COPD患者血清8-iso-PGF-2α、MCP-1及SAA水平与认知功能的关系

Relationship between serum 8-iso-PGF-2α,MCP-1,SAA levels,and cognitive function in patients with COPD

目的探讨慢性阻塞性肺疾病(COPD)患者血清8前列腺异素F2α(8-iso-PGF-2α)、单核细胞趋化蛋白-1(MCP-1)、淀粉样蛋白A(SAA)与认知功能的关系。方法选取2018年1月至2019年6月在本院治疗的COPD患者127例,按照蒙特利尔认知评估量表对患者的认知功能进行评估,将患者分为认知正常组69例和认知障碍组58例,选取同期60例健康志愿者作为对照组。比较各组血清8-iso-PGF-2α、MCP-1、SAA水平,采用受试者工作特征(ROC)曲线分析8-iso-PGF-2α、MCP-1、SAA对COPD认知功能障碍的预测价值。结果认知障碍组、认知正常组的血清8-iso-PGF-2α、MCP-1、SAA水平均明显高于对照组(均P<0.05);认知障碍组的血清8-iso-PGF-2α、MCP-1、SAA水平均明显高于认知正常组(均P<0.05)。ROC曲线分析显示,8-iso-PGF-2α、MCP-1、SAA预测COPD认知功能障碍的AUC分别为0.762、0.862、0.878,均具有一定的预测价值(均P<0.05),并且三者联合预测COPD认知功能障碍的AUC为0.912,预测价值更高(P<0.05)。最佳临界值对应的敏感度、特异度分别为:8-iso-PGF-2α50.0%、100.0%;MCP-177.6%、91.3%;SAA 89.7%、76.8%;三者联合89.7%、87.0%。结论COPD患者血清8-iso-PGF-2α、MCP-1、SAA水平呈高表达,且有认知功能障碍患者高于认知正常患者,血清8-iso-PGF-2α、MCP-1、SAA对COPD认知功能障碍均有一定的预测价值,三者联合的预测价值更高。

Objective To explore the levels of serum 8-prostaglandin F2α(8-iso-PGF-2α),monocyte chemoattractant protein-1(MCP-1),and amyloid A(SAA)in patients with chronic obstructive pulmonary disease(COPD),and analyze their relationship with cognitive function.Methods 127 patients with COPD treated in our hospital from January 2018 to June 2019 were selected,and the patients'cognitive function was evaluated with the Montreal Cognitive Assessment Scale.The patients were divided into 69 cases with normal cognitive function and 58 cases with cognitive impairment,and 60 healthy volunteers during the same period were selected as the control group.The levels of serum 8-iso-PGF-2α,MCP-1,and SAA in the three groups were compared,and the receiver operating characteristic(ROC)curve was used to analyze the predictive value of 8-iso-PGF-2α,MCP-1,and SAA for cognitive dysfunction in COPD.Results The levels of serum 8-iso-PGF-2α,MCP-1,and SAA in the cognitive impairment group and normal cognitive function group were significantly higher than those in the control group(all P<0.05);the serum 8-iso-PGF-2α,MCP-1,SAA levels in the cognitive impairment group were significantly higher than those in the normal cognitive function group(all P<0.05).ROC curve analysis showed that the AUC of 8-iso-PGF-2α,MCP-1,and SAA in predicting cognitive dysfunction of COPD were 0.762,0.862,and 0.878,respectively,all of which had a certain predictive value(all P<0.05),and the AUC of the combined detection in predicting cognitive dysfunction of COPD was 0.912,whose predictive value was higher(P<0.05).The sensitivity and specificity corresponding to the optimal cut-off value were:50.0%and 100.0%for 8-iso-PGF-2α,77.6%and 91.3%for MCP-1,89.7%and 76.8%for SAA,89.7%and 87.0%for the combination of the three.Conclusion Serum 8-iso-PGF-2α,MCP-1,and SAA levels in COPD patients are highly expressed,and those in patients with cognitive dysfunction are higher than those in patients with normal cognitive function.Serum 8-iso-PGF-2α,MCP-1,and SAA have certain predictive values for cognitive dysfunction in COPD,and the combined predictive value of the three is higher.