血清脑钠肽、白细胞介素-6、外泌体环状RNA BPTF对慢性阻塞性肺疾病急性加重期患者的预后分析OACSTPCD

Objective To investigate the levels of serum brain natriuretic peptide(BNP),interleukin-6(IL-6),and extracellular vesicle-derived circular RNA BPTF(circRNA BPTF)in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD),and to assess their predictive values for the prognosis of patients.Methods Between May 2021 and May 2023,118 patients experiencing acute exacerbation of COPD were selected from Changzhou Maternal and Child Health Care Hospital as the acute exacerbation group.Additionally,80 patients in the stable phase of COPD were included as the stable phase group,and 80 healthy adults undergoing routine checkups during the same period were selected as the control group.Differences in the expressions of serum BNP,IL-6,and circRNA BPTF among the three groups were compared,and the correlations between the disease severity and serum levels of BNP,IL-6,and circRNA BPTF were analyzed.Multivariable regression analysis was utilized to identify risk factors for poor prognosis in patients with acute exacerbation of COPD,and predictive values of BNP,IL-6,and circRNA BPTF for the prognosis were assessed through the receiver operating characteristic(ROC)curve analysis.Results The levels of BNP,IL-6,and circRNA BPTF were found to be higher in both the acute exacerbation group and the stable phase group compared to those in the control group(P＜0.05),and those in the acute exacerbation group were even higher than those in the stable phase group(P＜0.05).The disease severity was negatively correlated with the serum levels of BNP,IL-6,and circRNA BPTF(rs=-0.733,-0.918,and-0.926,all P＜0.05).Multivariable Logistic regression analysis indicated that grade Ⅲ and Ⅳ pulmonary function[(OR)=55.649(95％CI:10.429,296.939)],high APACHE Ⅱ scores[(OR)=1.213(95％CI:1.020,1.444)],Charlson Comorbidity Index ≥ 3[(OR)=81.696(95％CI:15.888,420.076)],and high levels of PCT[(OR)=4.629(95％CI:1.198,17.888)],BNP[(OR)=1.025(95％CI:1.009,1.042)],IL-6[(OR)=1.429(95％CI:1.021,1.999)],and circRNA BPTF[(OR)=20.942(95％CI:2.772,158.200)]were independent risk factors for death of patients with acute exacerbation of COPD(P＜0.05).ROC curve analysis showed that the area under the curve of the combined detection of serum BNP,IL-6,and circRNA BPTF for predicting the poor prognosis of patients with acute exacerbation of COPD was 0.943(95％CI:0.875,1.000),with a sensitivity of 91.7％(95％CI:0.861,0.972),and a specificity of 94.7％(95％CI:0.924,0.969).Conclusion The serum levels of BNP,IL-6,and circRNA BPTF are closely related to the disease severity and prognosis of patients with acute exacerbation of COPD,and can serve as effective prognostic biomarkers.