河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (9): 1027-1031.doi: 10.3969/j.issn.1007-3205.2023.09.007

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血液CC16、PCT、FKN水平与慢性阻塞性肺疾病患者衰弱的临床研究

  

  1. 重庆市铜梁区人民医院呼吸与危重症医学科，重庆 402560

  • 出版日期:2023-09-25 发布日期:2023-10-12
  • 作者简介:张欣（1991-），女，重庆人，重庆市铜梁区人民医院主治医师，医学硕士，从事呼吸与危重症医学科诊治研究。
  • 基金资助:
    重庆市科卫联合医学科研项目（2020FYYX229）

Clinical study on the relationship between the levels of CC16, PCT, FKN in blood and the frailty of patients with chronic obstructive pulmonary disease

  1. Department of Respiratory and Critical Care Medicine, People′s Hospital of Tongliang District, Chongqing 402560, China

  • Online:2023-09-25 Published:2023-10-12

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摘要： 目的  探讨血清Clara细胞分泌蛋白（Clara cell secretory protein,CC16）、降钙素原（procalcitonin，PCT）、不规则趋化因子（fractalkine,FKN）水平与慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）患者衰弱的预测价值。
方法  选取老年COPD患者142例，依据入院时Frail衰弱筛查量表分为2组，评分3~5分为衰弱组43例，评分＜3分为非衰弱组99例（随机选取43例为对照组），对比2组肺功能、血清CC16、PCT及FKN水平差异，采用Pearson相关性分析血液指标与COPD患者肺功能的相关性，Logistic回归分析诱发COPD患者衰弱的影响因素，利用受试者工作特征曲线（receiver operating characteristic curve,ROC）分析阳性指标在预测衰弱风险的价值。
结果  衰弱组血清CC16显著低于对照组，而PCT及FKN水平明显高于对照组，数据差异有统计学意义（P＜0.05）；COPD伴衰弱组第1秒用力呼气容积(exhale volume by force 1 second，FEV1)，用力肺活量(forced vital capacity，FVC)及FEV1/FVC水平均显著低于对照组（P＜0.05）；Pearson相关性分析显示，血清CC16与肺功能指标均呈正相关(P＜0.05)；血清PCT、FKN水平与肺功能指标均呈负相关(P＜0.001)。Logistic回归分析显示，血清学指标CC16、PCT、FKN均是影响老年COPD患者衰弱的影响因素，其中CC16为保护性因素（P＜0.05）；CC16、PCT及FKN水平与老年COPD患者衰弱发生密切相关，并且均可作为预测衰弱风险的检ROC曲线分析显示，PCT曲线下面积最大0.890（0.824~0.956），FKN次之为0.830（0.742~0.914），CC16最小0.771，3项指标均具有预测老年COPD患者衰弱的价值（P＜0.05）。
结论  血清CC16、PCT及FKN水平与老年COPD患者衰弱发生密切相关，并且均可作为预测衰弱风险的检测指标。


关键词: 肺疾病, 慢性阻塞性, 降钙素原, 子宫珠蛋白

Abstract: Objective  To investigate the predictive value of serum Clara cell secretory protein (CC16), procalcitonin (PCT) and fractalkine (FKN) levels in frailty of patients with chronic obstructive pulmonary disease (COPD). 
Methods  A total of 142 elderly patients with COPD admitted were selected and divided into two groups according to the score of the Frail Screening Scale at admission: a frailty group (n=43, with a score of 3-5), and a non-frailty group (n=99, with a score of less than 3). Another 43 patients were randomly selected as the control group. The differences in pulmonary function, serum CC16, PCT and FKN levels between the two groups were compared. Pearson correlation was used to analyze the correlation between blood indicators and pulmonary function of patients with COPD. Logistic regression analysis was used to analyze the influencing factors of COPD patients' frailty, and the value of positive indicators in predicting the risk of frailty was analyzed by using the receiver operating characteristic (ROC) curve. 
Results  The levels of serum CC16 in frailty group were significantly lower than those in the control group, while the levels of PCT and FKN were significantly higher than those in the control group (P＜0.05). The levels of forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC in patients with COPD and frailty were significantly lower than those in the control group (P＜0.05). Pearson correlation analysis showed that serum CC16 was positively correlated with pulmonary function indicators (P＜0.05), while serum PCT and FKN levels were negatively correlated with pulmonary function (P＜0.001). Logistic regression analysis showed that the serological indicators CC16, PCT, FKN were all factors affecting the frailty of COPD patients, among which CC16 was a protective factor (P＜0.05). CC16, PCT, and FKN levels were closely associated with frailty of elderly patients with COPD, which could be used as predictive indicators. ROC curve analysis showed that the area under ROC curve (AUC) of PCT was the largest, which was 0.890 (0.824-0.956), followed by FKN ［0.830 (0.742-0.914)］, and CC16 (0.771). All three indicators had the value of predicting the frailty of elderly COPD patients (P＜0.05). 
Conclusion  The levels of serum CC16, PCT and FKN are closely related to the occurrence of frailty in elderly patients with COPD, and can be used as detection indicators to predict the risk of frailty. 


Key words: pulmonary disease, chronic obstructive, procalcitonin, uteroglobin

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