慢性阻塞性肺疾病患者血清CatS、CatL、CatB与炎性因子、CAT评分及预后的相关性研究  

A study on the correlation between serum CatS,CatL,CatB,inflammatory factors,CAT scores and prognosis in patients with chronic obstructive pulmonary disease

作　　者：王辉[1] 康肖菲 郭立娟 冯淬灵 WANG Hui;KANG Xiaofei;GUO Lijuan;FENG Cuiling(Department of Respiratory Medicine,The Affiliated Hospital of Hebei University,Baoding 071000,Hebei,China;Hebei Chest Hospital,Shijiazhuang 050000,Hebei,China)

机构地区：[1]河北大学附属医院呼吸科,河北保定071000 [2]河北省胸科医院,河北石家庄050000

出　　处：《西部医学》2024年第12期1798-1802,共5页Medical Journal of West China

基　　金：国家重点研发计划课题项目(2018YFC1704803);河北省医学科学研究基金项目(20231499)。

摘　　要：目的探究急性加重期慢性阻塞性肺疾病(AECOPD)患者血清组织蛋白酶L(CatL)、组织蛋白酶S(CatS)、组织蛋白酶B(CatB)与炎性因子(IL-8、IL-10、TNF-α、CRP)、COPD评估测试(CAT)评分及预后的关系。方法选择2022年1月—12月河北大学附属医院收治的224例AECOPD患者为病例组,同期选择健康体检肺功能正常者62例为对照组。比较两组血清CatS、CatL、CatB、CRP、IL-8、IL-10、TNF-α水平及CAT评分;采用Pearson检验分析AECOPD患者血清CatS、CatL、CatB与炎性因子和CAT评分的相关性。对224例AECOPD患者随访28 d,统计死亡例数,比较生存组与死亡组临床资料及各实验室指标,采用Logistic回归模型分析AECOPD预后的影响因素。结果病例组血清CatB低于对照组(P<0.05),CatS、CatL高于对照组(P<0.05);病例组血清IL-10低于对照组(P<0.05),CRP、IL-8、TNF-α、CAT显著高于对照组(P<0.05)。Pearson检验显示,AECOPD患者血清CatS、CatL与CRP、IL-8、TNF-α、CAT评分呈正相关(P<0.05),与IL-10呈负相关(P<0.05);血清CatB与CRP、IL-8、TNF-α、CAT评分呈负相关(P<0.05),与IL-10呈正相关(P<0.05)。224例AECOPD患者中,随访28 d死亡39例。生存组和死亡组性别、年龄、COPD病程、白细胞计数、白蛋白、饮酒史、饮酒史、高血压占比、糖尿病占比、冠心病占比差异无统计学意义(P>0.05);与生存组比较,死亡组机械通气占比、PaCO_(2)、CatS、CatL升高(P<0.05),PaO_(2)、CatB显著降低(P<0.05)。Logistic回归模型显示,机械通气、PaCO_(2)、CatS、CatL是AECOPD预后的危险因素(P<0.05),PaO_(2)、CatB为其保护因素(P<0.05)。结论AECOPD患者血清CatS、CatL、CatB与炎性因子、CAT评分及预后关系密切,三者水平检测有助于评估AECOPD病情和预后。Objective To investigate the relationship between serum cathepsin L(CatL),cathepsin S(CatS),cathepsin B(CatB),inflammatory factors such as interleukin-8(IL-8),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),COPD assessment test(CAT)scores,and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 224 AECOPD patients admitted to our hospital from January 2022 to December 2022 were selected as the case group,while 62 healthy individuals with normal lung function were selected as the control group.The serum levels of CatS,CatL,CatB,CRP,IL-8,IL-10,TNF-α,and CAT scores were compared between the two groups.Pearson test was used to analyze the correlation between serum CatS,CatL,CatB,inflammatory factors,and CAT scores in AECOPD patients.224 AECOPD patients were followed up for 28 days,and the number of deaths was counted.Clinical data and laboratory indicators were compared between the survival and death groups.Logistic regression models were used to analyze the influencing factors of AECOPD prognosis.Results The serum CatB levels in the case group were significantly lower than those in the control group(P<0.05),while CatS and CatL levels were significantly higher than those in the control group(P<0.05);The serum IL-10 levels in the case group were significantly lower than those in the control group(P<0.05),and the CRP,IL-8,TNF-α,and CAT scores were significantly higher than those in the control group(P<0.05).Pearson test showed that serum CatS and CatL in AECOPD patients were positively correlated with CRP,IL-8,TNF-α,and CAT scores(P<0.05),and negatively correlated with IL-10 scores(P<0.05);Serum CatB was negatively correlated with CRP,IL-8,TNF-α,and CAT scores(P<0.05),and positively correlated with IL-10 scores(P<0.05).Among 224 AECOPD patients,39 died after 28 days of follow-up.There was no significant difference between the two groups in gender,age,course of COPD,white blood cell count,albumin,drinking history,drinking history,hypert

关 键 词：急性加重期慢性阻塞性肺疾病 组织蛋白酶L 组织蛋白酶S 组织蛋白酶B 炎性因子 CAT评分 预后 

分 类 号：R563[医药卫生—呼吸系统]