[1]陈桂涛,晏斌林,周晖东,等.COPD并发呼吸衰竭患者血清14-3-3β，CC16水平表达及与预后的关系研究[J].现代检验医学杂志,2025,40(05):113-118,135.[doi:10.3969/j.issn.1671-7414.2025.05.021]
　CHEN Guitao,YAN Binlin,ZHOU Huidong,et al.Study on the Expression of Serum 14-3-3β，CC16 Levels in Patients with COPD Complicated with Respiratory Failure and Their Relationship with Prognosis[J].Journal of Modern Laboratory Medicine,2025,40(05):113-118,135.[doi:10.3969/j.issn.1671-7414.2025.05.021]
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COPD并发呼吸衰竭患者血清14-3-3β，CC16水平表达及与预后的关系研究()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第40卷
期数:
2025年05期
页码:
113-118,135
栏目:
论著
出版日期:
2025-09-15

文章信息/Info

Title:
Study on the Expression of Serum 14-3-3β，CC16 Levels in Patients with COPD Complicated with Respiratory Failure and Their Relationship with Prognosis
文章编号:
1671-7414（2025）05-113-07
作者:
陈桂涛a，晏斌林a，周晖东a，傅钰雁a，左 乐b
南方科技大学盐田医院 a.呼吸与危重症医学科；b.检验科，广东深圳 518081
Author(s):
CHEN Guitaoa，YAN Binlina，ZHOU Huidonga，FU Yuyana，ZUO Leb
a. Department of Respiratory and Critical Care Medicine；b. Department of Laboratory Medicine，Southern University of Science and Technology Yantian Hospital，Guangdong Shenzhen 518081，China
关键词:
慢性阻塞性肺疾病; 呼吸衰竭; 酪氨酸3-单加氧酶/色氨酸5-单加氧酶激活蛋白β; 克拉拉细胞分泌蛋白16
分类号:
R563；R392.11
DOI:
10.3969/j.issn.1671-7414.2025.05.021
文献标志码:
A
摘要:
目的探讨慢性阻塞性肺疾病（COPD）并发呼吸衰竭患者血清酪氨酸3-单加氧酶/色氨酸5-单加氧酶激活蛋白β（14-3-3β），克拉拉细胞分泌蛋白16（CC16）水平表达及与预后的关系。方法选取2020年4月～2023年10月南方科技大学盐田医院收治的COPD并发呼吸衰竭患者232例纳入COPD并发呼吸衰竭组，根据病情程度分为轻度组（n=67）、中度组（n=73）和重度组（n=92）；根据28天预后分为死亡组（n=73）和存活组（n=159）；另选择同时间段单纯COPD患者80例（COPD组）和80例体检健康者（对照组），采用酶联免疫吸附法（ELISA）检测血清14-3-3β，CC16表达。通过多因素Logistic回归分析COPD并发呼吸衰竭患者死亡的因素，受试者工作特征(ROC)曲线分析血清14-3-3β，CC16表达对COPD并发呼吸衰竭患者死亡的预测价值。结果COPD并发呼吸衰竭组血清14-3-3β表达高于COPD组和对照组（U＝3.894，11.417），CC16表达低于COPD组和对照组（t=5.845，14.306），差异具有统计学意义（均P＜0.05）。重度组血清14-3-3β表达高于中度组和轻度组（U=5.179，8.234），CC16表达低于中度组和轻度组（t=4.090，9.281），差异具有统计学意义（均P＜0.05）。232例COPD并发呼吸衰竭患者28天死亡率为31.47%（73/232）。死亡组血清14-3-3β表达高于存活组，CC16表达低于存活组，差异具有统计学意义（U/t=6.790，8.265，均P＜0.05）。死亡组年龄大于存活组，气流受限程度、1年内急性加重次数高于存活组，差异具有统计学意义（t/χ2/U=3.895，7.202，3.360，均P＜0.05）。年龄增加、重度气流受限、极重度气流受限、1年内急性加重次数增加、14-3-3β升高为COPD并发呼吸衰竭患者死亡的独立危险因素（Waldχ2=3.914～22.668，均P＜0.05），CC16升高为独立保护因素（Waldχ2=23.675，P＜0.05）。血清14-3-3β，CC16表达联合预测COPD并发呼吸衰竭患者死亡的曲线下面积（AUC）大于血清14-3-3β，CC16表达单独预测，差异具有统计学意义（Z=3.995，3.813，均P＜0.01）。结论COPD并发呼吸衰竭患者血清14-3-3β表达升高和CC16表达降低与病情加重、不良预后密切相关，血清14-3-3β，CC16表达联合预测COPD并发呼吸衰竭患者死亡的价值较高。
Abstract:
Objective To investigate the expression levels of serum tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein β (14-3-3β) and clara’s cell secretory protein 16 (CC16) in patients with chronic obstructive pulmonary disease (COPD) complicated by respiratory failure, and their relationship with prognosis. Methods A total of 232 patients with COPD complicated with respiratory failure admitted to Yantian Hospital of Southern University of Science and Technology from April 2020 to October 2023 were enrolled in the COPD complicated with respiratory failure group.According to the severity of the disease, they were divided into mild group（n=67）, moderate group （n=73）and severe group (n= 92 ).According to the 28-day prognosis, they were divided into death group (n=73) and survival group (n=159). In addition, 80 patients with simple COPD (COPD group ) and 80 healthy subjects (control group ) were selected at the same time. Enzyme-linked immunosorbent assay（ELISA） was used to detect the expression of serum 14-3-3β and CC16. Multivariate Logistic regression analysis was used to analyze the factors of death in patients with COPD complicated with respiratory failure. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum 14-3-3β and CC16 expression on the death of patients with COPD complicated with respiratory failure. Results The expression of serum 14-3-3β in COPD complicated with respiratory failure group was higher than that in COPD group and control group (U = 3.894, 11.417)，the expression of CC16 was lower than that in COPD group and control group (t= 5.845, 14.306)，and the differences were statistically significant(all P<0.05)，respectively.The expression of serum 14-3-3β in severe group was higher than that in moderate group and mild group (U = 5.179, 8.234)，the expression of CC16 was lower than that of moderate group and mild group (t = 4.090, 9.281), and the differences were statistically significant(all P< 0.05)，respectively. The 28-day mortality rate of 232 COPD patients with respiratory failure was 31.47 % (73/232). The expression of serum 14-3-3β in the death group was higher than that in the survival group, and the expression of CC16 was lower than that in the survival group，the differences were statistically significant (U/t = 6.790, 8.265, all P < 0.05 ). The age of the death group was older than that of the survival group, the degree of airflow limitation and the number of acute exacerbations within 1 year were higher than those of the survival group, and the differences were statistically significant (t/χ2/U= 3.895, 7.202, 3.360, all P < 0.05 ).Age, severe airflow limitation, extremely severe airflow limitation, and the number of acute exacerbations within 1 year, elevated 14-3-3β were independent risk factors for death in patients with COPD complicated with respiratory failure(Wald χ2=3.914～22.668, all P < 0.05 ), and elevated CC16 was an independent protective factor (Wald χ2=23.675, P < 0.05 ). The area under the curve（AUC）of serum 14-3-3β combined and CC16 expression in predicting the death of patients with COPD complicated with respiratory failure which was greater than that of serum 14-3-3β and CC16 expression alone，the differences were statistically significant (Z = 3.995, 3.813, all P < 0.01 ). Conclusion The increase of serum 14-3-3β expression and the decrease of CC16 expression in patients with COPD complicated by respiratory failure are closely related to the aggravation of the disease and poor prognosis. The combination of serum 14-3-3β and CC16 expression is of high value in predicting the death of patients with COPD complicated with respiratory failure.

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备注/Memo

备注/Memo:
基金项目：广东省医学科研基金立项项目（A2023159）。
作者简介：陈桂涛（1984-），男，硕士研究生，主治医师，研究方向：呼吸与危重症，E-mail：nfkjdxcgt@163.com。
通讯作者：晏斌林（1979-），男，硕士研究生，主任医师，研究方向：呼吸与危重症，E-mail：cycgt@163.com。
更新日期/Last Update: 2025-09-15