血清CYR61、suPAR、8-OHdG联合检测在AECOPD并发肺动脉高压患者中的临床应用

Clinical application of combined detection of serum CYR61,suPAR and 8-OHdG in patients with AECOPD complicated with pulmonary hypertension

目的研究血清富半胱氨酸蛋白61(CYR61)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)、8-羟基脱氧鸟苷酸(8-OHdG)联合检测在慢性阻塞性肺疾病急性加重期(AECOPD)并发肺动脉高压(PH)患者的临床价值。方法选取2019年1月至2022年3月该院158例AECOPD患者,根据肺动脉收缩压(PASP)测量结果分为AECOPD组(n=102)与并发PH组(n=56),并发PH组进一步分为轻度组、中度组、重度组。另选同期60例体检健康者作为健康组。检测各组血清CYR61、suPAR、8-OHdG水平,分析AECOPD并发PH的影响因素,以及CYR61、suPAR、8-OHdG对AECOPD并发PH的诊断效能。结果AECOPD组与并发PH组血清CYR61、suPAR、8-OHdG水平高于健康组,差异有统计学意义(P<0.05);并发PH组CYR61、suPAR、8-OHdG水平高于AECOPD组,差异有统计学意义(P<0.05)。中度组、重度组血清CYR61、suPAR、8-OHdG水平高于轻度组,差异有统计学意义(P<0.05);重度组CYR61、suPAR、8-OHdG水平高于中度组,差异有统计学意义(P<0.05)。Logistic回归分析显示PASP、CYR61、suPAR、8-OHdG水平为AECOPD并发PH的独立影响因素(P<0.05)。受试者工作特征曲线(ROC曲线)及联合应用的回归预测模型分析显示,血清CYR61、suPAR、8-OHdG单独及联合应用时,对AECOPD并发PH的诊断评估价值:ROC曲线的曲线下面积(95%CI)分别为0.726(0.496~0.931)、0.753(0.514~0.986)、0.715(0.510~0.911)、0.866(0.798~0.925)。结论血清CYR61、suPAR、8-OHdG在AECOPD并发PH患者中水平上升,3个指标联合应用对AECOPD并发PH具有更高的诊断价值。

Objective To study the clinical value of combined detection of serum cysteine rich protein 61(CYR61),soluble urokinase type plasminogen activator receptor(suPAR)and 8-hydroxydeoxyguanosine acid(8-OHdG)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with pulmonary hypertension(PH).Methods 158 patients with AECOPD who were admitted to a hospital from January 2019 to March 2022 were selected.According to the measurement results of pulmonary artery systolic pressure(PASP),the patients were divided into AECOPD group(n=102 cases)and complicated with PH group(n=56 cases).The complicated with PH group was further divided into mild group,moderate group and severe group.Another 60 healthy people in the same period were selected as the healthy group.The serum levels of CYR61,suPAR and 8-OHdG were detected in each group,and the influencing factors of AECOPD complicated with PH were analyzed.The diagnostic efficacy of CYR61,suPAR and 8-OHdG for AECOPD complicated with PH was analyzed.Results The levels of serum CYR61,suPAR and 8-OHdG in the AECOPD group and complicated with PH group were higher than those in the healthy group,and the difference was statistically significant(P<0.05).The levels of CYR61,suPAR and 8-OHdG in complicated with PH group were higher than those in AECOPD group,and the difference was statistically significant(P<0.05).The levels of serum CYR61,suPAR and 8-OHdG in the moderate group and severe group were higher than those in the mild group,and the difference was statistically significant(P<0.05).The levels of CYR61,suPAR and 8-OHdG in severe group were higher than those in moderate group,and the difference was statistically significant(P<0.05).Logistic regression analysis showed that PASP,CYR61,suPAR and 8-OHdG levels were independent influencing factors in AECOPD complicated with PH(P<0.05).Analysis of receiver Operating characteristic curve(ROC curve)and regression prediction model of combined application showed that serum CYR61,suPAR and 8-OHdG alone and combined application had the diagnostic value of AECOPD complicated with PH:the AUC(95%CI)of ROC curve were 0.726(0.496—0.931),0.753(0.514—0.986),0.715(0.510—0.911)and 0.866(0.798—0.925)respectively.Conclusion The levels of serum CYR61,suPAR and 8-OHdG increased in patients with AECOPD complicated with PH,the combined application of these three index has higher diagnostic value for AECOPD complicated with PH.