[1]龙借帆a,李　翠a,高元标a,等.联合检测血清SIRT1和CTRP5水平对慢性阻塞性肺疾病急性加重期患者预后的预测价值研究[J].现代检验医学杂志,2022,37(03):162-166.[doi:10.3969/j.issn.1671-7414.2022.03.034]
　LONG Jie-fana,LI Cuia,GAO Yuan-biaoa,et al.Prognostic Value of Combined Detection of Serum SIRT1 and CTRP5 Levels in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease[J].Journal of Modern Laboratory Medicine,2022,37(03):162-166.[doi:10.3969/j.issn.1671-7414.2022.03.034]
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联合检测血清SIRT1和CTRP5水平对慢性阻塞性肺疾病急性加重期患者预后的预测价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年03期
页码:
162-166
栏目:
检验与临床
出版日期:
2022-05-15

文章信息/Info

Title:
Prognostic Value of Combined Detection of Serum SIRT1 and CTRP5 Levels in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease
文章编号:
1671-7414（2022）03-162-06
作者:
龙借帆a; 李　翠a; 高元标a; 王妹妹b; 肖钦晓c
( 海南省东部中心医院a. 急诊科；b. 检验科；c. 呼吸科，海南琼海 571400）
Author(s):
LONG Jie-fana;  LI Cuia;  GAO Yuan-biaoa;  WANG Mei-meib;  XIAO Qin-xiaoc
(a. Department of Emergency；b. Department of Clinical Laboratory；c. Department of Respiratory Medicine, Central Hospital of Eastern Hainan, Hainan Qionghai 571400,China)
关键词:
慢性阻塞性肺疾病; 急性加重期; 沉默信息调节因子2 相关酶1; 补体1q/ 肿瘤坏死因子相关蛋白5
分类号:
R563；R392.11
DOI:
10.3969/j.issn.1671-7414.2022.03.034
文献标志码:
A
摘要:
目的　探讨沉默信息调节因子 2相关酶 1(silent information regulator 2 related enzyme 1，SIRT1)联合补体 1q/肿瘤坏死因子相关蛋白 5(complement 1q/tumor necrosis factor-related protein 5 ，CTRP5)对慢性阻塞性肺疾病急性加重期 (acute exacerbation of chronic obstructive pulmonary disease，AECOPD)患者预后的预测价值。方法　选取海南省东部中心医院收治的 152例 COPD患者，根据病情程度分为急性加重期组 (n=84)和稳定期组 (n=68)，随访 1年根据预后情况将急性加重期组分为预后不良组 (n=32)和预后良好组 (n=52)。比较各组血清 SIRT1和 CTRP5水平，采用多因素逐步 Logistics回归分析 AECOPD患者预后的影响因素，绘制 ROC曲线分析 SIRT1联合 CTRP5对 AECOPD患者预后不良的预测价值。结果　急性加重期组血清 SIRT1水平 (0.68±0.19ng/ml)低于稳定期组 (0.93±0.22ng/ml)，CTRP5水平 (51.98±6.82ng/ml)高于稳定期组 (41.36±8.35ng/ml)，差异具有统计学意义 (t=-7.451，8.630，均 P＜ 0.001)。预后不良组血清 SIRT1水平 (0.57±0.13ng/ml)低于预后良好组 (0.75±0.19ng/ml)，CTRP5水平 (56.51±6.06ng/ml)高于预后良好组 (49.19±5.71ng/ml)，差异具有统计学意义 (t=-4.759，5.582，均 P＜ 0.001)。多因素逐步 Logistics回归分析显示，年龄≥ 60岁 (OR=1.389，95%CI 1.052～ 1.632)、并发肺心病 (OR=4.575，95%CI 2.143～ 8.322)、机械通气 (OR=3.804， 95%CI 1.695～ 7.705)、高血清 CTRP5水平 (OR=4.073，95%CI 2.604～ 8.082)为 AECOPD患者预后不良独立危险因素，高血清 SIRT1水平 (OR=0.976，95%CI 0.881～ 1.082)为独立保护因素 (均 P＜ 0.05)。ROC曲线显示，SIRT1联合 CTRP5(AUC=0.905，95%CI 0.821～ 0.958)预测 AECOPD患者预后不良的曲线下面积 (AUC)大于 SIRT1(AUC=0.816， 95%CI 0.716～ 0.892)，CTRP5(AUC=0.810，95%CI 0.709～ 0.887)单独预测 (Z=2.296，3.328，P=0.022，0.001)，联合检测的敏感度和特异度分别为 78.12%，90.38%。结论　AECOPD患者血清 SIRT1水平降低， CTRP5水平提高，二者均为预后不良独立影响因素，联合检测能提高预后不良预测价值。
Abstract:
Objective　To investigate the prognostic value of silent information regulator 2 related enzyme 1 (SIRT1) combined with complement 1q/tumor necrosis factor-related protein 5 (CTRP5) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods　152 patients with COPD enrolled in Central Hospital of Eastern Hainan were selected, and they were divided into acute exacerbation group (n=84) and stable group (n=68) according to the degree of disease. The acute exacerbation group was divided into poor prognosis group (n=32) and good prognosis group (n=52) according to the prognosis at 1 year follow-up.The levels of serum SIRT1 and CTRP5 in each group were compared. The influencing factors of prognosis in patients with AECOPD were analyzed by multivariate stepwise logistic regression, and the ROC curve was drawn to analyze the predictive value of SIRT1 combined with CTRP5 for poor prognosis in patients with AECOPD. Results　The level of serum SIRT1 (0.68±0.19ng/ml) in acute exacerbation group was lower than that in stable group (0.93±0.22ng/ml), and the level of CTRP5 (51.98±6.82ng/ml) was higher than that in stable group (41.36±8.35ng/ml),the differences were statistically significant (t=-7.451，8.630, all P ＜ 0.001).The serum SIRT1 level (0.57±0.13ng/ml) in the poor prognosis group was lower than that in the good prognosis group (0.75 ±0.19ng/ml), and the CTRP5 level (56.51±6.06ng/ml) was higher than that in the good prognosis group (49.19±5.71ng /ml),the differences were statistically significant (t = -4.759，5.582, all P ＜ 0.001). Multivariate stepwise logistic regression analysis showed that age ≥ 60 years old (OR=1.389, 95%CI 1.052 ～ 1.632), complicated with cor pulmonale(OR=4.575, 95%CI 2.143 ～ 8.322), mechanical ventilation (OR=3.804, 95%CI 1.695 ～ 7.705), high serum CTRP5 level (OR=4.073, 95%CI 2.604 ～ 8.082) were independent risk factors for poor prognosis of AECOPD patients, and high serum SIRT1 level (OR=0.976, 95%CI 0.881 ～ 1.082) was an independent protective factor (P ＜ 0.05).The ROC curve showed that the area under the curve (AUC) predicted by SIRT1 combined with CTRP5(AUC = 0.905, 95% CI 0.821 ～ 0.958) was greater than that predicted by SIRT1 (AUC = 0.816, 95% CI 0.716 ～ 0.892) and CTRP5 (AUC = 0.810, 95% CI 0.709 ～ 0.887) alone (Z=2.296，3.328，P=0.022，0.001)，and the sensitivity and specificity of combined detection were 78.12% and 90.38% ，respectively. Conclusion　Serum SIRT1 level decreased and CTRP5 level increased in patients with AECOPD. Both of them are independent influencing factors of poor prognosis. Combined detection can improve the predictive value of poor prognosis.

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备注/Memo

备注/Memo:
基金项目：海南省自然科学基金项目（818MS124）。
作者简介：龙借帆（1988-），男，学士，主治医师，研究方向：呼吸系统疾病急诊，E-mail：doctorlongjf@163.com。
更新日期/Last Update: 1900-01-01