CURB-65评分系统及血清炎症因子检测对慢性阻塞性肺疾病急性加重患者严重程度及预后评估价值

Value of CURB-65 scoring system and serum inflammatory factors test in accessing the severity and prognosis of AECOPD

目的探讨CURB-65评分系统及血清炎症因子检测对AECOPD患者严重程度及预后评估价值。方法选择2017年1月-2018年9月浙江省诸暨市人民医院收治的AECOPD患者80例为AECOPD组和COPD稳定期患者80例为COPD组,应用ABC-ELISA法测定IL-8、IL-6、TNF-α和IFN-γ,分析CURB-65评分及血清炎症因子表达水平与患者预后的相关性。结果AECOPD组患者血清IL-8、IL-6、TNF-α和IFN-γ表达水平均明显高于COPD组(P<0.05)。血清IL-8、IL-6、TNF-α和IFN-γ水平和CURB-65评分均呈正相关,相关系数分别为0.627、0.703、0.594、0.561。存活组的CURB-65评分在0分~1分的比例明显高于死亡组,而3分~5分的比例明显低于死亡组(P<0.05)。存活组患者入院时的血清IL-8、IL-10、TNF-α和IFN-γ表达水平均明显低于死亡组患者(P<0.05)。结论CURB-65评分系统及血清炎症因子检测在AECOPD患者的早期诊断、病情发展及预后评估中有着十分重要指导作用,两者结合,能为病情监测、治疗方案制定及预后评估提供重要的参考指标。

Objective To evaluate the severity and prognosis of AECOPD patients with CURB-65 scoring system and serum inflammatory cytokines.Methods From January 2017 to September 2018,80 cases of AECOPD patients admitted to Zhuji People's Hospital were selected as the AECOPD group and 80 cases of COPD stable stage patients were selected as the COPD group.Double-antibody sandwich enzyme-linked immunosorbent assay(ABC-ELISA)was used to determine interleukin-8(IL-8),inter-leukin-6(IL-6)and tumor necrosis factor-alpha(TNF-α),Interferon-γ(IFN-γ).CURB-65 score,serum inflammatory factor expression level and prognosis of patients in AECOPD group were analyzed.Results The serum levels of IL-8,IL-6,TNF-αand IFN-γwere significantly higher in the AECOPD group than that in the COPD group(P<0.05).The rate of 0-1 score in the survival group was significantly higher than that in the death group,and the rate of 3-5 score in the survival group was lower than that in the death group(P<0.05).The levels of serum IL-8,IL-6,TNF-αand IFN-γin the survival group were significantly lower than those in the death group(P<0.05).Conclusion CURB-65 scoring system and serum inflammatory factor detection play an important guiding role in the early diagnosis,disease development and prognosis assessment of AECOPD patients.The combination of the two can provide important reference indicators for disease monitoring,treatment plan formulation and prognosis assessment.