血清组织蛋白酶S、颗粒蛋白前体及趋化因子配体12对慢性阻塞性肺疾病急性加重的预测价值  

Predictive value of serum cathepsin S,progranulin and chemokine ligand 12 for acute exacerbation of chronic obstructive pulmonary disease

作　　者：李於 张健 周娟娟 邓宇锋 朱胜康 LI Yu;ZHANG Jian;ZHOU Juanjuan;DENG Yufeng;ZHU Shengkang(Department of Emergency Medicine,Tongling Municipal Hospital,Tongling 244000,Anhui Province,China)

机构地区：[1]铜陵市立医院急诊内科,安徽铜陵244000

出　　处：《新乡医学院学报》2024年第8期766-771,共6页Journal of Xinxiang Medical University

摘　　要：目的探讨血清组织蛋白酶S(CTSS)、颗粒蛋白前体(PGRN)及趋化因子配体12(CXCL12)对慢性阻塞性肺疾病(COPD)急性加重的预测价值。方法选择2020年1月至2023年2月铜陵市立医院收治的202例COPD患者为研究对象,根据是否发生急性加重分为急性加重组(n=64)和非急性加重组(n=138),收集2组患者的血清CTSS、PGRN、CXCL12水平及年龄、性别、体质量指数(BMI)、病程、吸烟史、第一秒呼气容积占预计值百分比(FEV1%)、稳定期慢性阻塞性肺疾病评估测试(CAT)评分等临床资料。采用单因素分析比较2组患者各指标的差异,多因素logistic回归分析COPD患者发生急性加重的独立危险因素,Pearson相关分析血清CTSS、PGRN及CXCL12水平与FEV1%和CAT评分的相关性,相对危险度分析不同水平CTSS、PGRN及CXCL12对COPD患者急性加重的影响,受试者操作特征(ROC)曲线评估血清CTSS、PGRN及CXCL12水平对COPD患者急性加重的预测效能。结果单因素分析结果显示,2组患者的年龄、性别、BMI、病程比较差异无统计学意义(P>0.05);2组患者吸烟者占比、FEV1%、CAT评分及血清CTSS、PGRN、CXCL12水平比较差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,血清CTSS、PGRN及CXCL12水平升高是COPD患者急性加重的危险因素(P<0.05)。不同FEV1%、CAT评分患者血清CTSS、PGRN、CXCL12水平比较差异有统计学意义(P<0.05)。相关性分析显示,血清CTSS、PGRN、CXCL12水平与FEV1%呈负相关,与CAT评分呈正相关(P<0.05)。危险度分析显示,血清CTSS、PGRN、CXCL12高水平COPD患者急性加重的风险分别是低水平患者的2.089倍(95%置信区间:1.341~3.253)、2.294倍(95%置信区间:1.363~3.862)、2.359倍(95%置信区间:1.459~3.815)。ROC曲线分析显示,血清CTSS、PGRN、CXCL12水平单独预测COPD患者急性加重风险的曲线下面积分别为0.780、0.811、0.775,三者联合预测COPD患者急性加重风险的曲线下面积为0.923。结论血�Objective To explore the predictive value of serum cathepsin S(CTSS),progranulin(PGRN)and chemokine ligand 12(CXCL12)for acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods A total of 202 patients with COPD who were admitted to the Tongling Municipal Hospital from January 2020 to February 2023 were selected as the research subjects.The patients were divided into an acute exacerbation group(n=64)and a non-acute exacerbation group(n=138)according to whether acute exacerbation occurred.Clinical data such as serum CTSS,PGRN and CXCL12 levels,age,gender,body mass index(BMI),disease course,smoking history,forced expiratory volume in one second/forced vital capacity ratio(FEV1%),and COPD assessment test(CAT)score in the stable period were collected.Univariate analysis was made to compare the differences in relevant indicators between the two groups,and multivariate logistic regression analysis was made to identify the independent risk factors for acute exacerbation in COPD patients.The Pearson correlation method was used to analyze the correlation between serum CTSS,PGRN,CXCL12 levels and FEV1%,CAT score.Relative risk analysis was used to evaluate the influence of different CTSS,PGRN and CXCL12 levels on acute exacerbation in COPD patients.The predictive efficacy of serum CTSS,PGRN and CXCL12 levels on acute exacerbation in COPD patients was evaluated by receiver operating characteristic(ROC)curve.Results Univariate analysis showed that there was no significant difference in age,sex,BMI and disease course of patients between the two groups(P>0.05),while there were significant differences in the proportion of patients with smoking history,FEV1%,CAT score,and serum CTSS,PGRN and CXCL12 levels between the two groups(P<0.05).Multivariate logistic regression analysis showed that elevated serum CTSS,PGRN and CXCL12 levels were risk factors for acute exacerbation in COPD patients(P<0.05).There were significant differences in serum CTSS,PGRN and CXCL12 levels among patients with different FEV1%and CAT scor

关 键 词：慢性阻塞性肺疾病 急性加重 危险因素 组织蛋白酶S 颗粒蛋白前体 趋化因子配体12 预测效能 

分 类 号：R563.9[医药卫生—呼吸系统]