中国全科医学2017，Vol.20Issue(18)：2188-2192,5.DOI:10.3969/j.issn.1007-9572.2017.18.004
血清GRO-α水平和MRpro-ADM水平预测稳定期慢性阻塞性肺疾病患者急性加重和死亡风险的意义研究
Assessment of Acute Exacerbation and Mortality Risk in Patients with Stable COPD by Serum GRO-α and MRpro-ADM
摘要
Abstract
Objective To estimate the acute exacerbation and mortality risk in patients with stable chronic obstructive pulmonary disease (COPD)by serum growth - regulated oncogene α (GRO - α)and midregional pro - adrenomedullin (MRpro- ADM), so as to provide a basis for clinically identifying the high - risk ones among these patients as early as possible.Methods A total of 160 stable COPD patients enrolled were all from Department of Respiratory Medicine of Jinhua People′s Hospital,including outpatients who received medical care and inpatients who were discharged between January and February 2016.Measurement of serum GRO - α and MRpro - ADM was performed in all the participants.The values of median of these two biomarkers,73.5 ng/ L for GRO - α,and 0.69 nmol/ L for MRpro - ADM,were taken as the criterion for grouping them,respectively.Patients with GRO - α level≥73.5 ng/ L and those with GRO - α level < 73.5 ng/ L,were assigned to the high - level GRO - α group and low - level GRO - α group,respectively;patients with M pro - ADM level≥0.69 nmol/ L and those with MRpro - ADM level <0.69 nmol/ L were set as the high - level MRpro - ADM group,and low - level MRpro - ADM group,respectively.One hundred and fifty - three of them completed the 12 - month follow - up,the other 7 were missed.The attacking time of first acute exacerbation of COPD (AECOPD)after grouping,incidence of AECOPD,length of stay and mortality in the 153 participants during the follow - up period were recorded.ROC curve was used to study the optimal cut - off value and the corresponding sensitivity and specificity of GRO - α and MRpro - ADM in predicting the risk of AECOPD and mortality.Results Compared with the low - level GRO - α group,high - level GRO - α group had higher incidence of AECOPD and higher mortality,shorter period between the attacking time of first AECOPD and grouping time,and longer length of stay (P <0.05)in the follow - up period.High - level MRpro - ADM group had higher incidence of AECOPD and higher mortality, shorter period between the attacking time of first AECOPD and grouping time,and longer length of stay (P <0.05)than the low - level MRpro - ADM group during the follow - up period.For predicting the risk of AECOPD by serum GRO - α,the area under the ROC curve (AUC)was 0.866 〔95% CI (0.785,0.948)〕,the optimal cut - off value was 74.5 ng/ L with a sensitivity of 93% ,specificity of 74% and Youden′s index of 0.67.For predicting the risk of mortality by serum GRO - α,the AUC was 0.833 〔95% CI (0.729,0.937)〕,the optimal cut - off value was 93.5 ng/ L with a sensitivity of 94% ,specificity of 69% and Youden′s index of 0.62.For predicting the risk of AECOPD by serum MRpro - ADM,the AUC was 0.846 〔95% CI (0.762,0.930)〕,the optimal cut - off value was 0.70 nmol/ L with a sensitivity of 80% ,specificity of 78% and Youden′s index of 0.58.For predicting the risk of mortality by serum MRpro - ADM,the AUC was 0.871 〔95% CI (0.770,0.973)〕,the optimal cut - off value was 0.81 nmol/ L with a sensitivity of 69% ,specificity of 89% and Youden′s index of 0.58.Conclusion Serum GRO - α and MRpro - ADM can be used as the biological markers for predicting the risk of AECOPD and mortality in stable COPD patients.关键词
肺疾病/慢性阻塞性/预测/生长调节致癌基因-α/肾上腺髓质素前体中段肽Key words
Pulmonary disease/chronic obstructive/Forecasting/Growth-regulated oncogene α/Midregional pro-adrenomedullin分类
医药卫生引用本文复制引用
汪群智,盛美玲,宋昱晨,赵美芳,郭安..血清GRO-α水平和MRpro-ADM水平预测稳定期慢性阻塞性肺疾病患者急性加重和死亡风险的意义研究[J].中国全科医学,2017,20(18):2188-2192,5.基金项目
浙江省金华市科技局社会发展类一般项目(2016-4-026) （2016-4-026）
