血清sPLA2-X、8-羟基-2'-脱氧鸟苷及hs-CRP水平诊断慢性阻塞性肺疾病急性加重的价值

摘要 目的：探究血清sPLA2-X、8-羟基-2''-脱氧鸟苷及hs-CRP水平诊断慢性阻塞性肺疾病急性加重的价值。方法：随机选取2021年3月~2023年11月在我院进行治疗的COPD患者128例，以患者是否出现急性加重分为稳定组和AECOPD组，其中稳定组29例，AECOPD组99例。比较两组研究对象外周血sPLA2-X、8-OHdG及hs-CRP水平水平差异；COX比例风险因素回归模型分析AECOPD的影响因素，采用ROC曲线分析相关指标单独及联合检测诊断AECOPD的价值。结果：AECOPD组FEV₁指标显著低于稳定组，差异具有统计学意义（P<0.05）。与稳定组组相比，AECOPD组患者外周血sPLA2-X、8-OHdG及hs-CRP水平均明显升高，差异具有统计学意义（P<0.01）。外周血sPLA2-X、8-OhdG、hs-CRP水平与GOLD分级成正相关（P<0.05），外周血sPLA2-X、8-OhdG、hs-CRP水平与FEV₁/FVC（%）、FEV₁%pred成负相关（P<0.05）。采用COX比例风险因素回归模型分析，外周血sPLA2-X、8-OhdG、hs-CRP均为影响AECOPD的独立危险因素。ROC曲线分析外周血sPLA2-X、8-OhdG、hs-CRP诊断AECOPD的曲线下面积（AUC）分别为0.689、0.708、0.642、0.875，联合各指标预测价值明显高于单独检测。结论：AECOPD 患者外周血sPLA2-X、8-OhdG、hs-CRP水平高表达。外周血sPLA2-X、8-OhdG、hs-CRP水平与肺功能严重程度、肺功能指标相关，同时三者可用作诊断COPD患者急性加重的潜在预测指标。三者联合具有更高的诊断价值。

The Value of Serum sPLA2-X, 8-hydroxy-2'-deoxyguanosine, and hs-CRP Levels in the Diagnosis of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

ABSTRACT Objective: To explore the value of serum sPLA2-X, 8-hydroxy-2 ''- deoxyguanosine, and hs CRP levels in diagnosing acute exacerbation of chronic obstructive pulmonary disease. Methods: A total of 128 COPD patients who underwent treatment in our hospital from March 2021 to November 2023 were randomly selected. The patients were divided into a stable group and an AECOPD group based on whether they experienced acute exacerbation. Among them, 29 were in the stable group and 99 were in the AECOPD group. Compare the differences in peripheral blood sPLA2-X, 8-OHdG, and hs CRP levels between the two groups of study subjects; The COX proportional risk factor regression model is used to analyze the influencing factors of AECOPD, and the ROC curve is used to analyze the value of related indicators for individual and combined detection and diagnosis of AECOPD. Results: The FEV₁ index in the AECOPD group was significantly lower than that in the stable group, with a statistically significant difference(P<0.05). Compared with the stable group, the peripheral blood sPLA2-X, 8-OHdG, and hs CRP levels in the AECOPD group were significantly increased, with statistical significance (P<0.01). The levels of sPLA2-X, 8-OhdG, and hs CRP in peripheral blood were positively correlated with GOLD grading (P<0.05), while the levels of sPLA2-X, 8-OhdG, and hs CRP in peripheral blood were negatively correlated with FEV₁/FVC (%) and FEV₁% pred(P<0.05). Using the COX proportional risk factor regression model analysis, peripheral blood sPLA2-X, 8-OhdG, and hs CRP were all independent risk factors affecting AECOPD. The area under the curve (AUC) of peripheral blood sPLA2-X, 8-OhdG, and hs CRP in diagnosing AECOPD using ROC curve analysis were 0.689, 0.708, 0.642, and 0.875, respectively. The combined predictive value of each indicator was significantly higher than that of individual detection. Conclusion: The peripheral blood sPLA2-X, 8-OhdG, and hs CRP levels in AECOPD patients are highly expressed. The levels of sPLA2-X, 8-OhdG, and hs CRP in peripheral blood are correlated with the severity of lung function and lung function indicators, and can be used as potential predictive indicators for diagnosing acute exacerbation in COPD patients. The combination of the three has higher diagnostic value.