血清白介素-12p70、淀粉样蛋白A水平变化与慢性阻塞性肺疾病患者并发冠心病的关系  

Relationship between changes in serum interleukin-12p70 and amyloid A levels and concomitant coronary heart disease in patients with chronic obstructive pulmonary disease

作　　者：王尚宏 郑丽琴[1] 王耀勇[1] 赵建玲[1] Wang Shanghong;Zheng Liqin;Wang Yaoyong;Zhao Jianling(Department of Respiratory and Critical Care Medicine,Shanxi Fenyang Hospital/Fenyang Hospital,Shanxi Medical University,Shanxi Province,Fenyang 032200,China)

机构地区：[1]山西省汾阳医院/山西医科大学附属汾阳医院呼吸与危重症医学科,032200

出　　处：《疑难病杂志》2024年第3期292-296,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：山西省医学重点科研项目(2020XM30)。

摘　　要：目的分析慢性阻塞性肺疾病(COPD)患者血清白介素-12p70(IL-12p70)、淀粉样蛋白A(SAA)水平变化及其与并发冠心病(CHD)的关系。方法选取2019年5月—2023年5月山西医科大学附属汾阳医院呼吸与危重症医学科诊治COPD患者150例,其中并发CHD患者58例纳入COPD-CHD组,未并发CHD患者92例纳入COPD组。检测血清IL-12p70、SAA水平;比较不同血清IL-12p70、SAA水平COPD患者并发CHD发生率;Logistic回归模型分析血清IL-12p70、SAA与COPD患者并发CHD的独立关系,受试者工作特征曲线(ROC曲线)分析血清IL-12p70、SAA预测COPD患者并发CHD的价值。结果COPD-CHD组吸烟史比例、糖尿病比例、纤维蛋白原及血清IL-12p70、SAA水平高于COPD组[χ^(2)(t)/P=4.696/0.030、4.801/0.029、2.629/0.010、6.111/<0.001、5.744/<0.001];随着血清IL-12p70、SAA水平升高,COPD患者并发CHD发生率呈升高趋势(χ^(2)/P=27.864/<0.001、31.346/<0.001);血清IL-12p70、SAA升高均是COPD患者并发CHD的独立危险因素[OR(95%CI)=3.350(2.002~5.607),3.658(2.268~5.899)];ROC曲线分析显示,血清IL-12p70、SAA联合预测COPD患者并发CHD的AUC为0.835,优于各自单独预测效能(Z/P=2.180/0.029,2.244/0.025)。结论COPD患者血清IL-12p70、SAA水平升高,尤其是并发CHD时升高更显著,二者均为COPD患者并发CHD的独立危险因素,临床可通过检测两指标水平判断COPD患者并发CHD风险。Objective To analyze the changes of serum interleukin-12p70(IL-12p70)and amyloid A(SAA)levels in patients with chronic obstructive pulmonary disease(COPD)and their relationship with concomitant coronary heart disease(CHD).Methods One hundred and fifty COPD patients diagnosed and treated in the Department of Respiratory and Critical Care Medicine,Fenyang Hospital,Shanxi Medical University,were selected from May 2019 to May 2023,among which 58 patients with concurrent CHD were included in the COPD-CHD group,and 92 patients without concurrent CHD were included in the COPD group.Serum IL-12p70 and SAA levels were detected;the incidence of concurrent CHD in COPD patients with different serum IL-12p70 and SAA levels was compared;logistic regression modeling was used to analyze the independent relationship between serum IL-12p70 and SAA and concurrent CHD in COPD patients,and subjects'work characteristic curves(ROC curves)were used to analyze serum IL-12p70,the value of SAA in predicting the complication of CHD in COPD patients.Results The proportion of smoking history,proportion of diabetes,fibrinogen and serum IL-12p70,SAA levels in COPD-CHD group were higher than those in COPD group[χ^(2)(t)/P=4.696/0.030,4.801/0.029,2.629/0.010,6.111/<0.001,5.744/<0.001];with the increase of serum IL-12p70 and SAA levels,the incidence of concomitant CHD in patients with COPD showed a trend of increasing(χ^(2)/P=27.864/<0.001,31.346/<0.001);elevated serum IL-12p70 and SAA were both independent risk factors for the complication of CHD in patients with COPD[OR(95%CI)=3.350(2.002-5.607),3.658(2.268-5.899)];ROC curve analysis showed that the AUC of serum IL-12p70 and SAA combined in predicting concurrent CHD in patients with COPD was 0.835,which was better than their respective individual predictive efficacy(Z/P=2.180/0.029,2.244/0.025).Conclusion Serum IL-12p70 and SAA levels were elevated in patients with COPD,especially in the presence of CHD,and both of them are independent risk factors for CHD in patients with COPD,and the risk of

关 键 词：慢性阻塞性肺疾病 冠心病 白介素-12p70 淀粉样蛋白A 

分 类 号：R446.11[医药卫生—诊断学] R563.9[医药卫生—临床医学]