摘要
目的 :探讨炎性生物标志物对慢性阻塞性肺疾病(COPD)患者死亡风险的影响。方法 :以2011年1月至2013年12月在我院门诊就诊的106例COPD患者为研究对象。记录患者的一般临床资料,完成肺功能检查。同时抽取空腹静脉血化验炎性生物标志物包括中性粒细胞、C反应蛋白、纤维蛋白原、肿瘤坏死因子(TNF-α)、白介素(IL)-6和IL-8。每3个月进行1次随访,随访的终点事件是死亡(全死因),随访期3年。结果 :随访期间死亡11例(10.3%)。1年、2年、3年的生存率分别为92.5%、86.7%、82.6%。死亡者炎性生物标志物水平较生存者显著升高。Cox多因素回归分析证实年龄、中性粒细胞、CRP、纤维蛋白原、TNF-α、IL-6和IL-8为COPD患者死亡的独立危险因素。C统计分析发现,在将年龄、BODE指数构建的、基准模型基础上单独加上以上标志物并未明显改善C统计值,但是当所有生物标志物作为一个整体加入模型,可以明显提高C统计值。结论 :稳定期COPD死亡患者炎性生物标志物水平显著增高,中性粒细胞、CRP、纤维蛋白原、TNF-α、IL-6和IL-8为COPD患者死亡的独立危险因素,对患者的死亡风险具有预测作用。
Objective To investigate the association between inflammatory biomarkers and survival in patients with stable chronic obstructive pulmonary disease(COPD). Methods A total of 106 patients with stable COPD from January 2011 to December 2013 were included. Clinical characteristics and pulmonary function testswere completed. Fasting blood was obtained to detect inflammatory biomarkers including neutrophils, C-reactive protein(CRP), fibrinogen, TNF-α,IL-6 and IL-8. Participants were evaluated every 3 months,allcause mortality was used as the end event and follow-up period were 3 years. Results 11 patients(10.3%)died in the period of follow-up. Kaplan-Meier analysis showed that l year, 2-yearand 3-year survival rates were 92.5%、86.7%and 82.6%, respectively. Compared with survivors, those who died had a higher level of inflammatory biomarkers. Cox multivariate regression analysis demonstrated that the independent risk factors for death were neutrophils, CRP, fibrinogen, TNFα、IL-6 and IL-8. C statistical analysis showed that on singlebiomarker significantly improved the C statistic value on the base of clinical model. but it was further improved by the addition of a11 biomarkers1. Conclusion The level of inflammatory biomarkers in the death with stable COPD is significantly increased. Age, BODE index, neutrophils, CRP, fibrinogen TNF-α, IL-6 and IL-8 are independent risk factor for the prediction of mortality in patients with COPD, and can predict the patient’s risk of death.
出处
《湖南师范大学学报（医学版）》
2015年第4期9-11,共3页
Journal of Hunan Normal University(Medical Sciences)
关键词
慢性阻塞性肺疾病
炎性标志物
死亡
Chronic obstructive pulmonary disease
Inflammatory mediators
Death
