NE、IFN-γ、α1-AT水平及Treg/Th17对AECOPD患者并发呼吸衰竭的预测价值  

The predictive value of NE,IFN-γ,α1-AT levels and Treg/Th17 immune imbalance in patients with AECOPD complicated with respiratory failure

作　　者：于营[1] 卢冬喜[1] 赵婧 YU Ying;LU Dongxi;ZHAO Jing(Infectious diseases Department of Qinhuangdao First Hospital,Qinhuangdao,Hebei,China,066000)

机构地区：[1]秦皇岛市第一医院感染性疾病科,河北秦皇岛066000

出　　处：《分子诊断与治疗杂志》2025年第2期383-386,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河北省医学科学研究课题计划项目(20221618)。

摘　　要：目的研究中性粒细胞弹性蛋白酶(NE)、干扰素-γ(IFN-γ)、α1-抗胰蛋白酶(α1-AT)及调节性T细胞(Treg)/辅助性T细胞17(Th17)对慢性阻塞性肺疾病急性加重期(AECOPD)患者并发呼吸衰竭(RF)的预测价值。方法选取2019年10月-2022年12月秦皇岛市第一医院收治的160例AECOPD患者资料,将其按照是否并发RF分作RF组53例及无RF组107例。比较两组NE、IFN-γ、α1-AT及Treg/Th17以及各项临床资料。采用多因素Logistic回归分析AECOPD患者并发RF影响因素。采用受试者工作特征(ROC)曲线分析上述各项指标预测AECOPD患者并发RF的效能。结果RF组外周血NE、IFN-γ及α1-AT水平均高于无RF组,Treg/Th17低于无RF组,差异有统计学意义(均P<0.05)。RF组FEV1%预计值低于无RF组,差异有统计学意义(P<0.05)。经多因素Logistic回归分析证实:NE、IFN-γ、α1-AT升高均是AECOPD患者并发RF的危险因素,Treg/Th17、FEV1%预计值升高为AECOPD患者并发RF的保护性因素(均P<0.05)。经ROC曲线分析发现,NE、IFN-γ、α1-AT及Treg/Th17联合预测AECOPD患者并发RF的效能优于上述四项指标单独预测,差异有统计学意义(均P<0.05)。结论NE、IFN-γ、α1-AT水平升高及Treg/Th17降低会导致AECOPD患者并发RF的风险增加。Objective To investigate the predictive value of neutrophil elastase(NE),interferon-γ(IFN-γ),α1-antitrypsin(α1-AT)and regulatory T cells(Treg)/helper T cell 17(Th17)in respiratory failure(RF)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods The data of 160 AECOPD patients admitted to the First Hospital of Qinhuangdao City from October 2019 to December 2022 were selected and divided into the RF group(53 cases)and the non-RF group(107 cases)based on whether they were complicated with RF.NE,IFN-γ,α1-AT,Treg/Th17,and clinical data of the two groups were compared.Multivariate logistic regression was used to analyze the influencing factors of RF in AECOPD patients.Receiver operating characteristic(ROC)curves were used to assess the efficacy of the above indicators in predicting RF in AECOPD patients.Results The levels of NE,IFN-γ,andα1-AT in the peripheral blood of the RF group were higher than those of the non-RF group,while Treg/Th17 levels were lower in the RF group compared to the non-RF group,with a statistical significant difference(P<0.05).The predicted value of FEV1%in the RF group was lower than that in the non-RF group,and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis confirmed that the increase of NE,IFN-γ,andα1-AT was a risk factor for RF in AECOPD patients,while the increase in Treg/Th17 and FEV1%was a protective factor for RF in AECOPD patients(P<0.05).ROC curve analysis showed that NE,IFN-γ,α1-AT,and Treg/Th17 combined predicted RF complications in AECOPD patients better than the individual indicators alone,and the difference was statistically significant(P<0.05).Conclusions Elevated levels of NE,IFN-γ,andα1-AT,along with a decrease in Treg/Th17 are associated with an increased risk of RF complications in AECOPD patients.

关 键 词：慢阻肺急性加重期 呼吸衰竭 嗜中性粒细胞弹性蛋白酶 干扰素-Γ Α1-抗胰蛋白酶 

分 类 号：R563.9[医药卫生—呼吸系统] R563.8[医药卫生—内科学]