慢性阻塞性肺疾病并发感染患者PSGL-1和 IL-6与ANXA1的表达

Expression of PSGL-1,IL-6 and ANXA1 in chronic obstructive pulmonary disease patients complicated with infection

目的研究慢性阻塞性肺疾病(COPD)并发感染患者P选择素糖蛋白配体1(PSGL-1)、白介素-6(IL-6)、膜联蛋白A1(ANXA1)的临床价值。方法选取2017年5月-2019年4月新乡市中心医院收治的COPD患者(COPD组)及COPD合并感染患者(COPD并发感染组)各51例,选取同期体检中心51名健康体检者作为对照组,比较各组、不同COPD分级并发感染患者、不同病原体COPD并发感染患者PSGL-1、IL-6、ANXA1水平,绘制PSGL-1、IL-6、ANXA1接受者操作特性曲线(ROC),分析PSGL-1、IL-6、ANXA1预测COPD并发感染敏感度、特异度,采用Pearson分析PSGL-1、IL-6、ANXA1与第一秒用力呼气量(FEV_1)占预计值百分比(FEV_1%pred)、FEV_1/用力肺活量(FVC)相关性。结果对照组、COPD组、COPD并发感染组PSGL-1、IL-6、ANXA1水平依次递增(P<0.05);ANXA1预测COPD并发感染ROC曲线下面积(AUC)为0.872,高于PSGL-1的0.740、IL-6的0.807,ANXA1截断值为>2.859 ng/L,敏感度为74.51%,特异度为86.27%;Ⅲ+Ⅳ级COPD分级并发感染患者FEV_1%pred、FEV_1/FVC低于Ⅰ+Ⅱ级,PSGL-1、IL-6、ANXA1高于Ⅰ+Ⅱ级(P<0.05);PSGL-1、IL-6与FEV_1%pred、FEV_1/FVC呈负相关性(P<0.05);ANXA1与FEV_1%pred、FEV_1/FVC无相关性;细菌感染者PSGL-1、IL-6水平高于支原体、病毒感染者(P<0.05);病毒感染者ANXA1水平高于细菌、支原体感染者(P<0.05)。结论检测血清PSGL-1、IL-6、ANXA1表达,可用于预测COPD并发感染发生风险,且PSGL-1、IL-6与FEV_1%pred、FEV_1/FVC呈负相关性,有助于评估患者病情严重程度,ANXA1可用于病毒感染区分鉴别,PSGL-1、IL-6可用于细菌感染区分鉴别。

OBJECTIVE To explore the clinical value of P-selectin glycoprotein ligand 1(PSGL-1),interleukin-6(IL-6)and annexin A1(ANXA1)in chronic obstructive pulmonary disease(COPD)patients complicated with infection.METHODS Totally 51 COPD patients(the COPD group)and 51 COPD patients complicated with infection(the COPD concurrent infection group)who were treated in Xinxiang Central Hospital from May 2017 to Apr 2019 were enrolled in the study,meanwhile,51 healthy people who received physical examination were set as the control group.The levels of PSGL-1,IL-6 and ANXA1 were compared among the three groups,the different types of COPD patients complicated with infection and the COPD patients complicated with different pathogens infections,the receiver-operating-characteristic(ROC)curve was drawn,the sensitivity and specificity of PSGL-1,IL-6 and ANXA1 in prediction of concurrent infection of the COPD patients were observed,and Pearson analysis was performed for the correlation between the PSGL-1,IL-6,ANXA1 and the forced expiratory volume in 1 second(FEV1)as a percentage of the predicted value(FEV1%pred)and FEV1/forced vital capacity(FVC).RESULTS The levels of PSGL-1,IL-6 and ANXA1 of the control group,the COPD group and the e COPD concurrent infection group were successively increased(P<0.05).The area under ROC curve(AUC)of the ANXA1 was 0.872 in prediction of the COPD complicated with infection,higher than 0.740 of the PSGL-1 and 0.807 of the IL-6;the cutoff value of the ANXA1 was more than 2.859 ng/L,the sensitivity 74.51%,the specificity 86.27%.The FEV1%pred and FEV1/FVC of the gradeⅢplusⅣCOPD patients complicated with infection were lower than those of the gradeⅠplusⅡpatients;the PSGL-1,IL-6 and ANXA1 of the gradeⅢplusⅣCOPD patients complicated with infection were significantly higher than those of the gradeⅠplusⅡpatients(P<0.05).The PSGL-1 and IL-6 were negatively correlated with FEV1%pred and FEV1/FVC(P<0.05);the ANXA1 was not associated with FEV1%pred and FEV1/FVC.The levels of PSGL-1 and IL-6 of the patients with bacterial infection were significantly higher than those of the patients with Mycoplasma and viral infections(P<0.05);the ANXA1 level of the patients with viral infection was significantly higher than that of the patients with bacterial and Mycoplasma infections(P<0.05).CONCLUSION The serum PSGL-1,IL-6 and ANXA1 can be used for prediction of the risk of infection in the COPD patients,the PSGL-1 and IL-6 are negatively correlated with the FEV1%pred and FEV1/FVC,which may facilitates the assessment of illness condition of the patients.The ANXA1 can be used for identification of viral infection,and the PSGL-1 and IL-6 can be used for identification of bacterial infection.