老年COPD急性加重期病人血清IL-33/sST2轴表达及其对预后的预测价值

doi:10.3969/j.issn.1003-9198.2024.10.017

摘要/Abstract

摘要： 目的研究老年COPD急性加重期(AECOPD)病人血清IL-33/可溶型生长刺激表达基因2蛋白(sST2)轴表达及其对预后的预测价值。方法选取2020年6月至2023年6月北京怀柔医院收治的138例老年AECOPD病人作为研究组,另选取本院同时期就诊的138例老年COPD稳定期病人作为对照组。比较2组病人血清IL-33、sST2、IL-4、IL-10水平,并进一步将研究组病人根据预后情况分为预后良好组和预后不良组进行分析。采用Logistic回归分析老年AECOPD病人预后不良的危险因素,绘制ROC曲线分析血清IL-33、sST2、IL-4、IL-10水平对老年AECOPD病人预后的预测价值。结果研究组血清IL-33、sST2水平高于对照组(P<0.05),IL-4、IL-10水平低于对照组(P<0.05)。研究组138例病人中9例(6.52%)失访,129例病人中30例(23.26%)预后不良。预后不良组血清IL-33、sST2水平及合并症个数≥2个占比高于预后良好组(P<0.05),病程长于预后良好组(P<0.01),IL-4、IL-10水平低于预后良好组(P<0.01)。Logistic回归分析结果显示,IL-33、sST2、病程、合并症个数≥2个均是老年AECOPD病人预后不良的独立危险因素(P<0.05),IL-4、IL-10是保护因素(P<0.05)。ROC曲线分析显示,血清IL-33、sST2、IL-4、IL-10水平联合检测预测老年AECOPD病人预后不良的AUC为0.864,均明显高于上述指标单独预测价值(P<0.05)。结论血清IL-33、sST2、IL-4、IL-10水平在老年AECOPD病人体内表达异常,与老年AECOPD病人预后关系密切,且上述指标联合检测对老年AECOPD病人预后不良的预测价值更高。

关键词: 老年人, 慢性阻塞性肺疾病, 急性加重期, 白细胞介素-33, 可溶型生长刺激表达基因2蛋白

Abstract: Objective To investigate the expression of serum interleukin-33 (IL-33)/soluble ST2 (sST2) axis in the elderly patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD) and its prognostic value. Methods A total of 138 elderly patients with AECOPD admitted to Beijing Huairou Hospital from June 2019 to June 2022 were enrolled in the study group, and 138 elderly patients with stable COPD admitted to our hospital during the same period were enrolled in the control group. The serum levels of IL-33, sST2, IL-4 and IL-10 were detected and compared between the two groups, and the patients in the study group were divided into good prognosis group and poor prognosis group. Logistic regression analysis was used to evaluate the risk factors affecting the prognosis of the elderly patients with AECOPD, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum IL-33, sST2, IL-4 and IL-10 levels for the prognosis of the elderly patients with AECOPD. Results The levels of IL-33 and sST2 in the study group were higher and the levels of IL-4 and IL-10 were lower in the study group than those in the control group (P<0.05). Among the 138 patients in the study group, 9 cases( 6.52%) were lost to follow-up. Among the 129 patients, 30 cases (23.26%) presented with poor prognosis. The levels of serum IL-33 and sST2, course of disease and proportion of complications number ≥2 in the poor prognosis group were higher than those in the good prognosis group (P<0.05), and the levels of IL-4 and IL-10 were lower than those in the good prognosis group (P<0.01). Logistic regression analysis showed that the levels of IL-33 and sST2, course of disease and complications number ≥2 were independent risk factors, and IL-4 and IL-10 were protective factors for poor prognosis in the elderly patients with AECOPD (P<0.05). ROC curve showed that the area under the curve of combined detection of serum IL-33, sST2, IL-4 and IL-10 predicting poor prognosis in the elderly patients with AECOPD was 0.864, which was higher than that of serum IL-33, sST2, IL-4 and IL-10 alone (P<0.05). Conclusions The abnormal expression of serum IL-33, sST2, IL-4 and IL-10 is closely related to the prognosis in the elderly patients with AECOPD, and the combined detection of these indicators has a higher predictive value for the poor prognosis of the elderly patients with AECOPD.

Key words: aged, chronic obstructive pulmonary disease, acute exacerbation stage, interleukin-33, soluble ST2

中图分类号:

R 563.9

雷万锋, 马秀红. 老年COPD急性加重期病人血清IL-33/sST2轴表达及其对预后的预测价值[J]. 实用老年医学, 2024, 38(10): 1044-1048.

LEI Wanfeng, MA Xiuhong. Study on expression of serum IL-33/sST2 axis in elderly patients with acute exacerbation of COPD and its predictive value for prognosis[J]. Practical Geriatrics, 2024, 38(10): 1044-1048.

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