血清HSP70、sCD74对慢性阻塞性肺疾病患者急性加重风险的预测效能  

Efficacy of Serum HSP70 and sCD74 in Predicting the Risk of Acute Exacerbation in Patients with COPD

作　　者：李瑞彤 张志斌[1] LI Ruitong;ZHANG Zhibin(Department of Emergency,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院急诊科,河北张家口075000

出　　处：《临床误诊误治》2023年第12期62-65,95,共5页Clinical Misdiagnosis & Mistherapy

基　　金：2023年度河北省医学科学研究课题计划项目(20231452)。

摘　　要：目的探讨血清热休克蛋白70(HSP70)、可溶性CD74(sCD74)对慢性阻塞性肺疾病(COPD)患者急性加重风险的预测效能。方法选取2022年1—12月收治的COPD 103例为观察组,选取同期体检的健康者90例作为对照组。根据患者入院前1年内患者急性加重次数分为急性加重低风险组48例和急性加重高风险组55例。应用酶联免疫吸附试验检测血清热休克蛋白70(HSP70)、血清sCD74表达水平,采用受试者工作特征(ROC)曲线评估血清HSP70、sCD74对COPD患者急性加重风险的预测价值;采用多因素Logistic回归分析COPD患者急性加重风险的影响因素。结果观察组血清HSP70水平低于对照组,血清sCD74水平高于对照组(P<0.01)。急性加重低风险组血清HSP70水平高于高风险组,血清sCD74水平低于高风险组(P<0.01)。血清HSP70、sCD74联合预测COPD患者急性加重风险的曲线下面积大于二者单独预测。HSP70<1.16μg/L,sCD74≥75.56 ng/mL是COPD患者急性加重高风险的危险因素(P<0.01)。结论低水平HSP70与高水平sCD74会增加COPD急性加重风险。HSP70、sCD74联合检测在COPD急性加重风险预测中具有较高效能。Objective To investigate the predictive efficacy of serum heat shock protein 70(HSP70)and soluble CD74(sCD74)on the risk of acute exacerbation in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 103 patients with COPD treated from January to December 2022 were selected,and 90 healthy subjects who underwent physical examination during the same period were selected as the control group.According to the number of acute exacerbations within 1 year before admission,patients were divided into low-risk acute exacerbation group(n=48)and high-risk acute exacerbation group(n=55).The expression levels of serum HSP70 and serum sCD74 were detected by enzyme-related immunosorbent assay.The predictive value of serum HSP70 and sCD74 for the risk of acute exacerbation in COPD patients was evaluated by receiver operating characteristic(ROC)curve.Multivariate Logistic regression was used to analyze the factors affecting the risk of acute exacerbation in COPD patients.Results The serum HSP70 level in the observation group was lower than that in the control group,while the serum sCD74 level was higher than that in the control group(P<0.01).Serum HSP70 level in low-risk acute exacerbation group was higher than that in high-risk acute exacerbation group,while serum sCD74 level was lower than that in high-risk acute exacerbation group(P<0.01).The area under the ROC curve of combined detection of serum HSP70 and sCD74 in predicting the risk of acute exacerbation in COPD patients was greater than that of two factors alone in prediction.HSP70<1.16μg/L and sCD74≥75.56 ng/mL were risk factors for acute exacerbation in COPD patients(P<0.01).Conclusion Low levels of HSP70 and high levels of sCD74 can increase the risk of acute exacerbation of COPD,and the combined detection of HSP70 and sCD74 has high efficacy in predicting the risk of acute exacerbation of COPD.

关 键 词：肺疾病 慢性阻塞性 急性加重 HSP70热休克蛋白质类 可溶性CD74 预测 ROC曲线 曲线下面积 危险因素 

分 类 号：R563.9[医药卫生—呼吸系统]