血清甲状腺激素、EOS及GDF⁃15水平检测对AECOPD患者预后的评估价值  

The value of serum thyroid hormone,EOS and GDF⁃15 levels in evaluating the prognosis of AECOPD patients

作　　者：黄颖锋[1] 杨建华[1] 王锦涛[1] 常双喜[1] 李想 HUANG Yingfeng;YANG Jianhua;WANG Jintao;CHANG Shuangxi;LI Xiang(Department of Respiratory and Critical Care Medicine,Zhengzhou First People's Hospital,Zhengzhou,Henan,China,450000)

机构地区：[1]郑州市第一人民医院呼吸与危重症医学科,河南郑州450000

出　　处：《分子诊断与治疗杂志》2024年第12期2291-2294,2298,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20191403)。

摘　　要：目的探讨血清甲状腺激素、嗜酸性粒细胞(EOS)及生长分化因子⁃15(GDF⁃15)水平检测对慢性阻塞性肺疾病急性加重期(AECOPD)患者预后的评估价值。方法选取2019年7月至2023年12月郑州市第一人民医院收治的AECOPD患者117例为研究对象。统计AECOPD患者预后情况,比较预后良好组与预后不良组一般资料,比较两组血清甲状腺激素、EOS及GDF⁃15水平,分析影响AECOPD患者预后的多因素,分析甲状腺激素、EOS及GDF⁃15单独及联合评估AECOPD患者预后的价值。结果治疗10 d后,根据患者预后情况分为预后不良组(44例)与预后良好组(73例);两组性别、年龄、吸烟、机械通气时间、激素使用时间及COPD病程比较,差异无统计学意义(P>0.05);两组CRP、FEV_(1)、FEV_(1)/FVC比较,差异有统计学意义(P<0.05)。预后不良组T_(3)、FT_(3)、EOS水平低于预后良好组,GDF⁃15水平高于预后良好组,差异有统计学意义(P<0.05)。二元Logistic回归分析显示:CRP>10 mg/L、T_(3)<1.34,>2.73 nmol/L、FT_(3)<3.1,>6.8/L、EOS 0.5⁃5%及GDF⁃15>1200水平是影响AECOPD预后的危险因素(P<0.05)。T_(3)、FT_(3)、EOS及GDF⁃15联合预测AECOPD患者预后的AUC为0.894,高于T_(3)、FT_(3)、EOS及GDF⁃15单独检测(P<0.05)。结论T_(3)、FT_(3)、EOS及GDF⁃15水平在AECOPD预后评估中具有一定价值,可为临床制定更为精确且个体化治疗方案提供一定依据。Objective To investigate the prognostic value of serum thyroid hormone,eosinophil(EOS)and growth differentiation factor-15(GDF-15)level tests in assessing the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 117 patients with AECOPD admitted to Zhengzhou First People's Hospital from July 2019 to December 2023 were selected as the study subjects.The prognosis of AECOPD patients was statistically analyzed.The general data of the good prognosis group and the poor prognosis group were compared.The levels of serum thyroid hormone,EOS and GDF-15 were compared between the two groups.The multiple factors affecting the prognosis of AECOPD patients were analyzed.The value of thyroid hormone,EOS and GDF-15 alone and in combination in evaluating the prognosis of AECOPD patients was analyzed.Results After 10 days of treatment,patients were divided into two groups based on their prognosis:the poor prognosis group(44 cases)and the good prog-nosis group(73 cases).A comparison of gender,age,smoking history,duration of mechanical ventilation,duration of hormone uses and duration of COPD between the two groups showed no statistically significant difference(P>0.05).However,a comparison of CRP,FEV_(1),and FEV_(1)/FVC between the two groups revealed statistically significant differences(P<0.05).The levels of T_(3),FT_(3)and EOS in the poor prognosis group were lower than those in the good prognosis group,and the level of GDF-15 was higher than that in the good prog-nosis group,the differences were statistically significant(P<0.05).Binary logistic regression analysis showed that CRP>10 mg/L,T_(3)<1.34,>2.73 nmol/L,FT_(3)<3.1,>6.8/L,EOS 0.5-5%,and GDF-15>1200 levels were the risk factors affecting the prognosis of AECOPD(P<0.05).The AUC of T_(3),FT_(3),EOS,and GDF-15 combined to predict prognosis in AECOPD patients was 0.894,which was higher than that of T_(3),FT_(3),EOS,and GDF-15 alone(P<0.05).Conclusion The levels of T_(3),FT_(3),EOS,and GDF-15 hold significant value in

关 键 词：甲状腺激素 嗜酸性粒细胞 生长分化因子⁃15 慢性阻塞性肺疾病急性加重期 

分 类 号：R563.9[医药卫生—呼吸系统]