血清SFRP1水平与慢性阻塞性肺疾病急性加重期患者炎症反应及肺功能的关系

Relationship Between Serum SFRP1 Level and Inflammatory Response and Pulmonary Function in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的:探讨血清分泌型卷曲相关蛋白1(SFRP1)水平与慢性阻塞性肺疾病(COPD)急性加重期患者炎症反应及肺功能的关系。方法:选择2019年3月至2020年10月我院收治的COPD患者150例,其中急性加重期86例,稳定期64例,另选择同期医院体检的健康人60例作为对照组,比较各组血清SFRP1,炎症因子[白细胞介素-17(IL-17)、IL-33、超敏反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]水平,肺功能[第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FEV1/FVC)],分析COPD急性加重期患者血清SFRP1水平与炎症因子及肺功能的相关性,并应用受试者工作特征(ROC)曲线评估血清SFRP1对COPD急性加重期的诊断价值。结果:急性加重期组血清SFRP1、炎症因子水平高于稳定期组和对照组,稳定期组以上指标亦高于对照组(P<0.05)。急性加重期组肺功能低于稳定期组和对照组,稳定期组肺功能亦低于对照组(P<0.05)。急性加重期患者血清SFRP1水平与血清IL-17、IL-33、hs-CRP、TNF-α正相关(r=0.537、0.508、0.403、0.442 P<0.05),与FEV1、FEV1/FVC呈负相关(r=-0.524、-0.576,P<0.05)。ROC曲线显示,血清SFRP1水平预测COPD急性发作截断值为75.43pg/mL,预测COPD急性发作的敏感度:89.78%,特异度为92.03%,与《慢性阻塞性肺疾病基层诊疗指南》中COPD急性加重期诊断标准具有良好的一致性(Kappa值=0.835)。结论:COPD急性加重期患者血清SFRP1水平与血清炎症因子呈正相关与FEV1、FEV1/FVC呈负相关,血清SFRP1水平对COPD急性发作有很好的诊断价值。

Objective:To investigate the relationship between serum SFRP1 level and inflammatory response and pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods:150 patients of COPD in our hospital from March 2019 to October 2020 were selected,including 86 patients in acute exacerbation stage and 64 patients in stable stage,and 60 healthy people in the same period as the control group.The levels of serum SFRP1,inflammatory factors[interleukin-17(IL-17),IL-33,high sensitivity reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)]and lung function[the first group]were compared.The correlation was analyzed between serum SFRP1 level and inflammatory factors,lung function in patients with acute exacerbation of COPD.Receiver operating characteristic(ROC)curve was plotted to evaluate the diagnostic value of serum SFRP1 in acute exacerbation of COPD.Results:Levels of serum SFRP1 and inflammatory factors of the acute exacerbation group were significantly higher than those in the stable group and the control group,and the above indexes in the stable group were also higher than those in the control group(P<0.05).The lung function of acute exacerbation group were significantly lower than those of stable group and control group,and lung function of stable group was significantly lower than that of control group(P<0.05).Serum SFRP1 level of acute exacerbation patients was positive correlated with serum IL-17,IL-33,hs-CRP and TNF-α(r=0.537,0.508,0.403,0.442,P<0.05),and was negative correlated with FEV1,FEV1/FVC(r=-0.524,-0.576,P<0.05).ROC curve showed that the cut-off value of serum SFRP1 level for predicting acute exacerbation of COPD was 75.43 pg/ml,the sensitivity and specificity for predicting acute exacerbation of COPD were 89.78%and 92.03%,which were consistent with the diagnostic criteria of acute exacerbation of COPD(kappa=0.835).Conclusion:The serum SFRP1 level in patients of acute exacerbation of COPD is positively correlated with serum inflammatory factors,negatively correlated with FEV1 and FEV1/FVC.The serum SFRP1 level has a good diagnostic value for acute exacerbation of COPD.