慢性阻塞性肺炎患者血气结果、IL-17及8-异前列腺素对MoCA评分及急性加重的临床评估价值  

Blood gas results,IL-17 and 8-iso-pgf in patients with COPD The clinical evaluation value of(2α)for MOCA score and acute exacerbation

作　　者：章勇 李静 ZHANGYong;LIjing(Department of Clinical Laboratory Medicine,Lianyungang East Hospital,Kangda College of Nanjing Medical University,Jiangsu Lianyungang 222042)

机构地区：[1]南京医科大学康达学院附属连云港东方医院检验科,江苏连云港222042 [2]南京医科大学康达学院附属连云港东方医院呼吸与危重症医学科,江苏连云港222042

出　　处：《医学检验与临床》2025年第1期34-38,共5页Medical Laboratory Science and Clinics

摘　　要：目的:探究慢性阻塞性肺疾病(COPD)患者血气结果、IL-17及8-异前列腺素(8-iso-prostaglandin-F_(2α),8-iso-PGF_(2α))对急性加重的临床评估价值,及与MoCA评分相关性。方法:研究选取93例COPD患者,其中急性加重组51例、稳定期组42例;同时选取50例健康体检者作为对照组;分别测定各组8-iso-PGF_(2α)、IL-17及血气结果(PaO_(2)、PaCO),分析其对急性加重的评估价值。根据蒙特利尔认知评估,(Montreal Cognitive Assessment,MoCA)量表评分进行分组,MoCA<26分为认知障碍组43例,MoCA评分≥26分为认知正常组50例,统计两组8-iso-PGF_(2α)、IL-17及血气指标,分析各指标与MoCA评分相关性。结果:对照组健康人群IL-17、8-iso-PGF_(2α)、PaCO_(2)低于COPD稳定期组与急性加重组(P<0.05);而对照组PaO_(2)高于稳定期组、高于急性加重组(P<0.05);COPD组内对比,急性加重组患者PaO_(2)低于稳定期组,而IL-17、8-iso-PGF_(2α)、PaCO_(2)指标高于稳定期组,差异显著(P<0.05)。与0.5(无效假设)比较,COPD急性加重患者PaO_(2)的预测分析,ROC曲线下面积0.879(95%CI:0.217~1.682)(P<0.05)。血气PaCO_(2)预测分析,ROC曲线下面积0.781(95%CI:0.077~1.934)(P<0.05)。血清8-iso-PGF2。水平预测分析ROC曲线下面积为0.801(95%CI:0.709~0.897)(P<0.05)。血清IL-17水平预测分析ROC曲线下面积为0.792(95%CI:0.665~0.878)(P<0.05)。认知正常组患者血清因子IL-17、8-iso-PGF2。低于认知障碍组患者(P<0.05);认知正常组患者血气PaO,高于障碍组,PaCO_(2)低于障碍组(P<0.05)。分析结果显示,COPD患者MoCA评分与IL-17、8-iso-PGF_(2α)、PaCO_(2)呈负相关(均P<0.001);而PaO,与COPD患者MoCA评分呈正相关。结论COPD患者发病及急性加重与血清IL-17、8-iso-PGF_(2α)及血气PaCO_(2)、PaO,指标存在相关性,可作为预测COPD急性加重评估的指标;而8-iso-PGF_(2α)、IL-17、PaCO_(2)与患者MoCA评分呈负相关,MoCA评分与PaO,正相关,说明以上指标可能与COPD患者认知功能受损�Objective:To investigate the blood gas results,IL-17,and 8-iso-prostaglandin-F2 levels in patients with chronic obstructive pulmonary disease(COPD)α,(8-iso-PGF_(2α))The clinical evaluation value of acute exacerbation and its correlation with MoCA score.Methods:93 COPD patients were selected for the study,including 51 cases in the acute plus recombinant group and 42 cases in the stable phase group;At the same time,50 healthy exaninees were selected as the control group;Measure 8-iso-PGF2 in each group separatelyα、Analyze the evaluation value of IL-17 and blood gas results(PaO_(2)PaCO)for acute exacerbation.According to the Montreal Cognitive Asssment(MoCA)score,43 cases were clasifed as cognitive impairment group with MoCA<26 points,and 50 cases were classified as cognitive normal group with MoCA score≥26 points.8-iso-PGF_(2α)was calculated for both groupsα、Analyze the correlation between IL-17 and blood gas indicators and MoCA score.Results:IL-17 and 8-iso-PGF_(2α)in the control group of healthy individualsα、PaCO_(2)was lower than that of the stable COPD group and acute plus recombination group(P<0.05);The control group had higher levels of PaO_(2)than the stable phase group and higher levels of acute plus recombination(P<0.05);Compared within the COPD group,PaO_(2)in acute plus recombinant patients was lower than that in the stable phase group,while IL-17 and 8-iso-PGF_(2α)were lowerα、The PaCO_(2)index was significantly higher than that of the stable period group(P<0.05).Compared with 0.5(null hypothesis),the predictive analysis of PaO_(2)in patients with acute exacerbation of COPD showed an area under the ROC curve of 0.879(95%CI:0.217~1.682)(P<0.05).Prediction analysis of blood gas PaCO_(2)showed an area under the ROC curve of 0.781(95%CI:0.077~1.934)(P<0.05):Serum 8-iso-PGF_(2α)The area under the ROC curve for horizontal prediction analysis is 0.801(95%CI:0.709~0.897)(P<0.05):The area under the ROC curve for predicting serum IL-17 levels was 0.792(95%CI:0.665~0.878)(P<0.05).Serum factors I

关 键 词：急性加重 COPD 血气结果 IL-17 8-ISO-PGF2Α 

分 类 号：R563.1[医药卫生—呼吸系统]