血糖、炎症指标与COPD气流受限、治疗预后关联性及临床意义

doi:10.3969/j.issn.1007-3205.2023.12.012

河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (12): 1436-1441.doi: 10.3969/j.issn.1007-3205.2023.12.012

血糖、炎症指标与COPD气流受限、治疗预后关联性及临床意义

河北省石家庄市第二医院呼吸内科，河北石家庄 050051

出版日期:2024-01-02 发布日期:2024-01-02
作者简介:范素芳（1982-），女，河南民权人，河北省石家庄市第二医院主治医师，医学硕士，从事呼吸疾病诊治研究。
基金资助:
河北省医学科学研究课题计划（20181037）

Correlation of blood glucose and inflammatory markers with airflow limitation, treatment and prognosis in COPD and clinical significance

Department of Respiratory Medicine, the Second Hospital of Shijiazhuang City, Hebei Province, Shijiazhuang 050051, China

Online:2024-01-02 Published:2024-01-02

摘要/Abstract

摘要： 目的探讨血糖、炎症指标与慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）气流受限、治疗预后关联性及临床意义。
方法选取COPD急性加重期患者102例，其中气流受限分级Ⅱ级30例，Ⅲ级38例，Ⅳ级34例，比较不同气流受限分级患者治疗前血糖、肿瘤坏死因子α（tumor necrosis factor-α，TNF-α）、白细胞介素17（interleukin-17， IL-17），采用Pearson分析血糖、TNF-α、IL-17与气流受限分级相关性以及血糖与TNF-α、IL-17相关性，比较不同治疗预后患者治疗前、治疗1 d后、治疗3 d后血糖、炎症指标，采用受试者工作特征曲线（receiver operating characteristic，ROC）及ROC下面积（area under the curve，AUC）分析治疗1 d后、治疗3 d后血糖、TNF-α、IL-17预测治疗预后的价值。
结果气流受限分级Ⅲ、Ⅳ级患者血糖、TNF-α、IL-17高于Ⅱ级（P＜0.05）；血糖、TNF-α、IL-17均与气流受限分级呈正相关（r=0.778、0.828、0.731，P＜0.001）；血糖与TNF-α、IL-17呈正相关（r=0.830、0.812，P＜0.001）；随着治疗时间的延长，良好组血糖、TNF-α、IL-17水平逐渐降低，不良组血糖、TNF-α、IL-17水平变化不明显，2组组间、时间点、组间·时点间交互作用比较差异有统计学意义（P＜0.05）。治疗3 d后各指标预测治疗预后的AUC大于治疗1 d后各指标，治疗3 d后血糖、TNF-α联合IL-17预测效果最好。
结论血糖、TNF-α、IL-17与COPD气流受限、治疗预后有关，联合检测有望成为预测治疗预后的一个可靠方案，从而为临床治疗提供参考，促进患者症状和病情的缓解。

关键词: 肺疾病, 慢性阻塞性, 血糖, 肿瘤坏死因子α, 白细胞介素17

Abstract: Objective To investigate the correlation of blood glucose and inflammatory markers with airflow limitation, treatment and prognosis and clinical significance in chronic obstructive pulmonary disease (COPD).
Methods A total of 102 patients with acute exacerbation of COPD were selected, including 30 cases of airflow limitation grade Ⅱ, 38 cases of grade Ⅲ, and 34 cases of grade Ⅳ. Blood glucose, tumor necrosis factor-α (TNF-α), and interleukin-17 (IL-17) were compared between patients with different airflow limitation classification.Pearson analysis was performed to analyze the correlation of blood glucose, TNF-α and IL-17 with airflow limitation classification,and of blood glucose with TNF-α and IL-17.Blood glucose and inflammatory indicators of patients with different treatment outcomes before treatment, at 1 d after treatment, and at 3 d after treatment were compared. Receiver operating characteristic (ROC) and area under the ROC curve (AUC) analysis were used to analyze the value of blood glucose, TNF-α and IL-17 in predicting treatment outcomes at 1 d after treatment and 3 d after treatment.
Results The blood glucose, TNF-α and IL-17 of the patients with airflow limitation grades Ⅱ, Ⅲ and Ⅳ were higher than those of patients with grade Ⅱ (P＜0.05). Blood glucose, TNF-α, and IL-17 were positively correlated with airflow limitation classification (r=0.778, 0.828, 0.731, all P＜0.001), and blood glucose was positively correlated with TNF-α and IL-17 (r=0.830, 0.812, both P＜0.001). With prolongation of treatment time, the blood glucose, TNF-α and IL-17 in the good group were decreased gradually (P＜0.001), while there was no significant difference in blood glucose, TNF-α, IL-17 in the poor group, and the difference of interaction between groups, time points and time points between groups were statistically significant (P＜0.05). At 3 d after treatment, the area under the curve (AUC) of each index in predicting the prognosis was greater than that at 1 d after treatment, and the AUC of blood glucose, TNF-α combined with IL-17 in predicting the prognosis of the treatment was the largest at 3 d after treatment.
Conclusion Blood glucose, TNF-α and IL-17 are related to COPD airflow limitation and treatment prognosis. Combined detection is expected to be a reliable solution to predict treatment prognosis, so as to provide reference for clinical treatment and promote the relief of symptoms and conditions of patients.

Key words: pulmonary disease, chronic obstructive, blood sugar, tumor necrosis factor-α, interleukin-17

范素芳, 吕侯强. 血糖、炎症指标与COPD气流受限、治疗预后关联性及临床意义 [J]. 河北医科大学学报, 2023, 44(12): 1436-1441.

FAN Su-fang, LYU Hou-qiang. Correlation of blood glucose and inflammatory markers with airflow limitation, treatment and prognosis in COPD and clinical significance [J]. Journal of Hebei Medical University, 2023, 44(12): 1436-1441.

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血糖、炎症指标与COPD气流受限、治疗预后关联性及临床意义

Correlation of blood glucose and inflammatory markers with airflow limitation, treatment and prognosis in COPD and clinical significance

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