Expression of serum levels of CXCL9 and SFRP1 in patients with AECOPD complicated with pulmonary embolism and their influence on prognosis

doi:10.11958/20221267

Abstract

Abstract:

Objective To explore expression levels of serum C-X-C chemokine ligand 9 (CXCL9) and secretory frizzled-associated protein 1 (SFRP1) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with pulmonary embolism (PE) and their prognostic value. Methods Fifty-six AECOPD patients with PE were collected as the case group, and 80 patients with AECOPD in the same period were selected as the control group. The serum CXCL9 and SFRP1 levels were detected by enzyme-linked immunosorbent assay. Logistic regression model was used to analyze the influencing factors of PE in AECOPD patients, and the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of serum CXCL9 and SFRP1 on PE in AECOPD patients. COX proportional risk regression model was used to analyze the influencing factors of serum CXCL9 and SFRP1 on poor prognosis. Results The course of AECOPD was longer in the case group than that in the control group, and the serum CXCL9 and SFRP1 levels were higher than those in the control group (P<0.05). Long AECOPD course (OR=1.420，95%CI：1.246-1.620), higher CXCL9 (OR=1.835，95%CI：1.502-2.241) and SFRP1 (OR=1.608，95%CI：1.351-1.914) were independent risk factors for PE in AECOPD patients. Serum levels of CXCL9 and SFRP1 can predict the risk of PE in AECOPD patients, and the predictive value of combination of two indicators was more better. Serum CXCL9 and SFRP1 levels were positively associated with PESI grade (r_s=0.752, 0.716; P<0.05). Higher serum levels of CXCL9 (HR=1.374, 95%CI:1.184-1.595) and SFRP1 (HR=1.186，95%CI：1.329-1.542) were independent risk factors for death in AECOPD patients with PE. Conclusion The abnormal increased serum levels of CXCL9 and SFRP1 are risk factors for PE in AECOPD patients, which is closely related to the severity and prognosis of PE.

Key words: pulmonary disease, chronic obstructive, acute disease, pulmonary embolism, CXC chemokine ligand 9, secretory crimp-associated protein 1

CLC Number:

R563.5

Figures/Tables 7

References 19

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组别	n	性别（男/女）		年龄（岁）		BMI （kg/m²）		吸烟史		AECOPD 病程（d）
对照组	80	45/35		56.29±11.35		22.87±2.06		31（38.75）		2.34±0.67
病例组	56	34/22		58.17±10.63		23.05±2.18		19（33.93）		3.69±0.85
χ²或t		0.270		0.985		0.493		0.329		10.344^**
组别	高血压史		糖尿病史		冠心病史		CXCL9 （pmol/L）		SFRP1 （pmol/L）
对照组	27（33.75）		25（31.25）		13（16.25）		9.22±3.53		361.59±78.62
病例组	13（23.21）		10（17.86）		3（5.36）		12.09±3.82		455.57±90.35
χ²或t	1.761		3.092		3.765		4.518^**		6.455^**

组别	n	性别（男/女）		年龄（岁）		BMI （kg/m²）		吸烟史		AECOPD 病程（d）
对照组	80	45/35		56.29±11.35		22.87±2.06		31（38.75）		2.34±0.67
病例组	56	34/22		58.17±10.63		23.05±2.18		19（33.93）		3.69±0.85
χ²或t		0.270		0.985		0.493		0.329		10.344^**
组别	高血压史		糖尿病史		冠心病史		CXCL9 （pmol/L）		SFRP1 （pmol/L）
对照组	27（33.75）		25（31.25）		13（16.25）		9.22±3.53		361.59±78.62
病例组	13（23.21）		10（17.86）		3（5.36）		12.09±3.82		455.57±90.35
χ²或t	1.761		3.092		3.765		4.518^**		6.455^**

变量	β	SE	Wald χ²	P	OR	95%CI
AECOPD病程	0.351	0.067	27.445	<0.001	1.420	1.246~1.620
CXCL9	0.607	0.102	35.414	<0.001	1.835	1.502~2.241
SFRP1	0.475	0.089	28.484	<0.001	1.608	1.351~1.914
常数项	-2.029	0.395	26.386	<0.001	0.131

变量	β	SE	Wald χ²	P	OR	95%CI
AECOPD病程	0.351	0.067	27.445	<0.001	1.420	1.246~1.620
CXCL9	0.607	0.102	35.414	<0.001	1.835	1.502~2.241
SFRP1	0.475	0.089	28.484	<0.001	1.608	1.351~1.914
常数项	-2.029	0.395	26.386	<0.001	0.131

诊断指标	AUC（95%CI）	敏感度	特异度	约登指数	截断值
CXCL9	0.875（0.803~0.948）	0.88	0.69	0.57	10.98 pmol/L
SFRP1	0.907（0.842~0.972）	0.91	0.78	0.69	413.22 pmol/L
联合检测	0.946（0.891~1.000）	0.96	0.91	0.87