AECOPD患者血清FOXM1和CCR5水平与肺功能及预后的预测价值研究  

Predictive Value of Serum FOXM1 and CCR5 Levels in AECOPD Patients with Lung Function and Prognosis

作　　者：黄明民 李丹 李凰 付收硕 林春龙 HUANG Mingmin;LI Dan;LI Huang;FU Shoushuo;LIN Chunlong(Department of Respiratory,Yueyang People’s Hospital,Hunan Yueyang 414022,China)

机构地区：[1]岳阳市人民医院呼吸内科,湖南岳阳414022

出　　处：《现代检验医学杂志》2024年第3期176-182,共7页Journal of Modern Laboratory Medicine

摘　　要：目的探讨叉头框蛋白M1(fork head box M1,FOXM1),CC趋化因子受体5(CC chemokine receptor 5,CCR5)对老年慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者肺功能及预后的评估价值。方法选取2022年1月~2023年1月岳阳市人民医院收治的128例AECOPD患者作为急性加重期组,选择同期收治的135例稳定期COPD患者作为稳定期组,年龄、性别相仿的120例健康体检志愿者为对照组。采用酶联免疫吸附法(ELISA)检测血清中FOXM1和CCR5的表达水平,肺活量计检测肺功能指标。Pearson法分析AECOPD患者血清FOXM1,CCR5与肺功能指标的相关性;多因素Logistic回归分析筛选AECOPD患者预后影响因素,受试者工作特征(receiver operator characteristic,ROC)曲线分析FOXM1,CCR5水平对AECOPD患者预后不良的评估价值。结果AECOPD组患者和稳定期组患者血清中CCR5(49.36±12.31 ng/ml,34.25±8.87 ng/ml),FOXM1(40.21±10.74 pg/ml,23.38±5.77 pg/ml)水平较对照组(14.55±4.58 ng/ml,15.06±3.55 pg/ml)明显升高,FEV1(1.15±0.13 L,1.67±0.19 L),FVC(2.93±0.30 L,3.28±0.36 L),FEV1/FVC(39.25%±3.97%,50.91%±5.01%)较对照组(1.95±0.26 L,3.57±0.44 L,54.62%±5.20%)下降,差异具有统计学意义(F=111.034~641.907,均P<0.05)。血清FOXM1,CCR5水平随着肺功能分级加重而逐渐升高,肺功能指标FEV1,FVC水平随着肺功能分级加重而逐渐降低,差异具有统计学意义(F=31.27,49.37;42.72,29.48,均P<0.05)。血清FOXM1,CCR5表达与FEV1,FVC,FEV1/FVC呈负相关(r=-0.639~‐0.479,均P<0.05)。Logistic回归分析发现,CCR5[OR(95%CI):3.380(1.944~5.876)],FOXM1[OR(95%CI):5.711(3.175~10.273)],APACHEⅡ评分[OR(95%CI):2.132(1.243~3.60)],肺功能分级[OR(95%CI):2.017(1.007~4.037)]为预后不良发生的危险因素(均P<0.05),FEV1[OR(95%CI):0.649(0.441~0.955)],FVC[OR(95%CI):0.120(0.073~0.198)]为预后不良发生的保护因素(均P<0.05)。ROC曲线结果显示,血清FOXM1,CCR5水平预测AECOPD患者预后不良的曲线下面�Objective To explore the evaluation value of forkhead box M1(FOXM1)and CC chemokine receptor 5(CCR5)on lung function and prognosis in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 128 AECOPD patients admitted to Yueyang People’s Hospital from January 2022 to January 2023 were collected as the acute exacerbation group,135 stable COPD patients admitted at the same time were regarded as the stable phase group,and 120 health examination volunteers of similar age and gender were regarded as the control group.Enzyme-linked immunosorbent assay(ELISA)was applied to detect the expression levels of FOXM1 and CCR5 in serum,and the vital capacity meter was applied to measure pulmonary function.Pearson method was applied to analyze the correlation between serum FOXM1,CCR5 and lung function indicators in AECOPD patients.Multivariate logistic regression analysis was applied to screen prognostic factors for AECOPD patients.The evaluation value of FOXM1 and CCR5 levels in evaluating poor prognosis of AECOPD patients was analyzed by receiver operating characteristic(ROC)curve.Results In the serum of patients in the AE COPD group and stable stage group,the levels of CCR5(49.36±12.31 ng/ml,34.25±8.87 ng/ml)and FOXM1(40.21±10.74 pg/ml,23.38±5.77 pg/ml)were significantly higher than those in the control group(14.55±4.58 ng/ml,15.06±3.55 pg/ml),while FEV1(1.15±0.13 L,1.67±0.19 L),FVC(2.93±0.30 L,3.28±0.36 L)and FEV1/FVC(39.25%±3.97%,50.91%±5.01%)were lower than those in the control group(1.95±0.26 L,3.57±0.44 L,54.62%±5.20%),with significant differences(F=111.034~641.907,all P<0.05).The levels of serum FOXM1 and CCR5 were gradually increased with the aggravation of lung function grading,while the levels of lung function indicators FEV1 and FVC were gradually decreased with the aggravation of lung function grading,and the differences were statistically significant(F=31.27,49.37;42.72,29.48,all P<0.05).The serum levels of FOXM1 and CCR5 were negatively correl

关 键 词：慢性阻塞性肺疾病急性加重期 肺功能 叉头框蛋白M1 CC 趋化因子受体5 

分 类 号：R563[医药卫生—呼吸系统] R392.11[医药卫生—内科学]