老年AECOPD患者血清ACE2、EOS%、SP-D表达水平及预后的评估价值

Assessment Value of Serum ACE2,EOS%,SP-D Expression Levels and Prognosis in Elderly AECOPD Patients

目的 探讨老年慢性阻塞性肺疾病急性加重期(Acute Exacerbation of Chronic Obstructive Pulmonary Disease,AECOPD)患者血管紧张素转换酶2(Angiotensin-Converting Enzyme 2,ACE2)、嗜酸性粒细胞占白细胞的百分比(Eosinophil Percentage of White Blood Cells,ESO%)、肺表面活性蛋白D(Surfactant Protein D,SP-D)表达水平及预后的评估价值。方法 选取2022年4—12月化州市中医院收治的100例老年AECOPD患者作为研究对象,根据慢性阻塞性肺疾病评估测试(COPD Assessment Test,CAT)量表进行疾病严重程度分级分为轻度组(n=44)、中度组(n=30)、重度组(n=26),对比3组患者ACE2、EOS%、SP-D表达水平,并应用ROC曲线分析血清ACE2、EOS%、SP-D对老年AECOPD患者预后的评估价值。结果重度组AECOPD患者血清ACE2、EOS%、SP-D水平高于轻、中度组,差异有统计学意义(P均<0.05)。血清ACE2、EOS%、SP-D水平以及三者联合预测老年AECOPD患者预后的曲线下面积分别为0.715、0.751、0.854及0.901,敏感度分别为42.9%、71.4%、67.1%及87.1%,特异度分别为90.0%、63.3%、96.7%及90.0%。结论 老年AECOPD患者临床严重性与血清ACE2、EOS%、SP-D水平呈正相关,即疾病严重程度越重,三者水平越高,对于预后评估具有显著的预测性价值,能有效提升预后判断的精确度。

Objective To explore the values of angiotensin-converting enzyme 2(ACE2),eosinophils percentage of white blood cells(ESO%),expression level of surfactant protein D(SP-D) and prognostic assessment in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 100 elderly patients with AECOPD who were admitted to Huazhou Hospital of Traditional Chinese Medicine for treatment between April and December 2022 were selected as the study objects.Disease severity was graded according to the COPD Assessment Test(CAT) scale and categorized into mild group(n=44),moderate group(n=30),and severe group(n=26),and ACE2,EOS%,and SP-D expression levels of three groups were compared.The application of ROC curve was used to analyze the assessment value of serum ACE2,EOS%,and SP-D on the prognosis of elderly AECOPD patients.Results Serum ACE2,EOS%,and SP-D levels in the severe group of AECOPD patients were significantly higher than those in the mild and moderate groups,and the differences were statistically significant(all P<0.05).The areas under the curve of serum ACE2,EOS%,SP-D levels and the combination of the three for predicting the prognosis of elderly AECOPD patients were 0.715,0.751,0.854,and 0.901,with sensitivities of 42.9%,71.4%,67.1%,and 87.1%,and specificities of 90.0%,63.3%,96.7%,and 90.0%,respectively.Conclusion The clinical severity of elderly AECOPD patients was positively correlated with serum ACE2,EOS%,and SP-D levels,the more severe the disease severity,the higher the levels of the three,which had significant predictive value for prognostic assessment and could effectively improve the accuracy of prognostic judgment.