血清IMA水平对COPD病情的评估

目的 探讨血清缺血修饰清蛋白(IMA)在慢性阻塞性肺疾病(COPD)病情评估中的价值.方法 选取2015年9月至2016年3月在该院诊治的COPD患者81例纳入COPD组(急性加重期50例,稳定期31例),同时收集30例非COPD的志愿者作为对照组;测定两组血清IMA水平并进行比较,分析COPD患者血清IMA水平与血清肌红蛋白(MYO)、肌钙蛋白T(TNT)、C反应蛋白(CRP)水平及全血白细胞(WBC)计数的相关性,绘制受试者工作特征(ROC)曲线,分析血清IMA水平在COPD的诊断价值.结果 COPD组血清IMA水平明显高于对照组84.1(79.1,88.5)U/L vs.73.1(70.2,75.1)U/L],急性加重期COPD患者血清IMA水平明显高于稳定期患者85.5 (82.3,89.4)U/L vs.78.1(75.9,83.0) U/L],急性加重期和稳定期COPD患者血清IMA水平均明显高于对照组,差异均有统计学意义(P＜0.05).COPD患者血清IMA水平与血清MYO水平呈明显正相关(r=0.554,P=0.00);ROC曲线表明,当取截断值为76.55 U/mL时,IMA诊断COPD的灵敏度为88.5％,特异度为80.0％,ROC曲线下面积为0.88.结论 血清IMA水平在COPD病情评估方面有较好的临床价值,值得扩大样本进一步研究.

Assessment of disease severity by serum IMA levels in patients with COPD

Objective To explore the value of serum ischemia modified albumin (IMA) level in assessment of disease severity for patients with chronic obstructive pulmonary disease (COPD).Methods A total of 81 cases of patients with COPD treated in our hospital from September 2015 to March 2016 were selected (COPD group),including 51 cases of patients with acute exacerbation of COPD and 30 cases of patients with stable of COPD.Meanwhile,30 volunteers without COPD were collected as control group.Serum levels of IMA were detected and compared among different groups.Correlations between serum level of IMA and serum level of myoglobin (MYO),troponin T (TNT) and C reactive protein (CRP),and white blood cell (WBC) count were analyzed respectively.A receiver operating characteristic (ROC) curve was also plotted to investigate the diagnostic value of serum IMA level for diagnosing COPD.Results Serum level of IMA in the COPD group was higher than that in the control group 84.1 (79.1,88.5) U/L vs.73.1 (70.2,75.1)U/L],serum level of IMA in patients with acute exacerbation of COPD was higher than that of patients with stable of COPD 85.5 (82.3,89.4)U/L vs.78.1 (75.9,83.0)U/L],serum levels of IMA in patients with acute exacerbation and stable of COPD both were higher than that in the control group,there were statistically significant differences (P＜0.05).The serum level of IMA was positively related with serum level of MYO in patients with COPD (r=0.554,P =0.00).ROC curve indicated when the cutoff value was set as 76.55 U/L,the sensitivity and specificity of serum level of IMA for diagnosing COPD was 88.5％ and 80.0％ respectively,and area under the ROC curve was 0.88.Conclusion Serum level of IMA could be a valuable indicator for clinically assessing disease severity of patients with COPD,which deserves further study through expanding samples size.