摘要
目的分析吸烟的慢性阻塞性肺疾病(COPD)患者嗜酸性粒细胞(EOS)、C反应蛋白(CRP)、黏蛋白5AC(MUC5AC)水平变化与肺功能的关系。方法选取2020年1月—2021年5月西安医学院第一附属医院呼吸与危重症科收治吸烟COPD患者120例(COPD组),按病情严重程度分为轻度亚组40例、中度亚组50例、重度亚组30例;另选取同期健康体检者100例作为健康对照组。比较各组EOS、CRP、MUC5AC水平,COPD各亚组患者第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)占预计值的百分比(FEV_(1)%)、FEV_(1)/FVC水平,采用Pearson相关系数分析EOS、CRP、MUC5AC水平与FEV_(1)、FVC、FEV_(1)%、FEV_(1)/FVC水平的相关性,Logistic回归分析EOS、CRP、MUC5AC水平对患者预后的影响。结果COPD组患者EOS、CRP、MUC5AC水平均高于健康对照组(t=15.336、48.020、28.218,P均<0.001),重度亚组>中度亚组>轻度亚组(F=11.157、177.486、72.013,P均<0.001)。FEV_(1)、FVC、FEV_(1)%、FEV_(1)/FVC水平比较,重度亚组<中度亚组<轻度亚组(F=8.730、28.376、53.665、38.847,P均<0.001)。Pearson相关分析显示,EOS、CRP、MUC5AC水平与FEV_(1)、FVC、FEV_(1)%、FEV_(1)/FVC水平均呈负相关(EOS:r/P=-0.352/0.035、-0.458/0.029、-0.674/0.012、-0.658/0.014;CRP:r/P=-0.725/<0.001、-0.384/0.031、-0.658/0.021、-0.612/0.025;MUC5AC:r/P=-0.674/0.012、-0.721/0.002、-0.584/0.024、-0.624/0.027)。EOS、CRP、MUC5AC高水平均是影响COPD患者预后的独立危险因素[HR(95%CI)=1.037(1.002~1.053)、5.403(1.245~9.561)、5.150(3.028~7.272)]。结论吸烟的COPD患者EOS、CRP、MUC5AC水平均升高,其水平随着COPD患者病情程度的加重而升高,且与肺功能呈负相关。
Objective To analyze the relationship between changes in the levels of eosinophils(EOS),C-reactive protein(CRP),and mucin 5AC(MUC5AC)and lung function in smoking chronic obstructive pulmonary disease(COPD)patients.Methods From January 2020 to May 2021,120 smoking COPD patients(COPD group)admitted to the Department of Respiratory and Critical Care,The First Affiliated Hospital of Xi'an Medical College were selected.According to the severity of the disease,they were divided into mild subgroup of 40 cases,moderate subgroup of 50 cases,and severe subgroup of 30 cases.Another 100 healthy subjects during the same period were selected as the healthy control group.The levels of EOS,CRP,and MUC5AC in each group,forced expiratory volume in 1 second(FEV_(1)),forced vital capacity(FVC),percentage of FEV_(1) to predicted value(FEV_(1)%),and FEV_(1)/FVC levels in COPD subgroups were compared.Pearson correlation coefficient was used to analyze the correlation of EOS,CRP,MUC5AC levels with FEV_(1),FVC,FEV_(1)%,FEV_(1)/FVC levels,and Logistic regression was used to analyze the influence of EOS,CRP,MUC5AC levels on the prognosis of patients.Results The levels of EOS,CRP and MUC5AC in the COPD group were higher than those in the healthy control group(t=15.336,48.020,28.218,all P<0.001),and the severe subgroup>moderate subgroup>mild subgroup(F=11.157,177.486,72.013,both P<0.001).Comparison of FEV_(1),FVC,FEV_(1)%,FEV_(1)/FVC levels,severe subgroup<moderate subgroup<mild subgroup(F=8.730,28.376,53.665,38.847,all P<0.001).Pearson correlation analysis showed that EOS,CRP,MUC5AC levels were negatively correlated with FEV_(1),FVC,FEV_(1)%,FEV_(1)/FVC levels(EOS:r/P=-0.352/0.035,-0.458/0.029,-0.674/0.012,-0.658/0.014;CRP:r/P=-0.725/<0.001,-0.384/0.031,-0.658/0.021,-0.612/0.025;MUC5AC:r/P=-0.674/0.012,-0.721/0.002,-0.584/0.024,-0.624/0.027).High levels of EOS,CRP and MUC5AC were independent risk factors affecting the prognosis of COPD patients[HR(95%CI)=1.037(1.002-1.053),5.403(1.245-9.561),5.150(3.028-7.272)].Conclusion The levels of EOS,
作者
刁鑫
贾艳云
潘双
邸丽改
张进召
Diao Xin;Jia Yanyun;Pan Shuang;Di Ligai;Zhang Jinzhao(Department of Respiratory and Critical Care, The First Affiliated Hospital of Xi'an Medical College, Shaanxi Province, Xi'an 710077 ,China)
出处
《疑难病杂志》
CAS
2022年第4期377-382,共6页
Chinese Journal of Difficult and Complicated Cases
基金
陕西省社会发展科技攻关项目(2016SF-066)。
