河北医科大学学报 ›› 2024, Vol. 45 ›› Issue (4): 400-405.doi: 10.3969/j.issn.1007-3205.2024.04.006

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血清铁调节蛋白2、诱饵受体3水平与老年慢性阻塞性肺疾病急性加重期患者疾病转归的关系研究

  

  1. 华润武钢总医院呼吸与危重症医学科，湖北 武汉 430080

  • 出版日期:2024-04-25 发布日期:2024-04-22
  • 作者简介:吕睿冰 (1983-),女,湖北武汉人,华润武钢总医院主治医师,医学硕士,从事重症医学疾病诊治研究。
  • 基金资助:
    湖北省卫生健康委员会联合基金项目（WJ2019H200）

Relationship of serum iron-regulated protein 2 and decoy receptor 3 levels with disease outcome in elderly patients with acute exacerbation of chronic obstructive pulmonary disease

  1. Department of Respiratory and Critical Care Medicine, China Resources Wugang General Hospital, Hubei Province, Wuhan 430080, China

  • Online:2024-04-25 Published:2024-04-22

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摘要： 目的 探讨血清铁调节蛋白2（iron-regulated protein 2，IRP2）、诱饵受体3（decoy receptor 3，DcR3）水平与老年慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease，AECOPD）患者疾病转归的关系。
方法 选择AECOPD患者（AECOPD组）88例，检测血清IRP2、DcR3水平，追踪AECOPD患者临床疾病转归，根据临床疾病转归将其分为恶化组（22例）和好转组（66例）。多因素Logistic回归分析AECOPD患者疾病转归的影响因素。受试者工作特征曲线（receiver operating characteristic curve，ROC）分析IRP2、DcR3预测AECOPD患者疾病转归的价值。
结果 恶化组近1年AECOPD发作次数、急性生理和慢性健康状况评分、合并休克、呼吸困难评分（modified medical research council，mMRC）分级3~4级高于好转组（P＜0.05）。恶化组治疗前和治疗2周后血清IRP2、DcR3水平高于好转组，治疗2周后好转组血清IRP2、DcR3水平低于治疗前（P＜0.05）；恶化组血清IRP2、DcR3水平与治疗前比较差异无统计学意义（P＞0.05）。多因素Logistic回归分析结果显示，近1年AECOPD发作次数、mMRC分级、治疗前IRP2、治疗前DcR3是AECOPD患者疾病恶化的危险因素（P＜0.05）。治疗前IRP2、DcR3预测AECOPD患者疾病转归的曲线下面积为0.781、0.795，联合IRP2、DcR3预测AECOPD患者疾病转归的曲线下面积为0.918，大于单独IRP2、DcR3预测（P＜0.05）。
结论 AECOPD患者血清IRP2、DcR3水平均显著增高，且与肺功能降低以及疾病恶化有关，检测血清IRP2、DcR3水平有助于对AECOPD患者疾病转归的预测。


关键词: 肺疾病, 慢性阻塞性, 铁调节蛋白质2, 诱饵受体3

Abstract: Objective To investigate the relationship of serum iron-regulated protein 2 (IRP2) and decoy receptor 3 (DcR3) levels with disease outcome in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). 
Methods In total, 88 patients with AECOPD (AECOPD group) were selected, and serum IRP2 and DcR3 levels of subjects were detected. Clinical disease outcomes of AECOPD patients were tracked and they were divided into aggravation group (n=22) and improvement group (n=66) according to clinical disease outcomes. Multivariate Logistic regression analysis was used to analyze the factors influencing disease outcome of AECOPD patients. The value of IRP2 and DcR3 in predicting the outcome of AECOPD patients was analyzed by receiver operating characteristic curve (ROC). 
Results The number of AECOPD attacks, acute physiological and chronic health status scores, combined shock and dyspnea scores, and modified medical research council (mMRC) grades 3-4 in the aggravation group were better than those in the improvement group (P＜0.05). The serum IRP2 and DcR3 levels in the aggravation group were higher than those in the improvement group before and at 2 weeks after treatment, and the serum IRP2 and DcR3 levels in the improvement group at 2 weeks after treatment were lower than those before treatment (P＜0.05). There was no significant difference in serum IRP2 and DcR3 levels in the aggravation group compared with those before treatment (P＞0.05). Multivariate Logistic regression analysis showed that the number of AECOPD attacks within 1 year, mMRC grade, IRP2 before treatment, DcR3 before treatment were risk factors for disease deterioration in patients with AECOPD (P＜0.05). The area under the ROC curve (AUC) of IRP2 and DcR3 before treatment in predicting disease outcome of AECOPD patients was 0.781 and 0.795 respectively, and the AUC of IRP2 and DcR3 in combination was 0.918, which was greater than that predicted by IRP2 and DcR3 alone (P＜0.05). 
Conclusion Serum levels of IRP2 and DcR3 are significantly increased in AECOPD patients, and are associated with decreased lung function and disease deterioration. Detection of serum levels of IRP2 and DcR3 is helpful to predict the disease outcome in AECOPD patients. 


Key words: pulmonary disease, chronic obstructive, iron regulatory protein 2, decoy receptor 3

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