血清胱抑素C对慢性阻塞性肺疾病急性加重风险的诊断价值

Diagnostic value of serum cystatin C level on acute exacerbation of chronic obstructive pulmonary disease

目的 探讨血清胱抑素C(Cys C)对慢性阻塞性肺病急性加重(AECOPD)风险的诊断意义.方法 202例(AECOPD)患者根据1a内急性加重事件的发生频率分为频繁加重组(加重次数≥2)和非频繁加重组(加重次数<2),比较两组血液学指标、肺通气功能等.采用受试者工作特征曲线(ROC)和ROC曲线下面积(AUC)分析血清Cys C水平对AECOPD的诊断效能.结果 与非频繁加重组比较,频繁加重组FVC值更低、血清Cys C水平更高(P<0.01或0.05).CysC诊断AECOPD特异度、敏感度及AUC分别为70.7%、66.3%、0.707.Cys C为0.775 mg/L是区分患者频繁加重与否的最佳临界值.结论 血清Cys C水平可能对评估AECOPD具有潜在价值.

Objective To investigate the diagnostic significance of serum cystatin C(Cys C) level in acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods Based on frequency of acute exacerbation during 1 year, 202 AECOPD patients were divided into frequent exacerbation(frequency ≥ 2) and infrequent exacerbation(frequency <2) groups. Hematological indexes and pulmonary ventilation function were compared between two groups. The diagnostic efficacy of serum Cys C level for AECOPD was evaluated using receiver operating characteristic curve(ROC) and area under ROC curve(AUC). Results Compared with infrequent exacerbation group, forced vital capacity(FVC) was lower, while serum Cys C content was higher in frequent exacerbation group(P<0.01 or 0.05). The specificity, sensitivity and AUC of Cys C were 70.7%, 66.3% and 0.707 for AECOPD diagnosis, respectively. The optimal cut-off value of Cys C was 0.775 mg/L to delimit exacerbation frequency. Conclusion Serum Cys C level may have a potential value on evaluating the risk of AECOPD.