摘要
目的 研究血清诱导型一氧化氮合酶(inducible nitric oxide synthase,iNOS)、内皮型一氧化氮合酶(endothelial nitric oxide synthase,eNOS)水平对稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者频繁急性加重的评估价值。方法 选择2020年1月至2022年6月期间住院治疗的稳定期COPD患者作为研究对象,根据出院后1年内急性加重发生次数分组:≥2次为频繁急性加重组,≤1次为非频繁急性加重组。比较两组患者入院当天或次日血清iNOS、eNOS水平及临床资料的差异,以logistic回归模型分析疾病加重的风险因素并以受试者工作特征(ROC)曲线评估相关指标的预测价值。结果 频繁急性加重组患者的血清iNOS、eNOS水平及慢阻肺患者自我评估测试(CAT)评分高于非频繁急性加重组[(4.12±1.01)ng/mL vs.(3.07±0.65)ng/mL,(8.19±0.99)ng/mL vs.(6.24±1.13)ng/mL,17.33±5.19 vs.12.64±4.58,t=6.139、8.674、4.585,P<0.05],白蛋白水平低于非频繁急性加重组[(32.73±4.53)g/L vs.(34.29±4.06)g/L,t=2.732,P<0.05]。血清iNOS、eNOS水平高以及CAT评分高是稳定期COPD患者发生频繁急性加重的危险因素(OR=4.831、3.638、1.188,P<0.05)。血清iNOS、eNOS水平及CAT评分单独及联合均对频繁急性加重具有预测价值,3项指标联合预测的曲线下面积0.939(95%CI:0.890~0.989),对应的敏感度和特异度分别为86.21%和88.89%。结论 血清iNOS和eNOS水平升高与稳定期COPD患者频繁急性加重有关,两项指标与CAT评分具有一定的预测价值。
Objective To investigate the value of serum inducible nitric oxide synthase(iNOS)and endothelial nitric oxide synthase(eNOS)levels in assessing frequent acute exacerbations in stable chronic obstructive pulmonary disease(COPD)patients.Methods A total of stable COPD patients hospitalized from January 2020 to June 2022 were selected for the study.Patients were divided into two groups based on the frequency of acute exacerbations occurring within one year after discharge:≥2 exacerbations(frequent exacerbation group)and≤1 exacerbation(non-frequent exacerbation group).The serum levels of iNOS and eNOS,along with clinical data,were compared between the two groups.Logistic regression was used to analyze the risk factors for disease exacerbation,and receiver operating characteristic(ROC)curves were used to evaluate the predictive value of the related indicators.Results The serum iNOS and eNOS levels,as well as the COPD Assessment Test(CAT)scores,were significantly higher in the frequent exacerbation group compared to the non-frequent exacerbation group[(4.12±1.01)ng/mL vs.(3.07±0.65)ng/mL,(8.19±0.99)ng/mL vs.(6.24±1.13)ng/mL,17.33±5.19 vs.12.64±4.58,t=6.139,8.674,4.585,P<0.05],while albumin levels were lower in the frequent exacerbation group[(32.73±4.53)g/L vs.(34.29±4.06)g/L,t=2.732,P<0.05].High serum levels of iNOS,eNOS,and high CAT scores were identified as risk factors for frequent acute exacerbations in stable COPD patients(OR=4.831,3.638,1.188,P<0.05).The serum iNOS,eNOS levels,and CAT scores,both individually and in combination,all showed predictive value for frequent acute exacerbations.The combined prediction model showed an area under the curve of 0.939(95%CI:0.890-0.989),with a sensitivity of 86.21%and specificity of 88.89%.Conclusion Elevated serum iNOS and eNOS levels are associated with frequent acute exacerbations in stable COPD patients.Both iNOS and eNOS,in combination with CAT scores,show significant predictive value for exacerbation risk.
作者
郭志强
刘云峰
高晓玲
李润杰
赵立春
GUO Zhi-qiang;LIU Yun-feng;GAO Xiao-ling;LI Run-jie;ZHAO Li-chun(Department of Emergency,the First Affiliated Hospital,Hebei North University,Zhangjiakou 075000,Hebei,China;不详)
出处
《广东医学》
2025年第4期587-591,共5页
Guangdong Medical Journal
基金
河北省医学科学研究课题计划项目(20240420)
张家口市科技计划自筹经费项目(2221201D)。
关键词
慢性阻塞性肺疾病
频繁急性加重
诱导型一氧化氮合酶
内皮型一氧化氮合酶
影响因素
预测
chronic obstructive pulmonary disease
frequent acute exacerbations
inducible nitric oxide synthase
endothelial nitric oxide synthase
influencing factors
prediction
