摘要
目的分析血清黏膜相关淋巴样组织淋巴瘤易位蛋白1(MALT1)、可溶性分化簇146(sCD146)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并发肺栓塞(PE)的关系。方法AECOPD患者120例,记为AECOPD组;同期收治的稳定期慢性阻塞性肺疾病(SCOPD)患者120例,记为SCOPD组。采用酶联免疫吸附法检测血清MALT1、sCD146水平。根据病情严重程度将AECOPD患者分为轻度AECOPD组、中度AECOPD组、重度AECOPD组,采用Spearman相关分析法分析血清MALT1、sCD146水平与AECOPD患者病情严重程度的相关性。根据AECOPD患者入院后是否并发PE分为PE组与非PE组,采用受试者工作特征(ROC)曲线分析血清MALT1、sCD146水平对AECOPD并发PE的预测效能。结果与SCOPD组相比,AECOPD组患者血清MALT1水平升高、sCD146水平降低(P均<0.05)。轻度AECOPD组患者血清MALT1、sCD146水平分别为2.11(1.51,2.77)ng/mL、48.29(43.23,55.17)ng/mL,中度AECOPD组分别为3.88(3.21,4.67)ng/mL、36.05(31.86,39.50)ng/mL,重度AECOPD组分别为5.44(5.00,5.98)ng/mL、25.47(24.39,27.11)ng/mL;组间相比,P均<0.05。AECOPD患者血清MALT1水平与病情严重程度呈正相关,sCD146水平与病情严重程度呈负相关关系(r分别为0.749、-0.777,P均<0.05)。与非PE组相比,PE组患者血清MALT1水平升高、sCD146水平降低(P均<0.05)。血清MALT1水平预测AECOPD患者并发PE的ROC曲线下面积为0.780(95%CI:0.695~0.851),其预测AECOPD患者并发PE的灵敏度为0.616、特异度为0.809;血清sCD146水平预测AECOPD患者并发PE的曲线下面积为0.787(95%CI:0.703~0.857),其预测AECOPD患者并发PE的灵敏度为0.849、特异度为0.617;血清MALT1联合sCD146水平预测AECOPD患者并发PE的曲线下面积为0.867(95%CI:0.793~0.922),其预测AECOPD患者并发PE的灵敏度为0.849、特异度为0.787。结论AECOPD患者血清MALT1水平升高、sCD146水平降低,与病情严重程度有关,检测血清MALT1、sCD146水平有助于AECOPD并发PE的预测。
Objective To analyze the relationships between serum levels of mucosa-associated lymphoid tissue lym⁃phoma translocation protein 1(MALT1)and soluble cluster of differentiation 146(sCD146)and the severity of acute exac⁃erbation of chronic obstructive pulmonary disease(AECOPD)as well as the occurrence of pulmonary embolism(PE).Methods A total of 120 AECOPD patients were included as the AECOPD group,and 120 patients with stable COPD(SCOPD)during the same period were included as the SCOPD group.Serum MALT1 and sCD146 levels were measured using enzyme-linked immunosorbent assay.Based on disease severity,AECOPD patients were divided into mild,moderate,and severe AECOPD subgroups.Spearman correlation analysis was used to examine the association between serum MALT1 and sCD146 levels and disease severity in AECOPD patients.Patients were further categorized into PE and non-PE groups based on the occurrence of PE after admission.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive performance of serum MALT1 and sCD146 levels for PE in AECOPD patients.Results Com⁃pared with the SCOPD group,the serum MALT1 level increased and the sCD146 level decreased in the AECOPD group(both P<0.05).The levels of serum MALT1 and sCD146 in the mild AECOPD group were 2.11(1.51,2.77)ng/mL and 48.29(43.23,55.17)ng/mL,respectively.The levels of serum MALT1 and sCD146 in the moderate AECOPD group were 3.88(3.21,4.67)ng/mL and 36.05(31.86,39.50)ng/mL,respectively.The levels of serum MALT1 and sCD146 in the severe AECOPD group were 5.44(5.00,5.98)ng/mL and 25.47(24.39,27.11)ng/mL,respectively.There were significant differences between groups(all P<0.05).The level of serum MALT1 in AECOPD patients was posi⁃tively correlated with the severity of the disease,and the level of sCD146 was negatively correlated with the severity of the disease(r=0.749,-0.777,both P<0.05).Compared with the non-PE group,serum MALT1 level increased and sCD146 level decreased in the PE group(both P<0.05).The area under the curve of serum MALT1 level in predicting PE in AE⁃COPD patients was 0.780(95%CI:0.695-0.851).The sensitivity and specificity of serum MALT1 level in predicting PE in AECOPD patients were 0.616 and 0.809,respectively.The area under the curve of serum sCD146 level in predicting PE in AECOPD patients was 0.787(95%CI:0.703-0.857),and the sensitivity and specificity in predicting PE in AECO⁃PD patients were 0.849 and 0.617,respectively.The area under the curve of serum MALT1 combined with sCD146 in pre⁃dicting PE in AECOPD patients was 0.867(95%CI:0.793-0.922);the sensitivity and specificity of serum MALT1 com⁃bined with sCD146 in predicting PE in AECOPD patients were 0.849 and 0.787,respectively.Conclusions Serum MALT1 level increases and sCD146 level decreases in patients with AECOPD,which is related to the severity of the dis⁃ease.The detection of serum MALT1 and sCD146 levels is helpful for the prediction of AECOPD complicated with PE.
作者
曾明
肖永营
纪永章
ZENG Ming;XIAO Yongying;JI Yongzhang(Department of Health Management Center,The Air Force Hospital of the Eastern Theater Command of Chinese People’s Liberation Army,Nanjing 210000,China;不详)
出处
《山东医药》
2026年第1期33-37,共5页
Shandong Medical Journal
基金
江苏省卫生健康委科研项目(Z2023325)。
关键词
慢性阻塞性肺疾病
慢性阻塞性肺疾病急性加重
黏膜相关淋巴样组织淋巴瘤易位蛋白1
可溶性分化簇146
肺栓塞
chronic obstructive pulmonary disease
acute exacerbation of chronic obstructive pulmonary disease
mucosa-associated lymphoid tissue lymphoma translocation protein 1
soluble cluster of differentiation 146
pulmonary embolism
