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    哮喘、慢阻肺及哮喘-慢阻肺患者血清中IgE、CRP、IL-6的比较及临床意义

    Comparison and clinical significance of serum IgE, CRP and IL-6 in patients with asthma, chronic obstructive pulmonary disease and asthma-chronic obstructive pulmonary disease

    • 摘要: 目的 探讨哮喘、慢性阻塞性肺疾病(简称慢阻肺)及哮喘-慢阻肺患者血清中免疫球蛋白E(IgE)、C反应蛋白(CRP)、白介素-6(IL-6)的变化及临床意义。方法 选取2018年3月—2020年1月北京中医药大学房山医院65例哮喘-慢阻肺患者作为研究组,另选65例单纯哮喘、65例单纯慢阻肺患者分别作为对照组A、对照组B。检测比较3组一般资料、血清IgE、CRP、IL-6水平、肺功能指标〔第1秒用力呼气容积占预计值百分比(FEV1%)、用力肺活量(FVC)〕、血气分析指标〔动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)〕,评价血清IgE、CRP、IL-6与肺功能指标、血气分析指标的关系,探究血清IgE、CRP、IL-6诊断哮喘-慢阻肺的价值,统计研究组治疗3个月后预后情况,比较不同预后患者治疗前一般资料、治疗1周、3周后血清IgE、CRP、IL-6水平。结果 研究组血清IgE、CRP、IL-6水平及PaCO2均高于对照组A、对照组B,FEV1%、FVC、PaO2均低于对照组A、对照组B(P<0.05);血清IgE、CRP、IL-6与FEV1%(r=-0.674、-0.489、-0.716)、FVC(r=-0.689、-0.715、-0.691)及PaO2(r=-0.884、-0.789、-0.821)呈负相关,与PaCO2(r=0.664、0.514、0.646)呈正相关(P<0.05);血清IgE、CRP、IL-6联合诊断哮喘-慢阻肺的曲线下面积(AUC)为0.876,大于各指标单独诊断(0.817、0.846、0.737),联合诊断的最佳敏感度、特异度分别为75.38%、89.23%;研究组预后良好患者治疗3周后血清IgE、CRP、IL-6水平均低于预后不良患者(P<0.05)。结论 哮喘-慢阻肺患者血清中IgE、CRP、IL-6明显升高,早期明确各指标水平可在一定程度上反映患者肺功能及血氧状态,且与患者预后有关,可为哮喘-慢阻肺的临床诊断、治疗提供重要信息。

       

      Abstract: Objective To the compare serum immunoglobulin E (IgE), C-reactive protein (CRP) and interleukin-6 (IL-6) in patients with asthma, chronic obstructive pulmonary disease and asthma-chronic obstructive pulmonary disease and its clinical significance. Methods A total of 65 patients with asthma-chronic obstructive pulmonary disease in Fangshan Hospital, Beijing University of Chinese Medicine, from March 2018 to January 2020 were selected as a research group, while another 65 patients with asthma and 65 patients with chronic obstructive pulmonary disease were selected as a control A group and a control B group, respectively. They were compared for general information, serum IgE, CRP, and IL-6 levels, lung function indicators forced expiratory volume in the first second as a percentage of predicted value (FEV1%), and forced vital capacity (FVC), and blood gas analysis indexes arterial partial pressure of oxygen (PaO2), and arterial partial pressure of carbon dioxide (PaCO2). The relationship between serum IgE, CRP, IL-6 and pulmonary function indexes and blood gas analysis indexes was evaluated. The application of serum IgE, CRP, and IL-6 in the diagnosis of asthma-chronic obstructive pulmonary disease was explored. The prognosis of the research group after treatment for three months was calculated.Their general information before treatment and serum IgE, CRP and IL-6 one levels and three weeks after treatment were compared. Results The research group presented increases in the levels of serum IgE, CRP, IL-6 and PaCO2, as well as decreases in FEV1%, FVC, and PaO2, compared with the control A group and the control B group (P<0.05). The levels of serum IgE, CRP, and IL-6 were negatively correlated with FEV1% (r=-0.674, -0.489, and -0.716), FVC (r=-0.689, -0.715, and -0.691) and PaO2 (r=-0.884, -0.789, and -0.821), but positively correlated with PaCO2 (r=0.664, 0.514, and 0.646) (P<0.05). The area under the curve (AUC) of the combination of serum IgE, CRP, and IL-6 for the diagnosis of asthma-chronic obstructive pulmonary disease was 0.876, which was higher than that of each index alone (0.817, 0.846, and 0.737). The optimal sensitivity and specificity of the combined diagnosis was 75.38% and 89.23%, respectively. The levels of serum IgE, CRP and IL-6 in the patients of the research group with good prognosis were lower than those with poor prognosis after three-week treatment (P<0.05). Conclusions The levels of serum IgE, CRP and IL-6 in patients with asthma-chronic obstructive pulmonary disease significantly increased. Early determination of each index can reflect the patient's lung function and blood oxygen status to a certain extent, assist clinical diagnosis due to its relationship with patient prognosis, and provide important evidence for the clinical diagnosis and treatment of asthma-chronic obstructive pulmonary disease.

       

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