血清半乳糖凝集素3和白细胞介素17对慢性阻塞性肺疾病急性加重期的诊断价值

Diagnostic value of serum galectin-3 and interleukin-17 in acute exacerbation of chronic obstructive pulmonary disease

目的探讨血清半乳糖凝集素3(Gal-3)和白细胞介素17(IL-17)对慢性阻塞性肺疾病急性加重期(AECOPD)患者的诊断价值。方法选择中国中医科学院望京医院2018年1月至2020年6月收治的AECOPD患者71例(AECOPD组),稳定期COPD患者79例(COPD组),体检健康志愿者74例(对照组)。比较3组研究对象血清Gal-3、IL-17和肺功能指标水平,分析AECOPD组血清Gal-3和IL-17水平与肺功能指标水平的相关性,血清Gal-3与IL-17的相关性,以及血清Gal-3和IL-17对AECOPD的诊断价值。结果 AECOPD组和COPD组血清Gal-3和IL-17水平均高于对照组[(35.1±9.0)、(27.2±6.4)μg/L比(4.0±1.0)μg/L,(68±9)、(31±6) ng/L比(10±3) ng/L],且AECOPD组均高于COPD组(均P <0.05);第1秒用力呼气容积(FEV_(1))、FEV_(1)与用力肺活量(FVC)的比值(FEV_(1)/FVC)、FEV_(1)占预计值百分比(FEV_(1)%)均低于对照组,且AECOPD组均低于COPD组(均P <0.05)。AECOPD组患者血清Gal-3与IL-17呈正相关(r=0.554,P <0.05),且二者与FEV_(1)、FEV_(1)/FVC、FEV_(1)%均呈负相关(均P <0.05)。血清Gal-3联合IL-17诊断AECOPD的曲线下面积大于血清Gal-3和IL-17单独检测[0.927 (95%置信区间:0.871~0.982)比0.825 (95%置信区间:0.756~0.894)、0.760 (95%置信区间:0.677~0.843)](Z=2.121、2.851,均P <0.05)。结论稳定期COPD患者血清Gal-3和IL-17水平升高,AECOPD患者升高更明显。血清Gal-3和IL-17水平与AECOPD患者肺功能密切相关,二者联合检测有助于提高对AECOPD的诊断效能。

Objective To investigate the diagnostic value of serum galectin(Gal)-3 and interleukin(IL)-17 in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods From January2018 to June 2020,71 patients with AECOPD(AECOPD group),79 patients with stable COPD(COPD group)and 74 healthy volunteers(control group)admitted to Wangjing Hospital of China Academy of Chinese Medical Sciences were selected.The serum levels of Gal-3,IL-17 and lung function indexes of the three groups were compared.The correlation between serum Gal-3,IL-17 and lung function indexes,the correlation between serum Gal-3 and IL-17,and the predictive value of serum Gal-3 and IL-17 in AECOPD were analyzed.Results Serum levels of Gal-3 and IL-17 in AECOPD group and COPD group were higher than those in control group[(35.1±9.0),(27.2±6.4)μg/L vs(4.0±1.0)μg/L;(68±9),(31±6)ng/L vs(10±3)ng/L],and those in AECOPD group were higher than those in COPD group(all P<0.05);forced expiratory volume in 1 second(FEV_(1)),FEV_(1)/forced vital capacit(FVC)and percent predicted of FEV_(1)(FEV_(1)%)in AECOPD group and COPD group were lower than those in control group,and those in AECOPD group were lower than those in COPD group(all P<0.05).In AECOPD group,serum Gal-3 was positively correlated with IL-17(r=0.554,P<0.05),and they were negatively correlated with FEV_(1),FEV_(1)/FVC and FEV_(1)%(all P<0.05).The area under the curve of serum Gal-3 combined with IL-17 in the diagnosis of AECOPD was larger than that of serum Gal-3 and IL-17 alone[0.927(95%confidence interval:0.871-0.982)vs 0.825(95%confidence interval:0.756-0.894),0.760(95%confidence interval:0.677-0.843)](Z=2.121,2.851,both P<0.05).Conclusions The serum Gal-3 and IL-17 levels increase in stable COPD patients,and increase significantly more in AECOPD patients.Serum levels of Gal-3 and IL-17 are closely related to pulmonary function in patients with AECOPD.Combined detection of Gal-3 and IL-17 can improve the diagnostic efficiency of AECOPD.