支气管哮喘患者血清sCD74、LBP水平与急性发作的关系  

Serum sCD74 and LBP levels and their relationship with acute exacerbation in patients with bronchial asthma

作　　者：陈娣 刘元明[1] 何正平[1] 李琳雪 涂涛[2] 党垚 文璐 Chen Di;Liu Yuanming;He Zhengping;Li Linxue;Tu Tao;Dang Yao;Wen Lu(Department of Respiratory and Critical Care Medicine,Pengzhou People's Hospital,Chengdu 611930,China;Department of Anesthesiology,The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]四川省彭州市人民医院呼吸与危重症医学科,成都611930 [2]成都医学院第一附属医院麻醉科,成都610500

出　　处：《保健医学研究与实践》2024年第12期50-55,共6页Health Medicine Research and Practice

基　　金：四川省医学青年创新科研课题计划项目(Q20031)。

摘　　要：目的探讨支气管哮喘患者血清可溶性CD74(sCD74)、脂多糖结合蛋白(LBP)水平与急性发作的关系,以期为临床决策的制定提供参考。方法选取2021年1月—2023年12月四川某医院收治的74例支气管哮喘急性发作期患者(急性组)和46例支气管哮喘缓解期患者(缓解组),以及同期60例健康体检者(对照组)作为研究对象。检测所有研究对象入院时的血清sCD74、LBP水平,分析急性发作期患者血清sCD74、LBP与肺功能指标[第一秒用力呼气量与用力肺活量比值(FEV_(1)/FVC)、最大呼气流量占预计值百分比(PEF%pred)]的相关性,采用多因素logistic回归分析支气管哮喘急性发作的影响因素,并采用受试者工作特征(ROC)曲线评价血清sCD74、LBP对支气管哮喘急性发作的评估价值。结果3组研究对象sCD74、LBP水平及FEV_(1)/FVC、PEF%pred比较,差异均有统计学意义(P<0.05)。两两比较结果显示,急性组患者血清sCD74、LBP水平高于缓解组和对照组,缓解组高于对照组,差异有统计学意义(P<0.05);对照组患者FEV_(1)/FVC、PEF%pred均高于缓解组和急性组,缓解组高于急性组,差异有统计学意义(P<0.05)。不同病情严重程度的患者血清sCD74、LBP水平比较,差异有统计学意义(P<0.05)。两两比较结果显示,随着病情加重,患者血清sCD74、LBP水平逐渐升高,差异有统计学意义(P<0.05)。相关分析结果显示,急性组患者血清sCD74、LBP与FEV_(1)/FVC、PEF%pred均呈负相关(P<0.05)。以支气管哮喘患者是否急性发作作为因变量,以FEV_(1)/FVC、PEF%pred、血清sCD74、LBP作为自变量进行多因素logistic回归分析,结果显示,FEV_(1)/FVC越高(OR=0.613)、PEF%pred越高(OR=0.597),支气管哮喘患者急性发作的风险越小,而血清sCD74水平越高(OR=2.787)、血清LBP水平越高(OR=3.846),支气管哮喘患者急性发作的风险越大(P<0.05)。血清sCD74、LBP以及二者联合评估支气管哮喘患者急性发作的曲线下面积(AUC)(95%CObjective To explore the relationship between serum soluble CD74(sCD74)and lipopolysaccharide binding protein(LBP)levels and acute exacerbation in patients with bronchial asthma,aiming to provide a reference for clinical decision-mak-ing.Methods A total of 74 patients with acute exacerbation of bronchial asthma(acute group)and 46 patients with stable bronchial asthma(remission group),as well as 60 healthy individuals(control group),were selected as research participants from a hospital in Sichuan between January 2021 and December 2023.Serum levels of sCD74 and LBP were measured upon ad-mission for all participants.The correlation between serum sCD74,LBP,and pulmonary function indicators[ratio of forced expiratory volume in 1 second to forced vital capacity(FEV_(1)/FVC)and peak expiratory flow percentage of predicted value(PEF%pred)]in the acute group was analyzed.Multivariate logistic regression analysis was conducted to identify the influen-cing factors of acute exacerbation in bronchial asthma,and receiver operating characteristic(ROC)curves were used to evaluate the assessment value of serum sCD74 and LBP in acute exacerbation of bronchial asthma.Results Significant differences were observed in serum levels of sCD74,LBP,and FEV_(1)/FVC,PEF%pred among the three groups(P<0.05).Pairwise compari-sons showed that serum sCD74 and LBP levels were higher in the acute group than in the remission and control groups,and higher in the remission group than in the control group,with statistically significant differences(P<0.05).The FEV_(1)/FVC and PEF%pred values in the control group were higher than those in the remission and acute groups,and higher in the remis-sion group than in the acute group,with statistically significant differences(P<0.05).A comparison of serum sCD74 and LBP levels among patients with different severities of disease showed statistically significant differences(P<0.05).Pairwise comparisons indicated that with the progression of the disease,serum levels of sCD74 and LBP gradually increased,with statis

关 键 词：支气管哮喘 急性发作期 可溶性CD74 脂多糖结合蛋白 

分 类 号：R562.25[医药卫生—呼吸系统]