血清PCT、IL-17与CRP在AECOPD合并肺动脉高压患者中的表达及诊断价值

目的:探讨降钙素原(PCT),白介素17(IL-17)与C反应蛋白(CRP)在慢性阻塞性肺疾病急性加重期(AECOPD)合并肺动脉高压患者外周血中的表达水平,探究联合检测的诊断价值。方法:收集2015年8月至2017年2月我院收治的AECOPD患者120例,纳入研究患者根据是否合并肺动脉高压分为分为单纯AECOPD组60例及AECOPD合并肺动脉高压(AECOPD+PH)组60例,另选取20例健康志愿者作为对照组。采用化学发光法检测PCT水平,双抗夹心酶联免疫吸附试验法(ELISA)检测IL-17水平及生化分析仪检测CRP水平,采用受试者工作特征曲线(ROC)评估PCT,IL-17与CRP对AECOPD合并肺动脉高压的诊断价值。结果:AECOPD+PH组及AECOPD组的PCT,IL-17,CRP水平较健康对照组均明显升高,而AECOPD+PH组的各指标水平也均高于单纯AECOPD组,差异均有统计学意义(P0.05)。通过Pearson相关性分析发现,AECOPD合并肺动脉高压的PCT与IL-17之间存在表达正相关性(r=0.733,P0.05),PCT与CRP表达存在正相关性(r=0.817,P0.05)。此外,针对AECOPD合并肺动脉高压的诊断中PCT的ROC曲线下面积为0.83,IL-17为0.71,CRP为0.77,联合三者的ROC曲线下面积为0.94。结论:PCT、IL-17和CRP可能与AECOPD患者肺动脉高压的形成有关,各指标存在一定的相关性,联合以上三项生物学指标对诊断AECOPD合并肺动脉高压患者具有一定的临床参考价值。

Expression and Diagnostic Value of Serum PCT, IL-17 and CRP in AECOPD Complicated with Pulmonary Hypertension

ABSTRACT Objective: To investigate the expression of procalcitonin (PCT), interleukin 17 (IL-17) and C-reactive protein (CRP) in peripheral blood of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with pulmonary hypertension, and to explore the diagnostic value of combined detection. Methods: 120 patients with AECOPD admitted to our hospital from August 2015 to February 2017 were divided into 60 patients with simple AECOPD and 60 patients with AECOPD complicated with pulmonary hypertension (AECOPD+PH), and 20 healthy volunteers were selected as control group. The levels of PCT, IL-17 and CRP were measured by chemiluminescence, ELISA and biochemical analyzer. The diagnostic value of PCT, IL-17 and CRP in AECOPD complicated with pulmonary hypertension was evaluated by ROC. Results: The levels of PCT, IL-17 and CRP in AECOPD+PH group and AECOPD group were significantly higher than those in healthy control group, and the levels of each index in AECOPD+PH group were also higher than those in AECOPD group (P<0.05). Pearson correlation analysis showed that there was a positive correlation between the expression of IL-17 and PCT in AECOPD complicated with pulmonary hypertension (r=0.733, P<0.05), and positive correlation between the expression of PCT and CRP (r=0.817, P<0.05). In addition, in the diagnosis of AECOPD complicated with pulmonary hypertension, the area under ROC curve of PCT was 0.83, IL-17 was 0.71, CRP was 0.77, and the area under ROC curve of combined three was 0.94. Conclusion: PCT, IL-17 and CRP may be related to the formation of AECOPD complicated with pulmonary hypertension, and there is a certain correlation between these three biological indicators. Combining these three biological indicators has a certain clinical reference value in the diagnosis of AECOPD with pulmonary hypertension.