外周血中胸腺活化调节趋化因子17与老年慢性阻塞性肺疾病病人肺功能快速下降的相关性

doi:10.3969/j.issn.1003-9198.2022.03.013

摘要/Abstract

摘要： 目的探讨老年COPD病人血清胸腺活化调节趋化因子17(CCL17)水平与FEV1快速下降的相关性。方法纳入2018年8月至2019年12月间我院收治的203例COPD稳定期病人作为研究对象,根据随访1年后FEV1下降情况分为快速下降组和对照组。比较2组入组时基线资料,分析CCL17与随访1年FEV1变化值(ΔFEV1)的相关性,采用Logistic回归分析肺功能快速下降的相关因素。结果快速下降组急性加重次数及血清淀粉样蛋白A(SAA)、CCL17、FPG水平均高于对照组,BMI低于对照组(均P<0.01),2组吸烟状态比例构成差异有统计学意义(P<0.05);CCL17与ΔFEV1呈正相关(r=0.525,P<0.001)。多因素Logistic回归分析显示:SAA、CCL17、吸烟状态为病人肺功能快速下降的独立危险因素,BMI为独立保护因素;CCL17预测老年COPD病人随访1年后发生肺功能快速下降的最佳截点为364.04 pg/mL,AUC为0.876,诊断灵敏度为80.00%。结论老年COPD病人血清CCL17水平与肺功能变化相关,检测CCL17水平或有助于预测病人预后。

关键词: 慢性阻塞性肺疾病, 胸腺活化调节趋化因子17, 肺功能, 第1秒用力呼气容积

Abstract: Objective To explore the correlation between the serum level of thymus and activation-regulated chemokine/CC chemokine ligand 17(CCL17) and the rapid decline of forced expiratory volume in one second (FEV1) in the elderly patients with chronic obstructive pulmonary disease (COPD). Methods A total of 203 patients with stable COPD treated in our hospital from August 2018 to December 2019 were enrolled in this study, and the patients were divided into rapid decline group and control group according to FEV1 variation within 1 year of follow up. The basic data of two groups were compared,and the relationship between CCL17 and FEV1 variation within 1 year of follow up(ΔFEV1) was analyzed. Multivariate Logistic regression was performed to analyze the related factors of rapid decline of lung function. Results The frequency of acute exacerbation,the serum levels of amyloid A (SAA),CCL17 and fasting plasma glucose (FPG) in the rapid decline group were higher than those in the control group,and the level of body mass index (BMI) in the rapid decline group was lower than that in the control group(all P<0.05). CCL17 was positively correlated with ΔFEV1 (r=0.525,P<0.001). Multivariate Logistic regression showed that SAA,CCL17 and smoking were the independent risk factors of rapid decline in lung function, and BMI was the independent protective factor. The cut-off value of CCL17 to predict rapid decline of lung function in the elderly COPD patients was 364.04 pg/mL,with an AUC of 0.876,with a sensitivity of 80.00%. Conclusions Serum CCL17 level is related to lung function variation in the elderly patients with COPD,and detecting serum CCL17 may bring benefits to predict the patients’ prognosis.

Key words: chronic obstructive pulmonary disease, thymus and activation-regulated chemokine/CC chemokine ligand 17, lung function, forced expiratory volume in one second

中图分类号:

R 563

王永胜, 李东旭, 孟宪伟, 王培培, 赵瑞雪. 外周血中胸腺活化调节趋化因子17与老年慢性阻塞性肺疾病病人肺功能快速下降的相关性[J]. 实用老年医学, 2022, 36(3): 265-268.

WANG Yong-sheng, LI Dong-xu, MENG Xian-wei, WANG Pei-pei, ZHAO Rui-xue. Correlation between serum level of thymus and activation-regulated chemokine 17 and rapid decline of lung function in elderly patients with chronic obstructive pulmonary disease[J]. Practical Geriatrics, 2022, 36(3): 265-268.

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