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王刚.血清CXCR4联合IL-17A可预测慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者的预后[J].内科急危重症杂志,2025,31(5):435-439
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| DOI：10.11768/nkjwzzzz20250508 |
| 中文关键词: 慢性阻塞性肺疾病 Ⅱ型呼吸衰竭 血清CXC趋化因子受体4 白细胞介素-17A 预后 |
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| 摘要点击次数: 18 |
| 全文下载次数: 22 |
| 中文摘要: |
| 摘要 目的：探究慢性阻塞性肺疾病（COPD）合并Ⅱ型呼吸衰竭患者血清CXC趋化因子受体4（CXCR4）、白细胞介素-17A（IL-17A）水平及其对预后的预测价值。方法：收集80例COPD合并Ⅱ型呼吸衰竭稳定期患者的临床资料，根据入院治疗28 d内临床症状是否缓解分为预后良好组（46例）和预后不良组（34例）。采用logistic回归分析影响COPD合并Ⅱ型呼吸衰竭患者预后不良的因素，Pearson法分析血清CXCR4、IL-17A与患者临床资料的相关性。 采用受试者工作特征（ROC）曲线分析血清CXCR4及IL-17A表达对COPD合并Ⅱ型呼吸衰竭患者预后不良的预测价值。结果：与预后良好组比较，预后不良组患者的呼吸频率增加，血清CXCR4及IL-17A表达上调，用力肺活量占预计值百分比（FVC% pred）、第1秒用力呼气容积占预计值百分比（FEV1% pred）降低（P均＜0.05）。呼吸频率增加、血清CXCR4、IL-17A表达增加、FVC% pred、FEV1% pred降低为患者预后不良的危险因素（P均＜0.05）。COPD合并Ⅱ型呼吸衰竭患者血清CXCR4、IL-17A水平与呼吸频率呈正相关，与FVC% pred、FEV1% pred呈负相关（P均＜0.05）。血清CXCR4、IL-17A联合预测COPD合并Ⅱ型呼吸衰竭患者预后不良的曲线下面积显著大于血清CXCR4（Z=2.097，P=0.036）、IL-17A（Z=2.250，P=0.024）单独预测。结论：血清CXCR4及IL-17A联合检测对COPD合并Ⅱ型呼吸衰竭患者预后有预测价值。 |
| 英文摘要: |
| Abstract Objective: To explore the serum levels of CXC chemokine receptor 4 (CXCR4) and interleukin-17A (IL-17A) in patients with chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure and the predictive value of prognosis. Methods: The clinical data of 80 patients with COPD complicated with type Ⅱ respiratory failure in stable stage were collected. According to whether the clinical symptoms were relieved within 28 days after admission, they were grouped into good prognosis group (46 cases) and poor prognosis group (34 cases). Logistic regression was used to analyze the influencing factors of poor prognosis in patients with COPD complicated with type Ⅱ respiratory failure. Pearson method was used to analyze the correlation between serum CXCR4 and IL-17A with clinical data of patients. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum CXCR4 and IL-17A expression in patients with COPD complicated with type Ⅱ respiratory failure. Results: Compared with the good prognosis group, the respiratory rate of the poor prognosis group increased, the expression of serum CXCR4 and IL-17A was up-regulated, and the forced vital capacity as a percentage of predicted value (FVC% pred) and forced expiratory volume in the first second as a percentage of predicted value (FEV1% pred) decreased (all P<0.05). Increased respiratory rate, increased expression of serum IL-17A and CXCR4, and decreased FVC% pred and FEV1% pred were risk factors for poor prognosis (all P< 0.05). The serum levels of CXCR4 and IL-17A in patients with COPD complicated with type Ⅱ respiratory failure were positively correlated with respiratory rate, and negatively correlated with FVC% pred and FEV1% pred (all P< 0.05). The area under the curve of serum CXCR4 and IL-17A in predicting the poor prognosis of patients with COPD complicated with type Ⅱ respiratory failure was greatly larger than that of serum CXCR4 (Z=2.097, P=0.036) and IL-17A (Z=2.250, P=0.024) alone. Conclusion: The combined detection of serum CXCR4 and IL-17A have predictive value for the prognosis of patients with COPD complicated with type Ⅱ respiratory failure. |
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