检验医学与临床2025，Vol.22Issue(9)：1159-1164,6.DOI:10.3969/j.issn.1672-9455.2025.09.002
慢性阻塞性肺疾病患者血清Th17/Treg细胞因子、miR-146a与肺功能的关系及对预后的预测价值
Relationship between serum Th17/Treg cytokines and miR-146a with pulmonary function in patients with chronic obstructive pulmonary disease and their prognostic value
摘要
Abstract
Objective To explore the relationship between T helper 17(Th17)/regulatory T(Treg)cyto-kines and microRNA-146a(miR-146a)with the lung function in the patients with chronic obstructive pulmo-nary disease(COPD)and their predictive value for prognosis.Methods A total of 188 COPD patients admit-ted and treated in this hospital from January 2023 to January 2024 were selected as the study group,including 130 cases of acute exacerbation stage and 58 cases of stable stage.The other 100 healthy volunteers during the same period were selected as the control group.The levels of serum Th17/Treg cytokines[interleukin(IL)-17,IL-22,IL-10,IL-35]and miR-146a and lung function indicators were compared between the study group and control group.The Pearson correlation was used to analyze the correlation between the serum Th17/Treg cytokines and miR-146a levels with the lung function indicators in the patients with acute exacerbation of COPD.According to the 90 d survival prognosis of the patients with acute exacerbation of COPD,they were divided into the good prognosis group and poor prognosis group.The serum Th17/Treg cytokines and miR-146a levels were compared between the good prognosis group and poor prognosis group.The receiver operat-ing characteristic(ROC)curve was drawn to analyze the value of each indicator alone and combination in pre-dicting the poor prognosis of the patients with acute exacerbation of COPD.Results The serum IL-17 and IL-22 levels during the acute exacerbation stage and stable stage in the study group were higher than those in the control group(P＜0.05),while the serum IL-10,IL-35 and miR-146a levels,forced expiratory volume in one second as a percentage of predicted value(FEV1％),ratio of forced expiratory volume in one second to forced vital capacity(FEV1/FVC)and percentage of peak expiratory flow(PEF％)were lower than those in the control group(P＜0.05);the serum IL-17 and IL-22 levels during the acute exacerbation stage in the study group were higher than those in the stable stage(P＜0.05),while the serum IL-10,IL-35 and miR-146a lev-els,FEV1％,FEV1/FVC and PEF％were lower than those in the stable stage(P＜0.05).The results of Pearson correlation analysis showed that the serum IL-17 and IL-22 levels in the patients with acute exacerba-tion of COPD were negatively correlated with FEV1％,FEV1/FVC and PEF％(P＜0.05),and the serum IL-10,IL-35 and miR-146a levels were positively correlated with FEV1％,FEV1/FVC and PEF％(P＜0.05).The patients with acute exacerbation of COPD all received the 90 d follow up without no lost follow-up cases.There were 90 cases of survival(good prognosis group)and 40 cases of death(poor prognosis group).The ser-um IL-17 and IL-22 levels in the poor prognosis group were higher than those in the good prognosis group(P＜0.05),and the serum IL-10,IL-35 and miR-146a levels were lower than those in the good prognosis group(P＜0.05).The results of ROC curve analysis showed that the areas under the curve(AUC)of serumIL-17,IL-22,IL-10,IL-35 and miR-146a alone and 5-item combination in predicting the poor prognosis of the patients with acute exacerbation of COPD were 0.733,0.814,0.736,0.750,0.755 and 0.903,respectively.AUC of the 5 items combined prediction was greater than that of serum IL-17,IL-22,IL-10,IL-35 and miR-146a alone(Z=6.612,3.458,5.777,4.126,3.756,all P＜0.001).Conclusion The serum Th1 7/Treg cyto-kines(IL-17,IL-22,IL-10,IL-35)and miR-146a levels are correlated to the lung function in the patients with acute exacerbation of COPD.The combined detection of serum Th17/Treg cytokines and miR-146a is helpful to improve the predictive value for the poor prognosis of the patients with acute exacerbation of COPD and could guide clinical diagnosis and treatment.关键词
慢性阻塞性肺疾病/急性加重期/稳定期/细胞因子/微小RNA-146a/肺功能/预后Key words
chronic obstructive pulmonary disease/acute exacerbation stage/stable stage/cyto-kines/microRNA-146a/pulmonary function/prognosis分类
临床医学引用本文复制引用
郑向真,陈文灯,禹乐,陈刘通..慢性阻塞性肺疾病患者血清Th17/Treg细胞因子、miR-146a与肺功能的关系及对预后的预测价值[J].检验医学与临床,2025,22(9):1159-1164,6.基金项目
福建省自然科学基金资助项目(2023J011843) （2023J011843）
第九○九医院自主科研项目(22MS008). （22MS008）
