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    慢性阻塞性肺疾病稳定期患者血清内质网应激标志物预测频繁急性加重的研究

    Serum endoplasmic reticulum stress markers in predicting frequent acute exacerbations in stable chronic obstructive pulmonary disease patients

    • 摘要: 目的 研究血清内质网应激(ERS)标志物对慢性阻塞性肺疾病(COPD)稳定期患者频繁急性加重的评估价值。方法 选择2020年4月—2021年12月在北京市大兴区中西医结合医院完成治疗及出院后1年随访的88例稳定期COPD患者进行病例对照研究,登记患者的临床资料,根据加重频率,将患者分为非频繁急性加重组及频繁急性加重组,比较2组患者临床资料及血清葡萄糖调节蛋白78(GRP78)、CCAAT/增强子结合蛋白同源蛋白(CHOP)、含半胱氨酸的天冬氨酸蛋白水解酶-12(Caspase-12)的差异,采用logistic回归模型分析频繁急性加重的影响因素,采用受试者工作特征(ROC)曲线分析血清GRP78、CHOP、Caspase-12对频发急性加重的预测效能。结果 频繁急性加重组的1 s用力呼气容量/用力肺活量、1 s用力呼气容量占预计值百分比均低于非频繁急性加重组,血清GRP78、CHOP、Caspase-12含量均高于非频繁急性加重组(P<0.05);logistic回归分析显示,血清GRP78、CHOP、Caspase-12含量是频繁急性加重的影响因素(P<0.05);ROC曲线分析显示,血清GRP78、CHOP、Caspase-12含量对频繁急性加重具有预测价值,3项血清标志物联合预测的敏感度和特异度分别为89.66%和90.00%。结论 血清ERS标志物GRP78、CHOP、Caspase-12联合检测对频繁急性加重具有较好的预测效能。

       

      Abstract: Objective To investigate the value of serum endoplasmic reticulum stress (ERS) markers in evaluating frequent acute exacerbations in stable chronic obstructive pulmonary disease (COPD) patients.Methods A case-control study was conducted on 88 stable COPD patients who received treatment and were followed up for one year after discharge from Beijing Daxing District Hospital of Integrated Traditional Chinese and Western Medicine from April 2020 to December 2021. The patients’ clinical data were collected. Based on exacerbation frequency, they were divided into two groups:non-frequent acute exacerbation and frequent acute exacerbation. Both groups were compared for their clinical data and serum levels of glucose-regulated protein 78 (GRP78), CCAAT/enhancer-binding protein homologous protein (CHOP), and cysteine-aspartic acid protease-12 (Caspase-12). Logistic regression analysis was conduct to identify influencing factors of frequent acute exacerbations. Receiver operating characteristic (ROC) curves were plotted to assess the predictive value of serum GRP78, CHOP, and Caspase-12 for acute exacerbations.Results The frequent acute exacerbation group showed decreases in forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) and FEV1 percentage of predicted value, and increases in the levels of serum GRP78, CHOP, and Caspase-12, compared with the non-frequent acute exacerbation group (P<0.05). Logistic regression analysis indicated that serum GRP78, CHOP, and Caspase-12 contents were the factors influencing of frequent acute exacerbations (P<0.05). ROC curve analysis demonstrated that serum GRP78, CHOP, and Caspase-12 contents had predictive value for frequent acute exacerbations, with a combined sensitivity of 89.66% and specificity of 90.00%.Conclusions Combined detection of serum ERS markers GRP78, CHOP, and Caspase-12 has good predictive value for frequent acute exacerbations in stable COPD patients.

       

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