AECOPD患者血清PTX3与肺功能、炎性因子的相关性及其诊断价值分析

Correlation of serum PTX3 with lung function and inflammatory factors in patients with AECOPD and analysis of its diagnostic value

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者血清正五聚蛋白3(PTX3)与常见炎性因子以及肺功能的相关性,并分析PTX3对于AECOPD患者病情的诊断价值。方法选取2018年12月1日-2020年12月1日于天津市北辰医院呼吸与危重症医学科就诊的慢性阻塞性肺疾病(COPD)患者260例,其中COPD稳定期患者180例,AECOPD患者80例,同时选取同期到北辰医院体检的健康者260例纳入健康人群组。检测这三组人群的血清PTX3、降钙素原(PCT)、C反应蛋白(CRP)、白细胞-8(IL-8)及白细胞-6(IL-6),对比分析这三组患者的上述血清学相关指标以及肺功能相关指标;同时采用ROC曲线分析常见炎性指标与PTX3诊断AECOPD患者的灵敏度、特异度;并使用Person相关分析探讨PTX3与炎症因子和肺功能相关指标的相关性。结果AECOPD组患者的PTX3水平以及其他炎性因子的水平高于COPD稳定期组,COPD稳定期组的相关数据高于健康人群组;健康人群组的第一秒用力呼气容积占预计值百分比(FEV1%)、第一秒用力呼气容积占用力肺活量的百分比(FEV1/FVC%)、用力肺活量(FVC)、第一秒用力呼气容积(FEV1)均显著高于COPD稳定期组(P<0.05);而COPD稳定期组患者的FEV1/FVC%、FEV1%、FVC、FEV1%均显著高于AECOPD组(P<0.05);PerSon相关分析显示,血清PTX3与FEV1/FVC%、FEV1%、FVC、FEV1呈负相关(P<0.05);血清PTX3与IL-8、IL-6、PCT、CRP呈正相关(P<0.05);ROC曲线分析显示:PTX3对AECOPD患者的诊断特异性为90.76%,敏感性为86.34%,AUC面积为0.906,阳性预测值为84.53%,其敏感性、特异性、阳性预测值高于CRP、PCT、IL-8、IL-6。结论血清PTX3可用于AECOPD患者的病情评估,具有较高的诊断价值,与常见的炎性因子以及肺功能相关指标存在显著相关性。

Objective To investigate the correlation between serum pentraxin 3(PTX3)and common inflammatory factors and lung function in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to analyze the diagnostic value of PTX3 in patients with AECOPD.Methods Selected 260 chronic obstructive pulmonary(COPD)patients who were treated in our department from December 1,2018 to December 1,2020,including 180 patients with stable COPD and 80 patients with AECOPD.At the same time,we selected 260 healthy people in the hospital for physical examination.Detect the serum PTX3,procalcitonin(PCT),C-reactive protein(CRP)and leukocyte-8(IL-8),and leukocyte-6(IL-6)of these three groups of people,and compare and analyze the above-mentioned of these three groups of patients Serum related indexes and lung function related indexes;at the same time,ROC curve was used to analyze the sensitivity and specificity of common inflammatory indexes and PTX3 in diagnosing AECOPD patients;and Person correlation was used to analyze the correlation between PTX3 and inflammatory factors and lung function related indexes.Results The levels of PTX3 and other inflammatory factors in the AECOPD group were higher than those in the stable COPD group,and the relevant data in the stable COPD group were higher than those in the healthy control group;the first-second forced expiratory volume of the healthy group accounted for the estimated Value percentage(FEV1%),the percentage of forced vital capacity occupied by the first second forced breathing volume(FEV1/FVC%),forced vital capacity(FVC),and forced first second expiratory volume(FEV1)are significantly higher than the COPD stable period FEV1/FVC%,FEV1%,FVC,and FEV1 of patients in the COPD stable group were significantly higher than those in the AECOPD group(P<0.05);the relevant Person analysis showed that serum PTX3 and FEV1/FVC%,FEV1%,FVC,FEV1 are negatively correlated(P<0.05);serum PTX3 is positively correlated with IL-8,IL-6,PCT,and CRP(P<0.05);ROC curve analysis shows:PTX3 is positive for patients with AECOPD diagnosis specificity:90.76%,sensitivity:86.34%,AUC area 0.906,positive predictive value 84.53%,and its sensitivity,specificity,and positive predictive value are higher than CRP,PCT,IL-8,and IL-6.Conclusion Serum PTX3 can be used to evaluate the condition of patients with AECOPD,has high diagnostic value,and has a significant correlation with common inflammatory factors and related indicators of lung function.