血清Toll样受体4、氨基末端脑钠肽前体、甲壳质酶蛋白40水平与慢性阻塞性肺疾病患者急性加重期治疗预后的相关性  

Correlation between serum TLR4,NT-proBNP,YKL-40 levels and prognosis of patients with acute COPD exacerbation

作　　者：马南 周冰洁 张建银[3] MA Nan;ZHOU Bingjie;ZHANG Jianyin(Department of Respiratory and Critical Care Medicine,Binzhou People’s Hospital,Binzhou 256600,China;Department of Pediatrics,Binzhou People’s Hospital,Binzhou 256600,China;Department of Respiratory and Critical Care Medicine,Ningxia Hui Autonomous Region People’s Hospital,Yinchuan 750021,China)

机构地区：[1]滨州市人民医院呼吸与危重症医学科,山东滨州256600 [2]滨州市人民医院儿科,山东滨州256600 [3]宁夏回族自治区人民医院呼吸与危重症医学科,宁夏银川750021

出　　处：《陕西医学杂志》2025年第4期502-506,共5页Shaanxi Medical Journal

基　　金：山东省卫生健康委员会科研项目(2021KH-1266);山东省滨州市人民医院院级课题(LCYJZR202119)。

摘　　要：目的:探讨血清Toll样受体4(TLR4)、氨基末端脑钠肽前体(NT-proBNP)、甲壳质酶蛋白40(YKL-40)水平与慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗预后的相关性。方法:选取AECOPD患者142例为AECOPD组,另选92例同期健康体检者为对照组。比较两组受试者血清TLR4、NT-proBNP、YKL-40水平,多因素Logistic回归分析AECOPD患者预后不良的影响因素。结果:与对照组比较,AECOPD组患者血清TLR4、NT-proBNP、YKL-40水平升高(均P<0.05)。预后良好组与预后不良组比较,心力衰竭患者占比增加,血清TLR4、NT-proBNP、YKL-40水平升高(均P<0.05)。心力衰竭、高血清TLR4、NT-proBNP、YKL-40水平是AECOPD患者预后不良的危险因素(均P<0.05)。AECOPD患者血清TLR4、NT-proBNP、YKL-40水平均与患者预后不良呈正相关(均P>0.05)。结论:AECOPD患者血清TLR4、NT-proBNP、YKL-40水平显著升高,高血清TLR4、NT-proBNP、YKL-40水平是其预后不良的危险因素,且与患者预后不良呈正相关。Objective:To investigate the correlation between serum levels of Toll-like receptor 4(TLR4),amino-terminal brain natriuretic peptide precursor(NT-proBNP)and chitinase protein 40(YKL-40)and the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 142 patients with AECOPD were selected as AECOPD group,and 92 healthy subjects were selected as control group.Serum levels of TLR4,NT-proBNP and YKL-40 were compared between the two groups,and the influencing factors of poor prognosis in patients with AECOPD were analyzed by multivariate Logistic regression.Results:Compared with the control group,the levels of serum TLR4,NT-proBNP and YKL-40 in AECOPD group were significantly increased(P<0.05).Compared with the good prognosis group,the proportion of patients with heart failure,serum TLR4,NT-proBNP and YKL-40 levels in the poor prognosis group were significantly increased(all P<0.05).Heart failure,high serum TLR4,NT-proBNP,YKL-40 levels were the risk factors for poor prognosis in AECOPD patients(P<0.05).Serum levels of TLR4,NT-proBNP and YKL-40 in AECOPD patients were positively correlated with poor prognosis(P>0.05).Conclusion:Serum levels of TLR4,NT-proBNP and YKL-40 in AECOPD patients were significantly increased,and high serum levels of TLR4,NT-proBNP and YKL-40 were risk factors for poor prognosis,and were positively correlated with poor prognosis.

关 键 词：慢性阻塞性肺疾病急性加重期 TOLL样受体4 氨基末端脑钠肽前体 甲壳质酶蛋白40 预后 相关性 

分 类 号：R563.5[医药卫生—呼吸系统]