慢性阻塞性肺疾病合并肺间质纤维化患者VEGF、CRP、IL-6、PCT变化的研究  

Changes of VEGF,CRP,IL-6,and PCT in Patients with Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Fibrosis

作　　者：周舟[1] 周纪亮 Zhou Zhou;Zhou Jiliang(Department of Radiology,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;Department of Imaging Medicine and Nuclear Medicine,Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院放射科,郑州450000 [2]河南中医药大学影像医学与核医学系,郑州450000

出　　处：《成都医学院学报》2025年第1期58-61,65,共5页Journal of Chengdu Medical College

基　　金：2024年度河南省卫生健康委员会中医药科学研究专项课题(No:2024ZY3017)。

摘　　要：目的对慢性阻塞性肺疾病(COPD)合并肺间质纤维化(PF)患者胸部CT表现及血管内皮生长因子(VEGF)、C反应蛋白(CRP)、白细胞介素6(IL-6)、降钙素原(PCT)变化进行探讨。方法选取2020年1月至2024年2月在河南中医药大学第一附属医院接受治疗的124例COPD合并PF患者作为试验组,同期收治的124例单纯COPD患者作为对照组。比较两组胸部CT表现、临床资料及VEGF、CRP、IL-6、PCT水平,采用多因素Logistic回归分析法分析COPD合并PF患者的危险因素,采用受试者工作特征(ROC)曲线分析血清VEGF、CRP、IL-6、PCT水平联合检测对COPD合并PF患者的诊断价值。结果COPD合并PF患者的独立危险因素包括年龄大、COPD病程长、有吸烟史、COPD急性加重期、肺功能分级为3~4级、烟雾/粉尘工作环境、急性加重发作频率高以及血清VEGF、CRP、IL-6、PCT水平高(P<0.05);血清VEGF、CRP、IL-6、PCT水平及联合检测诊断COPD合并PF患者的曲线下面积(AUC)分别为0.650、0.689、0.667、0.702、0.913,敏感度分别为63.71%、64.52%、62.10%、71.77%、88.71%,特异度分别为62.90%、69.35%、71.77%、64.52%、81.45%,其中联合检测的AUC高于单一检测(P<0.05);与对照组比较,试验组网格状影、毛玻璃状影、点状及蜂窝状影的患者占比更高(P<0.05)。结论胸部CT检查在COPD合并PF患者的诊断中具有一定应用价值,COPD合并PF患者的独立危险因素包括COPD病程长、年龄大、COPD急性加重期、有吸烟史、烟雾/粉尘工作环境、肺功能分级为3~4级、急性加重发作频率高;血清VEGF、CRP、IL-6、PCT在COPD合并PF患者的诊断中具有较高应用价值,其中联合检测的诊断价值最高。Objective To explore the chest computed tomography(CT)findings and changes in serum levels of vascular endothelial growth factor(VEGF),C-reactive protein(CRP),interleukin-6(IL-6),and procalcitonin(PCT)in patients with chronic obstructive pulmonary disease(COPD)complicated by pulmonary fibrosis(PF).Methods A total of 124 patients with COPD complicated with PF who received treatment at the First Affiliated Hospital of Henan University of Chinese Medicine from January 2020 to February 2024 were selected as the experimental group,and 124 patients with COPD alone admitted during the same period were selected as the control group.The chest CT findings,clinical data,and serum levels of VEGF,CRP,IL-6,and PCT were compared between the two groups.Multivariate Logistic regression analysis was utilized to analyze the risk factors for COPD complicated with PF.The diagnostic value of combined detection of serum VEGF,CRP,IL-6,and PCT levels for COPD patients complicated with PF was analyzed using receiver operating characteristic(ROC)curves.Results The independent risk factors for COPD complicated with PF included advanced age,long course of COPD,smoking history,acute exacerbation of COPD,pulmonary function grade of 3-4,smoke/dust working environment,high frequency of acute exacerbation,and high levels of serum VEGF,CRP,IL-6,and PCT(P<0.05).The areas under the curve(AUCs)of serum VEGF,CRP,IL-6 and PCT levels and their combined detection for the diagnosis of COPD complicated with PF were 0.650,0.689,0.667,0.702,and 0.913,respectively.The sensitivities were 63.71%,64.52%,62.10%,71.77%,and 88.71%,and the specificities were 62.90%,69.35%,71.77%,64.52%,and 81.45%,respectively.The AUC of their combined detection was higher than that of single detection(P<0.05).Compared with the control group,the experimental group showed higher proportion of patients with grid like shadows,ground glass like shadows,and punctate and honeycomb like shadows(P<0.05).Conclusion Chest CT examination has certain application value in the diagnosis of COPD co

关 键 词：慢性阻塞性肺疾病 肺间质纤维化 电子计算机断层扫描 

分 类 号：R563.9[医药卫生—呼吸系统]