血清CIRBP Notch1水平与AECOPD患者病情严重程度及预后转归的关系

doi:10.3969/j.issn.1006-6233.2024.12.031

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摘要 目的: 探讨血清冷诱导RNA结合蛋白(CIRBP)、缺口受体1(Notch1)水平与慢性阻塞性肺疾病急性加重(AECOPD)患者病情严重程度及预后转归的关系。方法: 选取2023年2月至2024年1月我院收治的AECOPD患者157例(AECOPD组)、COPD稳定期患者70例(COPD稳定期组)和同期健康体检志愿者70名(对照组)。AECOPD患者根据病情严重程度分为轻度AECOPD组(60例)、中度AECOPD组(55例)、重度AECOPD组(42例),根据6个月预后转归分为不良预后组(50例)和良好预后组(107例)。采用酶联免疫吸附法检测血清CIRBP、Notch1水平。绘制受试者工作特征曲线分析血清CIRBP、Notch1水平对其的预测能效。结果: 对照组、COPD稳定期组、AECOPD组血清CIRBP、Notch1水平依次升高,差异有统计学意义(F=172.36、104.024,P均<0.001)。轻度AECOPD组、中度AECOPD组、重度AECOPD组血清CIRBP、Notch1水平依次升高,差异有统计学意义(F=64.686、54.409,P均<0.05)。随访6个月,157例AECOPD患者预后不良发生率为31.85%(50/157)。不良预后组血清CIRBP、Notch1水平高于良好预后组(t=7.261、6.956,P均<0.05)。病情程度加重(OR=4.012,95%CI:1.996~8.067)、CIRBP高(OR=1.012,95%CI:1.005~1.020)、Notch1高(OR=1.014,95%CI:1.007~1.022)为AECOPD患者预后转归不良的独立危险因素(P均<0.05)。血清CIRBP、Notch1水平联合预测AECOPD患者预后转归不良的曲线下面积为0.871,大于血清CIRBP、Notch1水平单独预测的0.793、0.798,差异有统计学意义(Z=2.833、2.696,P均<0.05)。结论: AECOPD患者血清CIRBP、Notch1水平升高与病情严重程度加重和预后转归不良有关,血清CIRBP、Notch1水平联合预测AECOPD患者预后转归不良的能效较高。

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关键词 ：慢性阻塞性肺疾病急性加重, 冷诱导RNA结合蛋白, 缺口受体1

Abstract：Objective: To investigate the relationship between serum levels of cold-inducible RNA-binding protein (CIRBP) and notch receptor 1 (Notch1) with disease severity and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: A total of 157 AECOPD patients (AECOPD group), 70 stable COPD patients (COPD stability group), and 70 healthy volunteers (control group) treated at our hospital from February 2023 to January 2024 were included. According to disease severity, the AECOPD patients were categorized into a mild AECOPD group (60 cases), moderate AECOPD group (55 cases), and severe AECOPD group (42 cases). Based on 6-month follow-up outcomes, they were further divided into a poor prognosis group (50 cases) and a good prognosis group (107 cases). Serum levels of CIRBP and Notch1 were measured by enzyme-linked immunosorbent assay, and the receiver operating characteristic curve(ROC) was drawn to evaluate their predictive efficacy for prognosis. Results: Serum levels of CIRBP and Notch1 progressively increased across the control, COPD stability, and AECOPD groups, with significant differences (F=172.36, 104.024, all P<0.001). Similarly, CIRBP and Notch1 levels rose significantly across the mild, moderate, and severe AECOPD groups (F=64.686, 54.409, all P<0.05). At the 6-month follow-up, the incidence of poor prognosis in 157 AECOPD patients was 31.85% (50/157). CIRBP and Notch1 levels were significantly higher in the poor prognosis group than in the good prognosis group (t=7.261, 6.956, all P<0.05). Independent risk factors for poor prognosis in AECOPD patients included increased disease severity (OR=4.012, 95%CI: 1.996 to 8.067), elevated CIRBP (OR=1.012, 95%CI: 1.005 to 1.020), and elevated Notch1 (OR=1.014, 95%CI: 1.007 to 1.022) (all P<0.05). The combined prediction using serum CIRBP and Notch1 levels yielded an area under the curve (AUC) of 0.871 for poor prognosis in AECOPD patients, which was significantly greater than the AUCs for CIRBP (0.793) or Notch1 (0.798) alone (Z=2.833, 2.696, all P<0.05). Conclusion: Elevated levels of serum CIRBP and Notch1 in AECOPD patients were associated with increased disease severity and poor prognostic turnover, and the combination of serum CIRBP and Notch1 levels had high energy efficiency in predicting poor prognostic turnover in AECOPD patients.

Key words： Acute exacerbation of chronic obstructive pulmonary disease Cold-induced RNA-binding protein Notch receptor 1

基金资助:江苏省老年健康科研课题,(编号:LK2021029);南京市卫生科技发展专项资金项目,(编号:YKK23199)

通讯作者: 景阅雯

引用本文:

高丽华, 李彦楠, 俞玲, 高春, 张静, 景阅雯. 血清CIRBP Notch1水平与AECOPD患者病情严重程度及预后转归的关系[J]. 河北医学, 2024, 30(12): 2107-2112.
GAO Lihua, LI Yannan, YU Ling, et al. Relationship between Serum Levels of CIRBP and Notch1 with Disease Severity and Prognosis in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease. HeBei Med, 2024, 30(12): 2107-2112.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.12.031 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I12/2107

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