CXCR1、ESM-1及IGFBP-2与COPD合并肺部感染患者疾病严重程度、预后的关系  

Relationship of CXCR1,ESM⁃1 and IGFBP⁃2 with disease severity and prognosis in patients with COPD and pulmonary infection

作　　者：王甲 李东风[1] 李雅琳[1] 李昊 李红涛 WANG Jia;LI Dongfeng;LI Yain;LI Hao;LI Hongtao(Intensive Care Unit(ICU),Fuyang People’s Hospital,Fuyang,Anhui,China,236000)

机构地区：[1]阜阳市人民医院重症医学科(ICU),安徽阜阳236000

出　　处：《分子诊断与治疗杂志》2024年第7期1381-1385,共5页Journal of Molecular Diagnostics and Therapy

基　　金：安徽高校自然科学研究项目(KJ2021A0320)。

摘　　要：目的 分析血清趋化因子受体1(CXCR1)、内皮细胞特异性分子-1(ESM-1)、胰岛素样生长因子结合蛋白2(IGFBP-2)水平与慢性阻塞性肺疾病(COPD)合并肺部感染患者疾病严重程度、预后的关系。方法 选取2021年1月至2023年1月于阜阳市人民医院就诊的COPD患者325例,根据肺部感染情况分为感染组及未感染组。比较两组入院时的血清CXCR1、ESM-1、IGFBP-2水平及常规感染指标[C-反应蛋白(CRP)、降钙素原(PCT)]水平,采用Pearson相关分析感染组上述指标的关系。比较不同病情严重程度COPD合并肺部感染患者入院时的CXCR1、ESM-1、IGFBP-2水平。对感染组患者跟踪随访6个月或死亡止,根据预后情况分为存活亚组及死亡亚组,比较两亚组患者入院时的血清CXCR1、ESM-1、IGFBP-2水平;采用受试者工作曲线(ROC)分析上述指标对COPD合并肺部感染患者死亡的预测价值。结果 325例COPD患者包括感染组109例及未感染组216例。感染组患者入院时的血清CXCR1、ESM-1、IGFBP-2、CRP、PCT水平高于未感染组,差异有统计学意义(P<0.05)。不同病情严重程度COPD合并肺部感染患者入院时的血清CXCR1、ESM-1、IGFBP-2水平比较差异有统计学意义(P<0.05)。Pearson相关分析显示,感染组入院时的血清CRP水平与CXCR1、ESM-1水平呈正相关(P<0.05)。随访期间感染组死亡19例(17.43%),存活90例(82.57%),死亡亚组入院时的血清CXCR1、ESM-1、IGFBP-2水平高于存活亚组,差异有统计学意义(P<0.05)。ROC结果显示,血清CXCR1、IGFBP-2水平预测COPD合并肺部感染患者死亡具有一定局限性(AUC=0.636、0.769),ESM-1的预测效能较好(AUC=0.827),CXCR1+ESM-1+IGFBP-2三项联合诊断的预测效能最佳(AUC=0.904)。结论 血清CXCR1、ESM-1、IGFBP-2水平在COPD合并肺部感染患者的疾病严重程度及预后评估方面具有一定指导意义。Objective To analyze the relationship of levels of serum chemokine receptor 1(CXCR1),endothelial cell specific molecule-1(ESM-1)and insulin-like growth factor binding protein 2(IGFBP-2)with disease severity and prognosis in patients with chronic obstructive pulmonary disease(COPD)complicated with pulmonary infection.Methods 325 patients with COPD who were treated at Fuy-ang People’s Hospital were selected from January 2021 to January 2023.The patients were divided into an in-fected group and a non-infected group based on pulmonary infection status.The levels of serum CXCR1,ESM-1 and IGFBP-2,as well as levels of conventional infection indicators[C-reactive protein(CRP)and procalcito-nin(PCT)]were compared between the two groups puon admission.The Pearson correlation coefficient was used to analyze the relationship among these indicators in the infected group.The levels of CXCR1,ESM-1,and IGFBP-2 at admission were compared among COPD patients with pulmonary infection of different disease severities.The infected patients were followed up for 6 months or until death and were then divided into a sur-vival subgroup and a death subgroup based on their prognosis status.The levels of serum CXCR1,ESM-1,and IGFBP-2 between these two subgroups were compared at admission.Finally,the predictive value of these indicators on the death of patients with COPD and pulmonary infections was analyzed using a receiver operat-ing characteristic curve(ROC).Results 325 patients with COPD were included in the study,with 109 cases in the infected group and 216 cases in the non-infected group.The levels of serum CXCR1,ESM-1,IGFBP-2,CRP,and PCT in the infected group at admission were higher than those in the non-infected group(P<0.05).There were statistically significant differences in serum CXCR1,ESM-1,and IGFBP-2 levels at admis-sion among patients with COPD and pulmonary infection of different disease severities(P<0.05).Pearson cor-relation coefficient analysis showed that serum CRP level in the infected group at admission was positively

关 键 词：慢性阻塞性肺疾病 肺部感染 趋化因子受体1 内皮细胞特异性分子-1 胰岛素样生长因子结合蛋白2 

分 类 号：R563.9[医药卫生—呼吸系统] R563.1[医药卫生—内科学]