血清GDF-15和CXCL12检测在老年慢性阻塞性肺疾病急性加重期的应用价值

目的探讨血清生长分化因子15(GDF-15)和趋化因子配体12(CXCL12)检测在老年慢性阻塞性肺疾病急性加重期(AECOPD)的应用价值。方法选取2017年1月至2018年12月该院诊治的119例慢性阻塞性肺疾病(COPD)患者,根据病情轻重分为AECOPD组(68例)和COPD稳定期组(51例),选取同期60例健康体检者作为对照组,检测各组血清GDF-15、CXCL12和降钙素原(PCT)水平,收集3组肺功能结果和慢性阻塞性肺疾病评估测试量表(CAT)评分。结果AECOPD组和COPD稳定期组血清GDF-15、CXCL12、PCT水平和CAT评分高于对照组(P<0.05),AECOPD组血清GDF-15、CXCL12、PCT水平和CAT评分高于COPD稳定期组(P<0.05)。AECOPD组和COPD稳定期组第1秒用力呼气容积占预计值的百分比(FEV1%pred)和第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)水平低于对照组,AECOPD组FEV1%pred和FEV1/FVC水平低于COPD稳定期组(P<0.05)。血清GDF-15、CXCL12、PCT水平与FEV1%pred和FEV1/FVC呈负相关(P<0.05),与CAT评分呈正相关(P<0.05)。受试者工作特征(ROC)曲线分析显示,血清GDF-15、CXCL12对AECOPD的诊断价值优于PCT。结论老年AECOPD患者血清GDF-15、CXCL12水平上升,与肺功能和CAT评分密切相关,GDF-15和CXCL12可作为老年AECOPD的诊断指标。

Application value of serum GDF-15 and CXCL12 detection in elderly patients with acute exacerbation of chronic obstructive pulmonary disease

Objective To investigate the application value of serum growth differentiation factor 15(GDF-15)and chemokine ligand 12(CXCL12)detection in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods One hundred and nineteen elderly patients with chronic obstructive pulmonary disease(COPD)diagnosed and treated in this hospital from January 2017 to December 2018 were selected and divided into the AECOPD group(68 cases)and COPD stable stage group(51 cases)according to the disease condition.At the same period,60 people undergoing healthy physical examination were selected as the control group.The serum levels of GDF-15,CXCL12 and procalcitonin(PCT)were detected in each group.The results of pulmonary function and CAT scores were collected in 3 groups.Results The levels of serum GDF-15,CXCL12,PCT and CAT scores in the AECOPD group and COPD stable stage group were higher than those in the control group,and the levels of serum GDF-15,CXCL12,PCT and CAT in the AECOPD group were higher than those in the COPD stable stage group(P<0.05).The FEV1%pred and FEV1/FVC in the AECOPD group and COPD stable stage group were lower than those in the control group,and the FEV1%pred and FEV1/FVC in the AECOPD group were lower than those in the COPD stable stage group(P<0.05).Serum GDF-15,CXCL12 and PCT levels were negatively correlated with FEV1%pred and FEV1/FVC,and positively correlated with CAT scores(P<0.05).The ROC curve analysis showed that serum GDF-15 and CXCL12 were superior to PCT in the diagnostic value of AECOPD.Conclusion The levels of GDF-15 and CXCL12 in elderly patients with AECOPD are increased,which are closely correlated with the pulmonary function and CAT score,and could be used as the diagnostic indicators in elderly patients with AECOPD.