急性加重期支气管扩张症患者血清HGF、LXA4水平与病情程度的关系及其对预后的评估价值  

Relationship between serum HGF and LXA4 levels in patients with acute exacerbation ofbronchiectasis and the disease severity and their evaluation value for the prognosis

作　　者：倪敏讷[1] 吕慧莹 池博 李彦平[1] NI Minna;LYU Huiying;CHI Bo;LI Yanping(Department of Emergency,Tsinghua University Yuquan Hospital/Tsinghua University Integrated Traditional Chinese and Western Medicine Hospital,Beijing 100049,China)

机构地区：[1]清华大学玉泉医院/清华大学中西医结合医院急诊科,北京100049

出　　处：《国际检验医学杂志》2024年第14期1699-1704,共6页International Journal of Laboratory Medicine

基　　金：首都卫生发展科研专项项目(2020-3Z-7083)。

摘　　要：目的探究急性加重期支气管扩张症患者血清肝细胞生长因子(HGF)、脂氧素A4(LXA4)水平与病情程度的关系及其对预后的评估价值。方法选取2019年1月至2021年1月该院诊治的138例急性加重期支气管扩张症患者作为急性加重期组。根据支气管扩张症严重程度指数(BSI评分),分为轻度组(40例)、中度组(46例)及重度组(52例)。根据患者预后,分为预后良好组(85例)和预后不良组(53例)。以同期诊治的70例稳定期支气管扩张症患者作为稳定期组。以同期体检的70例健康者为对照组。采用酶联免疫吸附试验检测血清HGF、LXA4水平。采用Logistic回归模型探讨影响急性加重期支气管扩张症患者预后的因素。采用受试者工作特征(ROC)曲线评估血清HGF、LXA4水平对急性加重期支气管扩张症患者预后的预测作用。结果相比于稳定期组和对照组,急性加重期组血清HGF水平较高,LXA4水平较低(均P<0.05)。急性加重期组患者病情程度越重,血清HGF水平越高,LXA4水平越低。相比于预后良好组,预后不良组血红蛋白、清蛋白、血清LXA4水平较低,而急性加重次数、BSI评分重度比例、血清HGF水平较高(均P<0.05)。急性加重次数(OR=1.185,P<0.001),BSI评分(OR=1.280,P<0.001),血清HGF(OR=1.189,P<0.001)是影响患者预后不良的危险因素,血清LXA4(OR=0.827,P<0.001)是保护因素。血清HGF、LXA4联合检测对患者预后不良评估的曲线下面积为0.912(95%CI:0.862~0.955),大于二者单项检测(Z=4.254、3.819,均P<0.001)。结论急性加重期支气管扩张症患者血清HGF水平升高,LXA4水平降低,二者与病情程度有关,联合检测对患者预后不良具有较高的预测价值。Objective To investigate the relationship between serum levels of hepatocyte growth factor(HGF)and lipoxygenase-4(LXA4)in patients with acute exacerbation of bronchiectasis and the severity of the disease,and their evaluation value for the prognosis.Methods A total of 138 patients diagnosed with and treated for acute exacerbation of bronchiectasis between January 2019 and January 2021 in the hospital were selected as acute exacerbation group.Based on the bronchiectasis severity index(BSI score),patients were divided into mild group(40 cases),moderate group(46 cases),and severe group(52 cases).Additionally,patients were categorized into a good prognosis group(85 cases)and a poor prognosis group(53 cases)based on their clinical outcomes.70 stable bronchiectasis patients treated concurrently were selected as the stable stage group.Furthermore,70 healthy individuals who underwent physical examinations during the same period was included as the control group.Serum HGF and LXA4 levels were measured by enzyme-linked immunosorbent assay.Logistic regression model was used to explore the factors affecting the prognosis of patients with acute exacerbation of bronchiectasis.The predictive effect of serum HGF and LXA4 levels on the prognosis of patients with acute exacerbation of bronchiectasis was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the stable stage group and the control group,the acute exacerbation group had higher serum HGF levels and lower LXA4 levels(all P<0.05).The more severe the condition was in the acute exacerbation group,the higher the serum HGF level and the lower the LXA4 level.Compared with the good prognosis group,the poor prognosis group had lower levels of hemoglobin,albumin,and serum LXA4,while the number of acute exacerbations,proportion of severe BSI scores,and serum HGF levels were higher(all P<0.05).In the acute exacerbation group,the more severe the disease,the higher the serum HGF level and the lower the LxA4 level.The number of acute exacerbations(OR=1.185,P<0

关 键 词：支气管扩张症 急性加重期 肝细胞生长因子 脂氧素A4 预后 

分 类 号：R446.1[医药卫生—诊断学]