外周血CXCL9、CX3CR1在老年慢性阻塞性肺疾病相关肺动脉高压病人中的表达水平及临床价值

doi:10.3969/j.issn.1003-9198.2025.04.015

Abstract

Abstract: Objective To investigate the expression and clinical significance of peripheral blood C-X-C motif chemokine ligand 9 (CXCL9) and C-X3-C motif chemokine receptor 1 (CX3CR1) in the elderly patients with chronic obstructive pulmonary disease (COPD)-related pulmonary hypertension (PH). Methods A total of 177 elderly patients with COPD-related PH treated at Xingtai Central Hospital from January 2021 to February 2023 were enrolled in this prospective study. The patients were divided into mild group(21 cases), moderate group(51 cases), severe group(84 cases) and very severe group(21 cases) according to pulmonary function classification, and were divided into poor prognosis group (81 cases) and good prognosis group(96 cases) based on one-year outcomes. The levels of peripheral blood CXCL9 and CX3CR1 were measured using enzyme-linked immunosorbent assay. A multivariate unconditional logistic regression model was applied to identify risk factors for poor prognosis in the elderly COPD-related PH patients, and receiver operating characteristic (ROC) curve was used to assess the predictive value of peripheral blood CXCL9 and CX3CR1 for poor prognosis. Results The levels of peripheral blood CXCL9 and CX3CR1 increased progressively from mild group to very severe group (P＜0.05). After a one year of follow-up, the incidence rate of poor prognosis was 45.76% (81/177). Elevated levels of N-terminal pro-B-type natriuretic peptide, CXCL9 and CX3CR1 were independent risk factors for poor prognosis in the elderly patients with COPD-related PH, while longer 6-minute walk distance (6MWD) and higher cardiac index were independent protective factors (P＜0.05). The area under the curve (AUC) of combined CXCL9 and CX3CR1 for predicting poor prognosis in the elderly patients with COPD-related PH was 0.897 (95%CI: 0.843-0.938), which was higher than that of CXCL9 (0.796, 95%CI: 0.729-0.853) or CX3CR1 (0.785, 95%CI: 0.717-0.843) alone. Conclusions Elevated peripheral blood CXCL9 and CX3CR1 levels in the elderly patients with COPD-related PH are closely associated with reduced lung function and poor prognosis. Combined measurement of peripheral blood CXCL9 and CX3CR1 has a high predictive value for poor prognosis in the elderly patients with COPD-related PH.

Key words: aged, chronic obstructive pulmonary disease, pulmonary hypertension, C-X-C motif chemokine ligand 9, C-X3-C motif chemokine receptor 1

CLC Number:

R 563.5

LI Junxian, WANG Jinguo, LI hui, JIA Liqian. Expression and clinical value of peripheral blood CXCL9 and CX3CR1 in elderly patients with pulmonary hypertension related to chronic obstructive pulmonary disease[J]. Practical Geriatrics, 2025, 39(4): 395-400.

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Expression and clinical value of peripheral blood CXCL9 and CX3CR1 in elderly patients with pulmonary hypertension related to chronic obstructive pulmonary disease

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