血清HMGB1、IL-17、IL-10在不同分期COPD患者中的表达及临床意义

Expression and Clinical Significance of Serum HMGB1,IL-17 and IL-10 in Patients with Different Stages of COPD

目的:探讨血清高迁移率蛋白1(HMGB1)、白细胞介素-17(IL-17)、白细胞介素-10(IL-10)在不同分期慢性阻塞性肺疾病(COPD)患者中的表达,分析其临床意义。方法:回顾性收集2021年1—12月宿州市第一人民医院收治的236例COPD患者临床资料作为观察组,同期收集健康体检者100例作为对照组。观察组根据疾病分期分为稳定期组(n=116)和加重期组(n=120),加重期组根据不同预后分为预后良好组(n=68)和预后不良组(n=52),并按照肺功能分级分为1级组(n=30)、2级组(n=43)、3级组(n=24)、4级组(n=23)。比较血清HMGB1、IL-17、IL-10在各组间的表达差异,分析其在患者预后评估中的价值,并探讨影响患者预后不良的独立危险因素。结果:加重期组血清HMGB1、IL-17水平高于稳定期组、对照组,IL-10水平低于稳定期组、对照组,稳定期组血清HMGB1、IL-17水平高于对照组患者,IL-10水平低于对照组,差异有统计学意义(P<0.05)。血清HMGB1、IL-17在加重期不同肺功能分级患者中逐渐升高,IL-10在加重期不同肺功能分级患者中逐渐降低,差异有统计学意义(P<0.05)。预后不良组血清HMGB1、IL-17水平高于预后良好组,IL-10水平低于预后良好组,差异有统计学意义(P<0.05)。血清HMGB1、IL-17、IL-10联合检测预测加重期患者预后不良的曲线下面积为0.851,敏感度和特异度可达89.3%、72.7%。血清HMGB1、IL-17是加重期组患者发生预后不良的独立危险因素,IL-10则是加重期组患者发生预后不良的保护因素(P<0.05)。结论:血清HMGB1、IL-17、IL-10在不同分期COPD患者中表达水平不同,可以作病情评估,联合检测对加重期患者预后不良具有一定预测价值,且是加重期患者发生预后不良的独立危险因素。

Objective:To investigate the expression of serum high mobility protein 1(HMGB1),interleukin-17(IL-17)and interleukin-10(IL-10)in patients with chronic obstructive pulmonary disease(COPD)at different periods,and to analyze their clinical significance.Method:The clinic data of 236 COPD patients who admitted to the First People's Hospital of Suzhou from January to December 2021 were retrospectively collected as the observation group,and 100 healthy physical examination patients were collected as the control group during the same period.The observation group was divided into the stable group(n=116)and the aggravated group(n=120)according to disease stage,the aggravated group was divided into the good prognosis group(n=68)and the poor prognosis group(n=52)according to different prognosis,the aggravated group was divided into grade 1 group(n=30),grade 2 group(n=43),grade 3 group(n=24)and grade 4 group(n=23)according to lung function stage.The expression differences of serum HMGB1,IL-17 and IL-10 among all groups were compared,their value in the prognosis assessment of patients were analyzed,and the independent risk factors affecting the poor prognosis of patients were explored.Result:The levels of serum HMGB1 and IL-17 in the aggravation group were significantly higher than those in stable group and the control group,and the level of IL-10 was significantly lower than those in the stable group and the control group,the levels of serum HMGB1 and IL-17 in the stable group were significantly higher than those in the control group,and the level of IL-10 was significantly lower than that in the control group,the differences were statistically significant(P<0.05).Serum HMGB1 and IL-17 were gradually increased in different lung function grades in exacerbation stage,while IL-10 was gradually decreased in different lung function grades in exacerbation stage,the differences were statistically significant(P<0.05).The levels of serum HMGB1 and IL-17 in the poor prognosis group were significantly higher than those in the good prognosis group,and the level of IL-10 was significantly lower than that in the good prognosis group,the differences were statistically significant(P<0.05).The area under the curve of serum HMGB1,IL-17 and IL-10 combined detection to predict poor prognosis in patients with exacerbation stage was 0.851,and the sensitivity and specificity could reach 89.3%and 72.7%.Serum HMGB1,IL-17 were independent risk factors for poor prognosis in the exacerbation group,while IL-10 was protective factor for poor prognosis in the aggravation group(P<0.05).Conclusion:Serum HMGB1,IL-17 and IL-10 are expressed at different levels in patients with COPD at different stages,which can be used as indicators for disease assessment,combined detection has certain predictive value for poor prognosis in patients with exacerbations,and is an independent risk factor for poor prognosis in patients with exacerbation stage.