河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (10): 1141-1145.doi: 10.3969/j.issn.1007-3205.2023.10.005

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AECOPD患者外周血NF-κB、IL-34、CCL18水平与预后的关系探讨

  

  1. 1.河北省胸科医院呼吸四科，河北 石家庄 050000;2.河北省胸科医院呼吸一科，河北 石家庄 050000;3.河北省胸科医院感染科，河北 石家庄 050000;4.河北省胸科医院结核五科，河北 石家庄 050000

  • 出版日期:2023-10-25 发布日期:2023-11-03
  • 作者简介:郭立娟（1988-），女，河北行唐人，河北省胸科医院主治医师，医学硕士，从事呼吸内科疾病诊治研究。
  • 基金资助:
    河北省医学科学研究课题计划（20200826）

Relationship between peripheral blood NF-κB, IL-34, CCL18 levels and prognosis in patients with AECOPD

  1. 1.The Fourth Department of Respiratory Diseases, Hebei Chest Hospital, Shijiazhuang 050000, China； 
    2.The First Department of Respiratory Diseases, Hebei Chest Hospital, Shijiazhuang 050000, 
    China； 3.Department of Infectious Diseases， Hebei Chest Hospital, Shijiazhuang 
    050000, China； 4.The Fifth Department of Tuberculosis, 
    Hebei Chest Hospital, Shijiazhuang 050000, China

  • Online:2023-10-25 Published:2023-11-03

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摘要： 目的 探讨慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease，AECOPD）患者外周血核转录因子κB（nuclear factor κB，NF-κB）、白细胞介素34（interleukin-34，IL-34）、趋化因子配体18（chemokine ligand 18，CCL18）水平与预后的关系。
方法 选取AECOPD患者100例作为AECOPD组，慢性阻塞性肺疾病稳定期（stable chronic obstructive pulmonary disease，SCOPD）患者100例作为SCOPD组，另选取体检健康者100例作为对照组，检测所有受试者外周血NF-κB、IL-34、CCL18水平。分析外周血NF-κB、IL-34、CCL18水平对AECOPD患者住院期间死亡的预测价值。
结果  AECOPD组和SCOPD组外周血NF-κB、IL-34、CCL18水平高于对照组，AECOPD组外周血NF-κB、IL-34、CCL18水平高于SCOPD组（P＜0.05）。外周血NF-κB、IL-34、CCL18高水平是AECOPD发生的危险因素（P＜0.05）；外周血NF-κB、IL-34、CCL18高水平患者AECOPD发生风险是低水平患者的4.165倍、4.012倍、4.027倍。住院期间死亡的AECOPD患者外周血NF-κB、IL-34、CCL18水平及急性生理与慢性健康评估（acute physiology and chronic health evaluation，APACHE）Ⅱ评分均高于住院期间生存患者（P＜0.05）。AECOPD患者外周血NF-κB、IL-34、CCL18水平与APACHEⅡ评分呈正相关关系（P＜0.05）。外周血NF-κB、IL-34、CCL18水平联合预测AECOPD患者住院期间死亡的曲线下面积最大，为0.933。
结论 AECOPD患者外周血NF-κB、IL-34、CCL18水平明显升高，且其水平升高与患者病情程度及预后密切相关，临床检测NF-κB、IL-34、CCL18水平可有效预测AECOPD患者预后。


关键词: 肺疾病,慢性阻塞性, NF-κB, 白细胞介素34, 趋化因子CCL18

Abstract: Objective To explore the relationship of peripheral blood nuclear transcription factor-κB (NF-κB), interleukin-34 (IL-34) and chemokine ligand 18 (CCL18) with the prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). 
Methods In total, 100 patients with AECOPD were selected as the AECOPD group, 100 patients with stable chronic obstructive pulmonary disease (SCOPD) were selected as the SCOPD group, and 100 healthy physical examinees were selected as the control group. The levels of NF-κB, IL-34, and CCL18 in peripheral blood of each group were detected, and the predictive value of peripheral blood NF-κB, IL-34, and CCL18 levels for the death of AECOPD patients during hospitalization was analyzed. 
Results The levels of NF-κB, IL-34 and CCL18 in peripheral blood in AECOPD group and SCOPD group were higher than those in control group, and the levels of NF-κB, IL-34 and CCL18 in peripheral blood in AECOPD group were higher than those in SCOPD group (P＜0.05). High levels of NF-κB, IL-34, and CCL18 in peripheral blood were risk factors for the occurrence of AECOPD (P＜0.05), and the risk of AECOPD in patients with high levels of NF-κB, IL-34, and CCL18 in peripheral blood was 4.165 times, 4.012 times, and 4.027 times higher than that in patients with low levels. The peripheral blood NF-κB, IL-34, CCL18 levels and acute physiology and chronic health evaluation (APACHE) Ⅱ scores of AECOPD patients who died during hospitalization were higher than those of surviving patients during hospitalization (P＜0.05). The levels of NF-κB, IL-34, CCL18 in peripheral blood of AECOPD patients were positively correlated with APACHE Ⅱ scores (P＜0.05). The combined detection of NF-κB, IL-34, and CCL18 levels in peripheral blood in predicting the death of AECOPD patients during hospitalization had the largest area under the receiver operating characteristic (ROC) curve, which was 0.933. 
Conclusion The levels of NF-κB, IL-34 and CCL18 in peripheral blood of patients with AECOPD are significantly increased, and the elevated levels are closely related to the prognosis of patients. Clinical detection of NF-κB, IL-34 and CCL18 levels can effectively predict the prognosis of patients with AECOPD. 


Key words: pulmonary disease, chronic obstructive, NF-kappa B, interleukin-34, chemokine CCL18

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