不同时期COPD患者血清DcR3、Survivin表达水平及临床意义

目的 探讨不同时期慢性阻塞性肺疾病(COPD)患者血清诱饵受体3(DcR3)、凋亡抑制蛋白(Survivin)表达水平及临床意义。方法 选取2018年9月—2019年12月本院收治的92名COPD患者为研究对象,其中稳定型COPD 50例,急性加重期COPD 42例;同期本院健康体检者88例为对照组。测定各组研究对象血清DcR3、Survivin水平及肺功能指标。结果 与对照组DcR3(106.54±48.35)pg/mL,Survivin(98.85±26.59)pg/mL]比较,稳定期组和急性加重期组血清DcR3(395.23±123.85)pg/mL,(1 248.81±213.59)pg/mL]、Survivin(267.54±84.69)pg/mL,(1 233.95±307.26)pg/mL]水平升高;与稳定期组比较,急性加重期组血清DcR3、Survivin水平升高。与对照组比较,稳定期组和急性加重期组FEV1%、FEV1/FVC、DLCO%水平降低(P<0.001);与稳定期组比较,急性加重期组FEV1%、FEV1/FVC、DLCO%水平降低(P<0.001)。随着低氧血症严重程度的增加,COPD患者血清DcR3、Survivin水平逐渐增加(P<0.001)。多因素logistics回归分析显示,高水平DcR3、Survivin、IL-12、hs-CRP为COPD病情的危险因素(P<0.001)。DcR3、Survivin与FEV、FEV1/FVC呈负相关,与IL-12、TNF-α、hs-CRP呈正相关(P<0.001)。结论COPD稳定期、急性加重期患者血清DcR3、Survivin表达水平升高,且DcR3、Survivin与COPD病情严重程度呈正相关。

Expression levels and clinical significance of serum DcR3 and Survivin in patients with COPD at different stages

Objective To investigate the expression levels and clinical significance of serum DcR3 and Survivin in chronic obstructive pulmonary disease (COPD) patients at different stages. Methods A total of 92 COPD patients admitted to the Dengfeng Traditional Chinese Medicine Hospital from September 2018 to December 2019 were selected as the study subjects, including 50 stable COPD cases and 42 acute exacerbation COPD cases. During the same period, 88 healthy people in this hospital were selected as the control group. The serum levels of DcR3, Survivin, IL-12, TNF-α, hs-CRP and lung function indexes of each group (sub-group) were determined. Results Compared with the levels of serum DcR3 and Survivin in the control group , the levels of serum DcR3 and Survivin were increased in the stable COPD sub-group and the acute exacerbation COPD sub-group: (395.23±123.85) pg/mL, (1 248.81±213.59) pg/mL, and (267.54±84.69) pg/mL, (1 233.95±307.26) pg/mL respectively; compared with the levels of serum DcR3 and Survivin in the stable sub-group, the levels of serum DcR3 and Survivin in the acute exacerbation COPD sub-group were increased. Compared with the control group, the levels of FEV1%, FEV1/FVC, and DLCO% of the stable COPD sub-group and acute exacerbation COPD sub-group were reduced (P<0.001). Compared with the stable sub-group, the levels of FEV1%, FEV1/FVC and DLCO% of the acute exacerbation sub-group were decreased (P<0.001). As the severity of hypoxemia was increased, the levels of serum DcR3 and Survivin in COPD patients were increased gradually (P<0.001). The multivariate logistic regression analysis showed that high levels of DcR3, Survivin, IL-12, and hs-CRP were risk factors for the severity of COPD (P<0.001). DcR3 and Survivin were negatively correlated with FEV and FEV1/FVC, and positively correlated with IL-12, TNF-α, and hs-CRP (P<0.001). Conclusion The expression levels of serum DcR3 and Survivin are increased in stable COPD patients and acute exacerbations COPD patients, and DcR3 and Survivin are positively correlated with the severity of COPD.