| 郑 涛,袁 红,黄彬彬,朱敬影,李 阳.血清IL-13、IL-17、IL-37与慢性阻塞性肺疾病急性加重期无创机械通气患者预后不良的关系分析[J].,2023,(9):1696-1701 |
| 血清IL-13、IL-17、IL-37与慢性阻塞性肺疾病急性加重期无创机械通气患者预后不良的关系分析 |
| Analysis of the Relationship between Serum IL-13, IL-17 and IL-37 and Poor Prognosis in Patients on Non-Invasive Mechanical Ventilation during Acute Exacerbations of Chronic Obstructive Pulmonary Disease |
| 投稿时间：2022-09-24 修订日期：2022-10-20 |
| DOI：10.13241/j.cnki.pmb.2023.09.019 |
| 中文关键词: 慢性阻塞性肺疾病 急性加重期 无创机械通气 白细胞介素-13 白细胞介素-17 白细胞介素-37 预后 |
| 英文关键词: Chronic obstructive pulmonary disease Acute exacerbation Non-invasive mechanical ventilation Interleukin-13 Interleukin-17 Interleukin-37 Prognosis |
| 基金项目:新疆维吾尔自治区自然科学基金项目（2019D0C081） |
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| 中文摘要: |
| 摘要 目的：分析慢性阻塞性肺疾病急性加重期（AECOPD）无创机械通气患者血清白细胞介素（IL）-13、IL-17、IL-37的变化并探讨其与患者预后不良的关系。方法：选取2019年1月～2022年2月我院收治的102例接受无创机械通气治疗的AECOPD患者（AECOPD组），根据预后情况分为预后不良亚组41例和预后良好亚组61例，另选取68例慢性阻塞性肺疾病稳定期（SCOPD）患者作为SCOPD组和57例体检健康者作为对照组。采用酶联免疫吸附法检测血清IL-13、IL-17、IL-37水平。采用单因素和多因素Logistic回归分析AECOPD无创机械通气患者预后不良的影响因素，受试者工作特征（ROC）曲线分析血清IL-13、IL-17、IL-37水平对AECOPD无创机械通气患者预后不良的预测价值。结果： 对照组、SCOPD组、AECOPD组血清IL-13、IL-17、IL-37水平依次升高（P＜0.05）。预后不良亚组血清IL-13、IL-17、IL-37水平高于预后良好亚组（P＜0.05）。单因素分析显示，预后不良亚组年龄大于预后良好亚组，心功能不全比例和COPD评估测试（CAT）评分、C反应蛋白高于预后良好亚组（P＜0.05），而两组性别、体质指数、AECOPD病程、吸烟、糖尿病、高血压、冠心病、慢性肾功能不全、第1秒用力呼气容积/用力肺活量（FEV1/FVC）、白细胞计数、降钙素原组间对比无差异（P＞0.05）。多因素Logistic回归分析显示，FEV1％增加为AECOPD无创机械通气患者预后不良的独立保护因素，年龄增加、CAT评分增加和IL-13、IL-17、IL-37升高独立危险因素（P＜0.05）。ROC曲线分析显示，血清IL-13、IL-17、IL-37水平联合预测AECOPD无创机械通气患者预后不良的曲线下面积大于IL-13、IL-17、IL-37水平单独预测。结论：AECOPD无创机械通气患者血清IL-13、IL-17、IL-37水平升高与预后不良密切相关，血清IL-13、IL-17、IL-37可作为AECOPD无创机械通气患者预后评估的潜在生物学指标。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the changes in serum interleukin (IL)-13, IL-17 and IL-37 in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) on non-invasive mechanical ventilation and to explore their relationship with poor prognosis of patients. Methods: 102 patients with AECOPD treated with non-invasive mechanical ventilation (AECOPD group) who were admitted to our hospital from January 2019 to February 2022 were selected, and they were divided into 41 patients in the poor prognosis subgroup and 61 patients in the good prognosis subgroup according to their prognosis situation, and 68 patients with stable chronic obstructive pulmonary disease (SCOPD) were selected as the SCOPD group and 57 physically healthy individuals were selected as the control group. The levels of serum IL-13, IL-17 and IL-37 were detected by enzyme-linked immunosorbent assay. Univariate and multivariate Logistic regression were used to analyze the influencing factors of poor prognosis in patients with AECOPD with non-invasive mechanical ventilation. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of the levels of serum IL-13, IL-17 and IL-37 on poor prognosis in patients with AECOPD with non-invasive mechanical ventilation. Results: The levels of serum IL-13, IL-17 and IL-37 in the control group, SCOPD group and AECOPD group were increased successively (P＜0.05). The levels of serum IL-13, IL-17 and IL-37 in the poor prognosis subgroup were higher than those in the good prognosis subgroup (P＜0.05). Univariate analysis showed that the age in the poor prognosis subgroup was higher than that in the good prognosis subgroup, and the proportion of cardiac insufficiency, COPD assessment test (CAT) score and C-reactive protein were higher than those in the good prognosis subgroup (P＜0.05). There were no differences in gender, body mass index, AECOPD course, smoking, diabetes mellitus, hypertension, coronary heart disease, chronic renal insufficiency, forced expiratory volume in one second/forced vital capacity (FEV1/FVC), white blood cell count and procalcitonin in the two groups (P＞0.05). Multivariate Logistic regression analysis showed that increased FEV1％was an independent protective factor for poor prognosis in patients with AECOPD on non-invasive mechanical ventilation, and increased age, increased CAT score and elevated IL-13, IL-17 and IL-37 were independent risk factors (P＜0.05). ROC curve analysis showed that the area under curve of serum IL-13, IL-17 and IL-37 combined in predicting poor prognosis of patients with AECOPD on non-invasive mechanical ventilation was greater than that of IL-13, IL-17 and IL-37 alone. Conclusion: Elevated the levels of serum IL-13, IL-17 and IL-37 are closely related to poor prognosis in patients with AECOPD on non-invasive mechanical ventilation. The levels of serum IL-13, IL-17 and IL-37 can be used as potential biological indicators for the prognosis assessment of patients with AECOPD on non-invasive mechanical ventilation. |
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