硫氧还蛋白Trx对COPD患者体内氧化应激和炎症情况评估的研究  

Detection value of thioredoxin(Trx)on the oxidative stress and inflammatory response in elderly patients with COPD

作　　者：杨剑[1] 张勇[1] 廖洁[1] 刘剑荣 任妹[1] 陈素婷 YANG Jian;ZHANG Yong;LIAO Jie(Department of Clinical Laboratory,Pingxiang People's hospital,Pingxiang 337000,China)

机构地区：[1]萍乡市人民医院检验科,337000 [2]萍乡市人民医院呼吸内科,337000

出　　处：《中国实用医药》2025年第3期10-14,共5页China Practical Medicine

基　　金：江西省卫生健康委科技计划项目(项目编号:202212195)。

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)急性加重期患者治疗前后硫氧还蛋白(Trx)的水平变化及意义。方法选取80例COPD急性加重期住院患者为COPD病例组,患者入院未采取治疗前(急性加重期)抽血检测Trx水平,经治疗后病情达稳定期出院时(稳定期)抽血再次检测Trx水平;另选取40例健康体检者为健康对照组。比较病例组不同时期和健康对照组的Trx、维生素C(VitC)和C反应蛋白(CRP)水平;分析COPD急性加重期Trx与VitC、CRP的相关性,住院天数的影响因素,单独Trx检测及Trx联合VitC、CRP检测对COPD急性加重期的诊断效能。结果病例组急性加重期Trx水平为(28.213±5.170)ng/ml、VitC水平为(27.112±4.000)μmol/L、CRP水平为(41.855±44.635)mg/L,稳定期Trx水平为(16.447±2.943)ng/ml、VitC水平为(44.450±5.512)μmol/L、CRP水平为(8.880±14.696)mg/L;健康对照组Trx水平为(7.665±0.346)ng/ml、VitC水平为(46.975±6.930)μmol/L、CRP水平为(1.806±0.202)mg/L。与健康对照组比较,病例组稳定期Trx、CRP水平升高,VitC水平降低(P<0.05);与急性加重期比较,病例组稳定期Trx、CRP水平降低,VitC水平升高(P<0.05)。多因素Logistic回归分析显示:Trx、VitC、CRP水平和年龄为住院天数的影响因素(P<0.05)。Pearson相关性分析显示:病例组急性加重期Trx与VitC呈负相关,与CRP呈正相关(r=-0.777、0.783,P<0.05)。绘制受试者工作特征曲线(ROC曲线),单独Trx检测的曲线下面积(AUC)为0.931,Trx联合VitC、CRP检测的AUC为0.947,联合检测对COPD急性加重期的诊断效能较高。结论COPD急性加重期患者Trx和炎症因子CRP高表达,VitC低表达;Trx与CRP、VitC水平密切相关,Trx水平高低能够反映COPD患者的氧化应激和炎症情况,可作为双重生物学指标用于COPD患者病情评估和疗效判断中,临床应用价值高。Objective To investigate the changes of thioredoxin(Trx)levels in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)before and after treatment.Methods 80 patients with acute exacerbation of COPD who were hospitalized were selected as the case group,the patient's blood was drawn to test for Trx levels before treatment(acute exacerbation stage)upon admission,and Trx level was detected again at discharge(stable stage)when the condition was stable after treatment.Besides,another 40 healthy people with physical examination were selected as the healthy control group.Comparison of levels of Trx,vitamin C(VitC)and C-reactive protein(CRP)between the case group at different periods and the healthy control group;analysis of the correlation of Trx with VitC and CRP in acute exacerbation of COPD,the factors influencing the length of hospital stay,and the diagnostic efficiency of the Trx alone or Trx combined with VitC and CRP for acute exacerbation of COPD.Results In the case group,the levels of Trx,VitC and CRP were(28.213±5.170)ng/ml,(27.112±4.000)μmol/L and(41.855±44.635)mg/L at acute exacerbation stage,and(16.447±2.943)ng/ml,(44.450±5.512)μmol/L and(8.880±14.696)mg/L at stable stage.The levels of Trx,VitC and CRP in healthy control group were(7.665±0.346)ng/ml,(46.975±6.930)μmol/L and(1.806±0.202)mg/L.Compared with the healthy control group,the levels of Trx and CRP were increased and the level of VitC was decreased in the case group(P<0.05).Compared with acute exacerbation stage,the levels of Trx and CRP were decreased,and VitC level was increased at stable stage in the case group(P<0.05).Multivariate Logistic regression analysis showed that Trx,VitC,CRP levels and age were the influencing factors of hospitalization days(P<0.05).Pearson correlation analysis showed that Trx at acute exacerbation stage was negatively correlated with VitC and positively correlated with CRP in the cases group(r=-0.777,0.783;P<0.05).Receiver operating characteristic(ROC)curve was plotted,and the area u

关 键 词：慢性阻塞性肺疾病 急性加重期 硫氧还蛋白 氧化应激 炎症反应 检测价值 

分 类 号：R563.9[医药卫生—呼吸系统]