摘要目的 通过测定不同时期的COPD患者及健康人群中血清正五聚蛋白-3(Pentraxin-3,PTX-3)的表达水平,探讨血清PTX-3水平对COPD急性加重的预测价值,为COPD患者病程分期的判断提供新的方法.方法 收集2016年1～12月于承德市中心医院呼吸内科住院治疗的COPD急性加重期患者90例、于该院呼吸内科门诊就诊的COPD稳定期患者90例及同期于承德市中心医院行健康体检的健康体检者90例.所有受试者均测定血清PTX-3、C反应蛋白(C-reactive protein,CRP)水平,比较各组间的差异.结果 ①COPD急性加重期患者及COPD稳定期患者血清PTX-3水平均高于正常体检者,各组间差异有统计学意义(P＜0.05).②COPD急性加重期患者血清CRP水平高于COPD稳定期患者(P＜0.05),而稳定期组与健康对照组间血清CRP水平差异无统计学意义(P＞0.05).③以受试者工作曲线(ROC)分析血清PTX-3、CRP水平对于COPD急性加重的预测价值,发现PTX-3 ROC曲线下面积为0.97,诊断阈值为＞5.86 μg/L,敏感度为91.1％,特异度为88.9％.CRP的ROC曲线下面积为0.739,提示与CRP相比,PTX-3对COPD患者出现急性加重的预测价值较高.结论 ①PTX-3不仅参与到COPD急性加重的过程中,也参与到了COPD稳定期慢性炎症的发生过程中.②与CRP相比,血清PTX-3水平对COPD的急性加重有更高的预测价值.

abstractsObjective To explore the predictive value of serum PTX-3 level in acute exacerbation of chronic obstructive pulmonary disease (COPD) by mensurating the levels of serum PTX-3 in patients with COPD in different stage of disease and healthy people,to provide a new method for judging the stage of disease in COPD patients.Methods Ninety patients with acute exacerbations of COPD who was hospitalized in the department of respiratory medicine,in Chengde Central Hospital,90 COPD patients in stable stage who admitted in the department of outpatient,and 90 normal persons for physical examination in Chengde Central Hospital from January 2016 to December 2016 were included in this study.All subjects were tested for serum PTX-3 and C-reactive protein (CRP) levels.Observing the differences among the groups.Results ① PTX-3 level in serum of patients with acute exacerbations and patients in the stable stage of COPD was higher than the healthy control group,the difference between the groups was statistically significant (P ＜ 0.05).②The serum level of CRP in patients with acute exacerbation of COPD was higher than that in patients in the stable stage of COPD.There was no significant difference in the level of CRP in serum between patients in the stable stage of COPD and healthy control group(P ＞0.05).③ Using the receiver operating curve (ROC) to analyze the predictive value of PTX-3,CRP level for COPD acute exacerbation,the area under the ROC curve of PTX-3 was found to be 0.97,the diagnostic threshold was ＞5.86μg/L,the sensitivity was 91.1 ％,the specificity was 88.9 ％,and the area under the ROC curve of CRP was 0.739,which indicated that serum PTX-3 levels have a better predictive value for acute exacerbation of COPD.Conclusions ① PTX-3 not only plays a role in the process of acute exacerbation of COPD,but also involved in the occurrence of chronic inflammation in the stable stage of COPD.② Compared with CRP,serum PTX-3 levels have a better predictive value for acute exacerbation of COPD.