急性加重型慢性阻塞性肺疾病患者血清淀粉样蛋白A、C反应蛋白与临床指标的相关性分析

Correlation of serum amyloid A and C-reactive protein with clinical indicators in patients with acutely exacerbated chronic obstructive pulmonary disease

目的探究AECOPD相关指标的临床意义,对AECOPD预防及早期诊治提供参考价值。方法2019年5月—2021年5月于安徽省太和县中医院肺病科就诊并被诊断为慢性阻塞性肺疾病的患者通过纳入标准和排除标准筛选入组,将其分为AECOPD组、COPD缓解组和对照组,对他们的临床指标进行回顾性统计分析,并绘制受试者工作特征曲线。结果对照组、COPD缓解组和AECOPD组在IL-8、IL-6、SAA、TNF-α、CRP、IP-10、PCT和Fbg这8个检测指标差异均有统计学意义(P<0.05),COPD缓解组患者检测的所有临床指标水平都显著高于对照组,而AECOPD组患者的临床指标水平又显著高于COPD缓解组。AECOPD组患者的FEV_(1)和FEV_(1):FVC相比起对照组和COPD缓解组来说明显较小(P<0.05)。而AECOPD组CAT评分相比起对照组和COPD缓解组来说明显较大,COPD缓解组又显著大于对照组(P<0.05)。以AECOPD患者为阳性组,COPD缓解患者为阴性组,通过绘制受试者工作特征曲线,IL-8、IL-6、SAA、TNF-α、CRP、IP-10、PCT和Fbg均差异有统计学意义,而其中SAA的曲线下面积最大为0.996,其次为CRP,面积为0.985。结论AECOPD的患者IL-8、IL-6、CRP、TNF-α、SAA、IP-10、PCT和Fbg炎症相关指标相比起COPD缓解患者和正常人表达水平较高,而其中SAA水平诊断AECOPD的效能最大,其次为CRP。SAA水平可用于AECOPD的临床诊断,使得患者能够早期进行诊断和治疗,获得较好预后。

Objective To investigate the clinical significance of AECOPD-related indicators and provide reference value for the prevention and early diagnosis and treatment of AECOPD.Methods Patients who attended the respiratory medicine department of Taihe County Hospital from May 2019 to May 2021 and were diagnosed with chronic obstructive pulmonary disease were divided into AECOPD group,COPD remission group and control group by screening them into the group through inclusion and exclusion criteria,and their clinical indicators were retrospectively statistically analyzed and their clinical indicators were analyzed by plotting the subjects'working characteristics receiver operator characteristic(ROC)curve.Results The control,COPD remission and AECOPD groups showed significant differences(P<0.05)in the eight clinical indicators of IL-8,IL-6,SAA,TNF-α,CRP,IP-10,PCT and Fbg,with the COPD remission group having significantly higher levels of all clinical indicators than the control group,and the AECOPD group having significantly higher levels of clinical indicators than the COPD remission group.FEV1 and FEV1:FVC were significantly smaller in the AECOPD group compared to the control group and the COPD remission group(P<0.05).The CAT score was significantly larger in the AECOPD group compared to the control and COPD remission groups,and significantly larger in the COPD remission group compared to the control group(P<0.05).By plotting the working characteristic curves of the subjects with AECOPD patients as the positive group and COPD remission patients as the negative group,IL-8,IL-6,SAA,TNF-α,CRP,IP-10,PCT and Fbg were all statistically significant,while SAA had the largest area under the curve of 0.996,followed by CRP with an area of 0.985.Conclusion Patients with AECOPD have higher expression levels of IL-8,IL-6,CRP,TNF-α,SAA,IP-10,PCT and Fbg inflammation-related indicators compared to patients in remission from COPD and normal subjects,with SAA levels being the most effective in diagnosing AECOPD,followed by CRP.SAA levels can be used in the clinical diagnosis of AECOPD,enabling early diagnosis and treatment and a better prognosis.