COPD缓解期患者血清PCT、IL-6、hs-CRP水平对急性加重的预测作用

发布时间：2018-04-17 06:40

本文选题：慢性阻塞性肺疾病 + 缓解期　；参考：《广东医学》2017年10期

【摘要】：目的探讨慢性阻塞性肺疾病(COPD)缓解期患者血清降钙素原(PCT)、白细胞介素-6(IL-6)、高敏C反应蛋白(hs-CRP)水平对急性加重的预测作用。方法连续选取缓解期COPD患者98例为观察组,以同期健康查体志愿者30例为对照组。检测比较两组入选次日血清PCT、IL-6、hs-CRP水平和肺功能指标,分析COPD缓解期患者血清PCT、IL-6、hs-CRP水平与肺功能指标[第1秒用力呼出量(FEV1)、用力肺活量(FVC)]及随访1年急性加重发生率的关系,以及血清PCT、IL-6、hs-CRP单独和联合检测预测COPD急性加重的价值。结果与对照组比较,观察组患者缓解期血清PCT、IL-6、hs-CRP水平均升高,同期FEV1、FVC等肺功能指标则降低(P0.05)。观察组急性加重发生率、首次急性加重时间和随访1年急性加重次数分别为88.78%(87/98)、(6.63±2.18)个月和(2.26±0.87)次。与随访1年内无急性加重患者比较,随访1年内急性加重COPD患者的血清PCT、IL-6、hs-CRP水平均升高,同期FEV1、FVC等肺功能指标则降低(P0.05)。Spearman相关法分析结果显示,COPD缓解期患者血清PCT、IL-6、hs-CRP水平与其FEV1、FVC均呈负相关(PCT:r=-0.856,-0.848;IL-6:r=-0.822,-0.878;hs-CRP:r=-0.898,-0.916,P0.05),与其随访1年急性加重发生率则呈正相关(r=0.874、0.765、0.773,P0.05)。ROC曲线分析结果显示,COPD缓解期患者血清PCT、IL-6、hs-CRP水平单独和联合预测其急性加重的敏感度和准确性均较高,其中以COPD缓解期血清PCT、IL-6、hs-CRP联合预测其急性加重的敏感度和准确性最高。结论 COPD缓解期患者血清PCT、IL-6、hs-CRP水平对急性加重的预测价值良好,这可能与PCT、IL-6、hs-CRP作为炎症因子参与可影响COPD发生发展的炎症反应相关。缓解期血清PCT、IL-6、hs-CRP可能作为COPD急性加重评估的参考指标。
[Abstract]:Objective to investigate the predictive effect of serum procalcitonin (PCT), interleukin-6 (IL-6) and Gao Min C-reactive protein (Gao Min) on acute exacerbation in patients with chronic obstructive pulmonary disease (COPD) in remission stage.Methods 98 patients with COPD in remission period were selected as observation group and 30 healthy volunteers as control group.The serum levels of IL-6 hs-CRP and pulmonary function were measured and compared between the two groups in the next day, and the relationship between the serum levels of IL-6 hs-CRP and pulmonary function [forced exhalation volume (FEV1), forced vital capacity (FVC)] and the incidence of acute exacerbation in one year were analyzed.And the value of serum PCT-6-hs-CRP in predicting acute exacerbation of COPD.Results compared with the control group, the serum levels of IL-6 hs-CRP in the patients in the observation group were increased in the remission period, while the pulmonary function indexes such as FEV1 and FVC were decreased in the same period (P 0.05).The incidence of acute aggravation in the observation group, the first acute exacerbation time and the acute exacerbation times of one year follow up were 88.78 / 87 / 98 and 6.63 卤2.18 months and 2.26 卤0.87 respectively.The serum levels of IL-6 hs-CRP in patients with acute exacerbation of COPD were higher than those in patients without acute exacerbation during one year follow-up.At the same time, the pulmonary function indexes such as FEV1 / FVC decreased P0.05N. Spearman correlation analysis showed that the level of serum PCTr-6hs-CRP in patients with COPD in remission stage was negatively correlated with their FEV1 FVC. The results showed that the level of IL-6IL-6r-0.8222r-0.878hs-CRPr-0.898hs-CRPr-0.916 was positively correlated with the incidence of acute exacerbation of COPD in one year. The results of ROC curve analysis showed that there was a positive correlation between the incidence of acute exacerbation and the incidence of acute exacerbation in one year. The results of ROC curve analysis showed that the level of IL-6IL-6r-0.82222 -0.878hs-CRPr-0.916 was positively correlated with the incidence of acute exacerbation in one year.The sensitivity and accuracy of predicting acute aggravation in patients with remission stage were higher than those in patients with remission stage.The sensitivity and accuracy of predicting acute aggravation in patients with acute aggravation were the highest in patients with COPD.Conclusion the level of IL-6hs-CRP in patients with COPD in remission stage is a good predictor of acute aggravation, which may be related to the involvement of IL-6hs-CRP as an inflammatory factor in the development of COPD.Serum PCT-6 hs-CRP in remission stage may be used as a reference index for acute exacerbation of COPD.
【作者单位】：四川省医学科学院四川省人民医院呼吸内科;
【基金】：四川省卫生和计划生育委员会基金项目(编号:110137)
【分类号】：R563.9

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