hs-CRP、IL-6和纤维蛋白原与AECOPD合并T2DM患者病情程度的相关性

Correlation on hs-CRP,IL-6,fibrinogen,and the severity of AECOPD patients with T2DM

目的研究超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)和纤维蛋白原与慢性阻塞性肺疾病急性加重(AECOPD)合并2型糖尿病(T2DM)患者病情程度的相关性。方法本研究为病例对照研究。采用非随机抽样法收集2020年6月至2022年6月上海市奉贤区中心医院呼吸科收治的AECOPD患者161例,按照入院诊断是否合并T2DM分为单纯AECOPD组104例和合并T2DM组57例。收集患者的一般临床资料和入院时检验指标数据。采用酶联免疫吸附试验测定患者血清IL-6水平。采用Pearson法分析患者hs-CRP、IL-6和纤维蛋白原水平与患者动脉血氧分压(PaO_(2))、动脉血二氧化碳分压、空腹血糖、糖化血红蛋白、住院天数及住院费用的相关性。采用二元logistic回归分析影响合并T2DM组患者预后的危险因素。结果与单纯AECOPD组比较,合并T2DM组患者hs-CRP[117.50(68.54,147.95)mg/L比91.27(50.50,122.20)mg/L)]、IL-6[(132.43±45.00)ng/L比(90.40±42.03)ng/L)]和纤维蛋白原[(4.31±1.60)g/L比(3.76±1.40)g/L)]水平均升高(t值分别为2.50、5.80、2.23,均P<0.05)。单纯AECOPD组患者hs-CRP水平与PaO_(2)呈负相关(r=-0.22,P=0.023),纤维蛋白原水平与糖化血红蛋白呈正相关(r=0.20,P=0.047);合并T2DM组患者hs-CRP、IL-6和纤维蛋白原水平与PaO_(2)均呈负相关(均P<0.05),与住院天数和住院费用均呈正相关(均P<0.05)。年龄和hs-CRP为合并T2DM组患者预后不良的危险因素(OR值分别为1.11和1.01,均P<0.05)。结论hs-CRP、IL-6和纤维蛋白原水平可以反映AECOPD合并T2DM患者病情严重程度和预后情况,从而为制定针对性治疗方案提供参考。

Objective To study the correlation between hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),fibrinogen,and the severity of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in patients with type 2 diabetes(T2DM).Methods This was a case-control study.Non-random sampling method was used to include 161 patients with AECOPD admitted to the respiratory department of Shanghai Fengxian Central Hospital from June 2020 to June 2022.The patients were divided into two groups:the pure AECOPD group,which included 104 cases without T2DM,and AECOPD combined with T2DM group,which included 57 cases with T2DM.General clinical data and admission laboratory indicators were collected.Enzyme-linked immunosorbent assay was used to measure the serum level of IL-6.Pearson′s correlation analysis was used to analyze the correlation between hs-CRP,IL-6,fibrinogen levels,and patients′PaO_(2),PaCO_(2),fasting blood glucose,glycated hemoglobin,length of hospital stay,and hospitalization costs.Binary logistic regression analysis was used to identify the risk factors that affect the prognosis of AECOPD patients combined with T2DM.Results Compared with the pure AECOPD group,the levels of hs-CRP(117.50[68.54,147.95]mg/L vs 91.27[50.50,122.20]mg/L),IL-6([132.43±45.00]ng/L vs[90.40±42.03]ng/L),and fibrinogen([4.31±1.60]g/L vs[3.76±1.40]g/L)in the patients of AECOPD combined with T2DM group were increased(t values were 2.50,5.80,and 2.23,respectively,all P<0.05).In the pure AECOPD group,the level of hs-CRP was negatively correlated with PaO_(2)(r=-0.22,P=0.023),and the level of fibrinogen was positively correlated with glycated hemoglobin(r=0.20,P=0.047).In the AECOPD combined T2DM group,the levels of hs-CRP,IL-6,and fibrinogen were negatively correlated with PaO_(2)(all P<0.05),and positively correlated with length of hospital stay and hospitalization cost(all P<0.05).Age and hs-CRP were risk factors for poor prognosis in the AECOPD combined T2DM group(OR values were 1.11 and 1.01,respectively,both P<0.05).Conclusions The levels of hs-CRP,IL-6,and fibrinogen can reflect the severity and prognosis of AECOPD patients with T2DM,thus it can provide reference for the formulation of targeted treatment.