血清富含半胱氨酸蛋白61预测慢性阻塞性肺疾病急性发作严重程度及短期预后临床价值

Clinical value of serum cysteine-rich 61 in predicting the severity and short-term prognosis of acute exacerbated COPD

目的 探讨血清富含半胱氨酸蛋白61(CYR61)与慢性阻塞性肺疾病(COPD)患者急性发作期时的严重程度及短期预后的关系。方法 选取自2020年2月至2022年2月期间住院治疗的59例急性发作期COPD患者(AECOPD组)及同期36例健康志愿者(健康组)为研究对象。采用酶联免疫吸附试验检测血清CYR61水平。通过随访1年COPD不良预后事件发生情况对预后进行评估。结果 AECOPD组急性发作期时血清CYR61水平显著高于健康组,差异有统计学意义(P<0.001)。AECOPD患者缓解期时血清CYR61水平降低,仍高于健康组,差异有统计学意义(P<0.05)。血清CYR61水平对AECOPD诊断的曲线下面积(AUC)值为0.948(95%可信区间:0.909~0.986)。经Spearman秩相关分析,AECOPD患者急性发作期血清CYR61水平与慢性阻塞性肺疾病全球倡议分级、中性粒细胞/淋巴细胞比值、住院时间呈正相关性(r=0.687、0.611、0.359,P<0.05)。预后不良亚组COPD患者急性发作期时血清CYR61水平显著高于预后良好亚组,差异有统计学意义(P<0.001)。急性发作期时血清CYR61水平预测COPD患者不良结局的AUC为0.880(95%可信区间:0.794~0.965)。结论 血清CYR61可能成为预测AECOPD患者疾病进展和不良结局的有用生物标志物。

Objective To analyze the relationship between serum cysteine-rich 61(CYR61)and the severity in acute exacerbated stage and short-term prognosis of patients with chronic obstructive pulmonary disease(COPD).Methods A retrospective study was performed on 59 patients with acute exacerbated COPD(AECOPD group)admitted from February 2020 to February 2022,and 36 healthy volunteers(health group)were selected.Serum CYR61 level was detected by enzyme-linked immunosorbent assay.Outcomes were assessed by the incidence of adverse prognostic events in COPD at 1-year follow-up.Results The serum CYR61 level in AECOPD group was significantlyhigher than that in the health group during acute exacerbated stage,the difference was statistically significant(P<0.001).and the serum CYR61 level decreasedin remission stage,but still higher than that in the control group,the difference was statistically significant(P<0.05).The area under the curve(AUC)for AECOPD diagnosis by serum CYR61 level was 0.948(95%CI:0.909-0.986).Spearmanrank correlation analysis showed that global initiative for chronic obstructive lung disease(GOLD)grade,neutrophil/lymphocyte ratio,length of hospital stay were positively correlated with serum CYR61 level with all lung function indexes(r=0.687,0.611,0.359,P<0.05).The serum CYR61 level in patients with COPD poor prognosis was significantly higher than that in patients with good prognosis,the difference was statistically significant(P<0.001).The AUC of serum CYR61 level predicting adverse outcomes in COPD patients during acute episode was 0.880(95%CI:0.794-0.965).Conclusion Serum CYR61 may be a useful biomarker for predicting disease progression and poor outcomes in patients with AECOPD.