急性加重期COPD患者血清Caspase-1和PTX3的表达水平及其与预后不良的相关性  

Expression levels of serum Caspase-1 and pentamerin-3(PTX3)in patients with acute exacerbation of COPD(AECOPD)and their correlation with poor prognosis

作　　者：陈文洁 姚传福 王婵娟 CHEN Wenjie;YAO Chuanfu;WANG Chanjuan(Department of General Practice,Shanghai Fengxian District Central Hospital,Shanghai 201400,China;Department of Emergency,Fengcheng Hospital of Fengxian District,Shanghai 201411,China)

机构地区：[1]上海市奉贤区中心医院全科医疗科,上海201400 [2]上海市奉贤区奉城医院急诊科,上海201411

出　　处：《新疆医科大学学报》2025年第1期43-48,54,共7页Journal of Xinjiang Medical University

基　　金：上海市卫生健康委员会科研项目(2022D075)。

摘　　要：目的探讨急性加重期慢性阻塞性肺疾病(AECOPD)患者血清Caspase-1和正五聚蛋白3(PTX3)的表达水平及其与预后不良的相关性。方法选取本院收治的110例AECOPD患者为研究对象,纳入AECOPD组,另选取稳定期COPD患者(稳定组,n=55)和体检健康者(对照组,n=55),所有受者入组时间均为2021年6月至2023年6月。比较3组血清Caspase-1、PTX3水平及临床资料。对AECOPD组患者进行随访,随访终点为患者发生死亡或再住院,或随访期满1年,根据随访结果分为预后良好组和预后不良组。对比预后不良组和预后良好组临床资料、血清Caspase-1、PTX3水平。采用Logistic筛选影响AECOPD患者预后不良的危险因素,分析血清Caspase-1、PTX3水平与AECOPD患者预后不良的相关性。结果与对照组相比,AECOPD组、稳定组患者血清Caspase-1、PTX3水平更高(P<0.05)。与稳定组相比,AECOPD组患者血清Caspase-1、PTX3水平更高(P<0.05)。110例AECOPD患者中,有35例患者预后不良,预后不良率为31.82%(35/110)。与预后良好组相比,预后不良组患者血清Caspase-1、PTX3、白细胞计数(WBC)、COPD评估测试(CAT)评分水平更高(P<0.05),第1秒用力呼气容积(FEV1)占预计值百分比(FEV1%)水平更低(P<0.05)。与预后良好组相比,预后不良组WBC、CAT评分水平更高(P<0.05),FEV1%水平更低(P<0.05)。WBC、CAT评分、Caspase-1、PTX3水平异常偏高是影响AECOPD患者预后不良的危险因素(P<0.05),FEV1%是影响AECOPD患者预后不良的保护因素(P<0.05)。血清Caspase-1、PTX3联合预测AECOPD患者预后不良的曲线下面积(AUC)(95%CI)为0.872(0.668~0.987),联合预测价值更高(P<0.05)。Spearman相关性分析显示,血清Caspase-1、PTX3水平与AECOPD患者预后不良呈正相关(r=0.541、0.595,P<0.05)。结论血清Caspase-1、PTX3在AECOPD患者体内水平异常高表达是AECOPD患者预后不良的独立危险因素,二者联合检测预测AECOPD患者预后不良的效能更高,可为AECOPD的临床防�Objective To investigate the expression levels of serum Caspase-1 and pentamerin-3(PTX3)and their correlation with poor prognosis in patients with acute exacerbation chronic obstructive pulmonary disease(AECOPD).Methods A total of 110 patients with AECOPD admitted to the hospital were select-ed as study objects and included inAECOPD group,as well as stable COPD patients(stable group,n=55 cases)and healthy people in physical examination(control group,n=55 cases).All recipients were en-rolled from June 2021 to June 2023.Serum Caspase-1 and PTX3 levels and clinical data of the 3 groups were compared.The patients in AECOPD group were followed up,and the end point of follow-up was death or re-hospitalization,or the follow-up period was 1 year.According to the follow-up results,the pa-tients were divided into good prognosis group and poor prognosis group.The clinical data,serum Caspase-1 and PTX3 levels of the poor prognosis group and the good prognosis group were compared.Logistic screening was used to screen the risk factors affecting the poor prognosis of AECOPD patients,and the correlation between serum Caspase-1 and PTX3 levels and the poor prognosis of AECOPD patients was an-alyzed.Results Compared with control group,serum Caspase-1 and PTX3 levels in AECOPD group and stable group were higher(P<0.05).Compared with stable group,serum Caspase-1 and PTX3 levels in AECOPD group were higher(P<0.05).Among 110 AECOPD patients,35 patients had poor prognosis,and the poor prognosis rate was 31.82%(35/110).Compared with the good prognosis group,the levels of serum Caspase-1,PTX3,white blood cell count(WBC)and COPD evaluation test(CAT)scores in the poor prognosis group were higher(P<0.05),and the percentage of forced expiratory volume in the first second(FEV1)to the expected value(FEV1%)was lower(P<0.05).Compared with the good progno-sis group,the level of WBC and CAT scores in the poor prognosis group was higher(P<0.05),and the level of FEV1%was lower(P<0.05).Abnormal high levels of WBC,CAT score,Caspase-1 and PTX3 were ris

关 键 词：急性加重期慢性阻塞性肺疾病(AECOPD) Caspase-1(PTX3) 正五聚蛋白3 预后 

分 类 号：R446.11[医药卫生—诊断学]