Abstract：Objective: To observe the changes in levels of postoperative serum neuropeptide Y (NPY), substance P (SP) and prostaglandin E2 (PGE2) in patients with spontaneous pneumothorax, and to explore their relationship with postoperative recurrence. Methods: A total of 80 patients with spontaneous pneumothorax who were admitted between May 2017 and December 2020 were selected as the case group, and 50 healthy subjects undergoing physical examination during the same period were included in the control group. All patients underwent single-port thoracoscopic pulmonary bulla resection. The changes in serum NPY, SP and PGE2 levels were detected in the case group before surgery and at 30 d after surgery and were compared with those in the control group. At 1 year of follow-up, the postoperative recurrence was statistically analyzed, and univariate analysis and multivariate Logistic regression analysis were used to explore the influencing factors of postoperative recurrence. Receiver operating characteristic curve (ROC curve) was plotted to explore the predictive value of postoperative serum NPY, SP and PGE2 levels on recurrence in patients. Results: The levels of serum NPY, SP and PGE2 after surgery in the case group were reduced compared with those before surgery (P<0.05), and the levels of preoperative serum NPY, SP and PGE2 in the case group were higher than those in the control group (P<0.05), and the levels of serum SP and PGE2 after surgery were higher than those in the control group (P<0.05). There were 11 cases of recurrence among 80 patients, with the recurrence rate of 13.75%. Univariate analysis showed that there were statistical differences between the recurrence group and the non-recurrence group in terms of body mass index, postoperative smoking, presence or absence of postoperative pulmonary bulla omission, presence or absence of pleurodesis, presence or absence of postoperative persistent air leakage, postoperative serum SP and postoperative serum PGE2 (P<0.05). Multivariate Logistic regression analysis showed that postoperative smoking, pulmonary bulla omission, persistent air leakage, serum SP and serum PGE2 were the influencing factors of postoperative recurrence of spontaneous pneumothorax (P<0.05). The areas under the ROC curves of serum SP and PGE2 on predicting recurrence were 0.921 and 0.872 respectively (P<0.05), and the cut-off value, sensitivity and specificity were 1.85 μg/mL, 90.91% and 85.51% of SP, and were 172.7 pg/mL, 72.73% and 92.75% of PGE2 respectively. Conclusion: The expressions of serum NPY, SP and PGE2 in patients with spontaneous pneumothorax are significantly increased, while the levels can be significantly decreased after surgical treatment. The expressions of serum SP and PGE2 in patients with recurrent pneumothorax are significantly higher than those in patients without recurrence, and the two levels may be used as predictors of postoperative recurrence of spontaneous pneumothorax.
左志刚, 陈朋娥, 廖勇胜, 黎林, 赵志宏. 自发性气胸术后血清NPY SP PGE2水平变化及与复发的关系[J]. 河北医学, 2022, 28(10): 1644-1649.
ZUO Zhigang, CHEN Peng'e, LIAO Yongsheng, et al. Changes in Levels of Serum NPY SP and PGE2 after Surgery for Spontaneous Pneumothorax and Their Relationship with Recurrence. HeBei Med, 2022, 28(10): 1644-1649.
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2022, Vol. 28 
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