老年AECOPD患者中血清sTREM-1、FABP4表达意义及对预后的评估价值分析

Expression Significance of Serum sTREM-1 and FABP4 in Elderly AECOPD Patients and Analysis of Their Prognostic Value

目的:分析老年慢性阻塞性肺疾病急性加重期(AECOPD)患者中血清可溶性髓系细胞触发受体-1(sTREM-1)、脂肪酸结合蛋白4(FABP4)表达意义及对预后的评估价值。方法:选择我院自2022年3月至2023年2月收治的128例老年AECOPD患者作为观察组,128例老年COPD稳定期患者作为对照组。检测所有患者血清sTREM-1、FABP4表达水平,分析老年AECOPD患者血清sTREM-1、FABP4表达水平与其肺功能指标及预后的关系。结果:观察组血清sTREM-1、FABP4表达水平均高于对照组(P<0.05);观察组FEV_(1)%pred、FEV_(1)/FVC均小于对照组(P<0.05);经Pearson相关性分析,老年AECOPD患者中血清sTREM-1、FABP4表达水平与FEV_(1)%pred、FEV_(1)/FVC均呈负相关(P<0.05);在128例老年COPD稳定期患者中,预后不良35例,占27.34%;经多因素Logistic回归分析,年龄、APACHEⅡ评分、继发休克、血清sTREM-1、FABP4均是老年AECOPD患者预后的独立危险因素(P<0.05);经ROC曲线分析,血清sTREM-1联合FABP4评估老年AECOPD患者预后不良的AUC为0.917(95%CI:0.837-0.998),敏感度为89.72%,特异度为51.47%。结论:老年AECOPD患者中血清sTREM-1、FABP4表达水平与其肺功能及预后密切相关,联合sTREM-1和FABP4检测有助于提高对预后不良的评估水平。

Objective:To analyze the significance of serum soluble triggering receptor on myeloid cells-1(sTREM-1)and fatty acid binding protein 4(FABP4)expression in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and their prognostic value.Methods:128 elderly patients with AECOPD admitted in our hospital from March 2022 to February 2023 were selected as the observation group,and 128 elderly patients with stable COPD were selected as the control group.Test all of the patients serum sTREM-1,FABP4 expression level.Analysis in elderly patients with AECOPD,serum sTREM-1,FABP4 expression levels and pulmonary function index of the relationship.Results:Observation group serum sTREM-1,FABP4 expression levels were higher than control group(P<0.05).Observation group percent of expected forced expiratory volume in 1 second(FEV_(1)%pred),forced expiratory volume in 1 second(FEV_(1)/FVC)and forced vital capacity ratio is less than the control group(P<0.05).Pearson correlation analysis showed that serum sTREM-1 and FABP4 expression levels were negatively correlated with FEV_(1)%PREd and FEV_(1)/FVC in elderly AECOPD patients(P<0.05).In 128 cases of elderly patients with COPD stabilization,poor prognosis,35 cases(27.34%);Multiple Logistic regression analysis showed that age,APACHEⅡscore,secondary shock,serum sTREM-1 and FABP4 were independent risk factors for prognosis in elderly patients with AECOPD(P<0.05).According to ROC curve analysis,the AUC of serum sTREM-1 combined with FABP4 in the assessment of poor prognosis in elderly AECOPD patients was 0.917(95%CI:0.837-0.998),the sensitivity was 89.72%,and the specificity was 51.47%.Conclusion:Serum sTREM-1,FABP4 in older patients with AECOPD expression levels and pulmonary function and prognosis is closely related to the joint sTREM-1 and FABP4 testing helps to improve the level of assessment of prognosis.