(Chengdu Shuangliu District First People's Hospital,Chengdu Sichuan 610299,China)

机构地区：[1]成都市双流区第一人民医院,四川成都610299

出　　处：《中国急救复苏与灾害医学杂志》2023年第12期1598-1601,1623,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：2020年四川省卫生健康委员会科研课题(编号:20PJ042)。

摘　　要：目的探究慢性阻塞性肺疾病急性加重期(AECOPD)患者血清诱骗受体3(DcR3)、Toll样受体4(TLR4)及嗜酸性粒细胞(EOS)的表达水平,并分析以上指标与AECOPD预后的关系。方法选取成都市双流区第一人民医院2019年1月—2021年12月收治的97例AECOPD患者纳入观察组,另选取同期在本院接受治疗的40例稳定期COPD患者纳入稳定组,同期体检健康志愿者40例为对照组。对比三组研究对象的临床治疗和血清DcR3、TLR4、EOS说,并分析各项指标与AECOPD预后的关系。结果三组血清DcR3、TLR4、EOS水平相比,观察组>稳定组>对照组,组间差异有统计学意义(P<0.05)。在随访期间,AECOPD患者预后不良31例,其中8例死亡,23例再次入院。预后不良组患者的血清DcR3、TLR4、EOS水平明显高于预后良好组,组间差异具有统计学意义(P<0.05)。logistics回归模型显示,血清DcR3、TLR4、EOS均为AECOPD预后不良的显著影响因素(OR=0.790、0.963、0.437,P<0.05)。ROC模型显示:血清DcR3、TLR4、EOS对AECOPD预后不良的预测效能一般,而三项联合的预测性较高,联合预测的AUC、约登指数、灵敏度、特异度分别为0.931、0.723、93.50%、78.80%。结论AECOPD患者的血清DcR3、TLR4、EOS水平均存在异常表达,且三项指标均为AECOPD预后不良的影响因素,三项联合可以提高临床对AECOPD预后质量的预测效能。Objective To explore the expression levels of serum decoy receptor 3(DcR3),toll-like receptor 4(TLR4),and eosinophils(EOS)in acute exacerbations of chronic obstructive pulmonary disease(AECOPD)and to analyze the relationship between the above indexes and the prognosis of AECOPD.Methods 97 AECOPD patients admitted to the First People's Hospital of Shuangliu District in Chengdu from January 2019 to December 2021 were included in the observation group,and 40 patients with stable COPD who received treatment in the hospital during the same period were included in the stable group,and 40 healthy volunteers who underwent physical examination during the same period were included in the control group.The clinical treatment and serum DcR3,TLR4 and EOS levels of the three groups were compared,and the relationship between each index and the prognosis of AECOPD was analyzed.Results Comparing the levels of serum DcR3,TLR4 and EOS among the three groups,the observation group>stable group>control group.There were statistically significant differences between the groups(P<0.05).During follow-up of patients,31 patients with AECOPD had poor outcomes,of which 8 died and 23 were readmitted to the hospital.Serum levels of DcR3,TLR4 and EOS in the poor prognosis group were significantly higher than those in the good prognosis group,and the difference between groups was statistically significant(P<0.05).Logistics regression model showed that serum DcR3,TLR4 and EOS were significant influencing factors for poor prognosis of AECOPD(OR=0.790,0.963,0.437,P<0.05).ROC model shows that serum levels of independent DcR3,TLR4,and EOS had a general predictive effect on the prognosis of AECOPD,while the combined index of DCR3,TLR4,and EOS had a higher predictive effect.The AUC,Yoden index,sensitivity and specificity of the combined index were 0.931,0.723,93.50%,and 78.80%,respectively.Conclusion There are abnormal expressions of serum DcR3,TLR4 and EOS in patients with AECOPD,and the three indexes are all factors affecting the poor prognosis of AEC

关 键 词：慢性阻塞性肺疾病急性加重期 诱骗受体3 Toll样受体4 嗜酸性粒细胞 预后 

分 类 号：R446.11[医药卫生—诊断学]