COPD并发感染患者PSGL-1、IL-6、膜联蛋白A1的临床价值研究

Clinical Value of PSGL-1,IL-6 and Annexin A1 in Patients with COPD Complicated infection

目的探讨慢性阻塞性肺病(COPD)并发感染患者血清中白介素-6(IL-6)、外周血中性粒细胞表面P-选择素糖蛋白配体1(PSGL-1)、及外周血单个核细胞中膜联蛋白A1的临床价值。方法选取2018年6月至2020年11月在定安县人民医院呼吸内科治疗的COPD患者84例,COPD并发感染患者85例,同时选取83例健康体检者作为对照组。检测三组患者血清中IL-6水平,中性粒细胞表面PSGL-1表达,同时检测膜联蛋白A1 mRNA及蛋白水平。结果COPD并发感染组血清中IL-6水平明显高于COPD组和对照组,差异有统计学意义(P<0.05);COPD并发感染组中性粒细胞表面PSGL-1表达较COPD组和对照组高,差异有统计学意义(P<0.05);COPD并发感染组患者外周血单个核细胞中膜联蛋白A1 mRNA及蛋白均较COPD组和对照组高,差异有统计学意义(P<0.05);COPD合并感染组死亡患者血清IL-6、PSG-1、膜联蛋白A1 m RNA相对表达量和膜联蛋白A1蛋白相对表达量明显高于存活患者,差异有统计学意义(P<0.05)。ROC分析显示:外周血膜联蛋白A1 mRNA、蛋白水平和IL-6、PSG-1及其联合应用对COPD合并感染患者预后有一定的评估价值(P<0.05)。结论COPD并发感染患者血清中IL-6明显升高,中性粒细胞表面PSGL-1表达增加,外周血单个核细胞中膜联蛋白A1 mRNA及蛋白表达水平明显升高,有利于对COPD并发感染患者的预后做出评估。

Objective To investigate the clinical value of serum interleukin-6(IL-6),P-selectin glycoprotein ligand-1(PSGL-1)on peripheral blood neutrophils and annexin A1 in peripheral blood mononuclear cells in patients with chronic obstructive pulmonary disease(COPD)complicated by infection.Methods From June 2018 to November 2020,84 COPD patients without infection and 85 COPD patients complicated by infection treated in our hospital were selected.At the same time,83 healthy people were selected as the control group.Serum IL-6 level,PSGL-1 expression on neutrophil surface were detected,and annexin A1 gene and protein levels were detected.Results The level of serum IL-6 in the COPD complicated with infection group was significantly higher than that in the COPD group and the control group(P<0.05).The expression of PSGL-1 on the surface of neutrophils in COPD complicated with infection group was higher than that in the COPD group and the control group(P<0.05).The levels of annexin A mRNA and protein in peripheral blood mononuclear cells of COPD complicated with infection group were higher than those of theCOPD group and the control group(P<0.05).The relative expression levels of IL-6,PSG-1,annexin A1 mRNA and Annexin A1 protein in the dead patients with COPD complicated with infection were significantly higher than those in the survival patients(P<0.05).ROC analysis showed that the AUC(0.95 ci)of annexin A1 mRNA and protein levels in peripheral blood,IL-6(P<0.05).Conclusion The level of IL-6 in serum,PSGL-1 expression on the surfsce of neutrophils and annexin A1 mRNA and protein expression in peripheral blood mononuclear cells were significantly increased in COPD patients complicated with infection,which is beneficial to evaluate the prognosis of COPD patients complicated with infection.