骨膜蛋白在慢性阻塞性肺病急性加重期的表达及诊断意义

Expression of periostin in acute exacerbation of chronic obstructive pulmonary disease and its diagnostic significance

目的探讨骨膜蛋白在慢性阻塞性肺病急性加重期(AECOPD)中的表达及其诊断意义。方法选取2017年2月-11月就诊于徐州医科大学附属医院呼吸内科的AECOPD患者62例作为AECOPD组,慢性阻塞性肺病稳定期(SCOPD)患者35例作为SCOPD组,健康体检群众40例作为对照组。所有受试者完成统一的调查问卷、抽血及肺功能检查,对各临床资料进行分析比较。结果 3组患者吸烟量、白细胞计数、中性粒细胞计数、骨膜蛋白、FEV1/FVC、嗜酸性粒细胞计数、CAT和mMRC评分比较,差异有统计学意义(P <0.05),骨膜蛋白与嗜酸性粒细胞计数呈负相关(P <0.05),骨膜蛋白与CAT评分、mMRC评分无相关性(P>0.05)。骨膜蛋白联合中性粒细胞和CAT评分诊断AECOPD的ROC曲线下面积为0.930(95%CI:0.875,0.986),敏感性为0.887(95%CI:0.782,0.947);特异性为0.886(95%CI:0.735,0.961)。结论骨膜蛋白联合中性粒细胞和CAT评分可作为诊断AECOPD的指标。

Objective To observe the expression and diagnostic significance of periostin in acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods In this study 62 patients with AECOPD(AECOPD group)and 35 patients with stable chronic obstructive pulmonary disease(SCOPD group)who were hospitalized in our department from February to November of 2017 were randomly selected.At the same time,40 healthy patients were selected as a control group.All subjects completed uniform questionnaires and finished blood tests and lung function tests.The measured data were statistically analyzed.Results There were significant differences in smoking,white blood cell count,neutrophil count,periostin,FEV1/FVC,eosinophil count,CAT score and mMRC score among the three groups(P<0.05).Periostin was negatively correlated with eosinophil count(P<0.05),but not correlated with CAT score or mMRC score(P>0.05).The area under the ROC curve for diagnosis of AECOPD with periostin combined neutrophil count and CAT score was 0.930(95%CI:0.875,0.986),the sensitivity was 0.887(95%CI:0.782,0.947),the specificity was 0.886(95%CI:0.735,0.961).Conclusions Periostin combined with neutrophil and CAT score can be used as an indicator for the diagnosis of AECOPD.