摘要
目的 探讨老年慢性阻塞性肺疾病(COPD)患者转化生长因子β1(TGF-β1)/Smads信号通路与肺动脉高压(PH)风险的关系.方法 回顾性分析2021年6月至2023年6月在榆林市第一医院接受治疗的102例老年COPD患者的临床资料,参照是否合并PH将所有老年COPD患者分为合并PH组(n=40)和未合并PH组(n=62).比较两组基础资料信息[性别、年龄、体重指数、COPD病程、糖尿病、高血压、高血脂、吸烟史、饮酒史、1秒用力呼气量(FEV1)/用力肺活量(FVC)、氧分压]与血清TGF-β1/Smads信号通路蛋白水平;采用多因素Logistic回归分析影响老年COPD患者合并PH危险因素;绘制受试者操作特征(ROC)曲线评价血清TGF-β1/Smads信号通路评估老年COPD患者合并PH的效能.结果 两组性别、年龄、体重指数、COPD病程、糖尿病、高血压、高血脂、吸烟史、饮酒史、FEV1/FVC、氧分压比较,差异均无统计学意义(P＞0.05);合并PH组TGF-β1、Smad2、Smad3均显著高于未合并PH组,而Smad6、Smad7均显著低于未合并PH组,差异均有统计学意义(P＜0.05).经多因素Logistic回归分析证实,TGF-β1/Smads信号通路被激活是影响老年COPD患者合并PH的危险因素(P＜0.05);经ROC分析证实,血清TGF-β1、Smad2、Smad3、Smad6、Smad7可用于老年COPD患者合并PH的评估,曲线下面积分别为0.804、0.908、0.851、0.898、0.872,均有P＜0.05.结论 老年COPD患者合并PH风险与TGF-β1/Smads信号通路的激活密切相关,临床可将TGF-β1、Smad2、Smad3、Smad6及Smad7作为评估患者病情和发生PH情况的标志物,为临床治疗和预后提供参考.
Abstract
Objective To investigate the relationship between transforming growth factor[31(TGF-β1)/Smads signaling pathway and pulmonary hypertension(PH)risk in elderly patients with chronic obstructive pulmonary disease(COPD).Methods The clinical data of 102 elderly COPD patients treated in Yulin First Hospital from June 2021 to June 2023 were retrospectively analyzed.All elderly COPD patients were divided into the PH combined group(n=40)and the non-pH combined group(n=62)according to whether PH combined or not.The basic data information[gender,age,body mass index,COPD course,diabetes,hypertension,hyperlipidemia,smoking history,drinking history,forced expiratory volume in 1 second(FEV1)/forced vital capacity(FVC),oxygen partial pressure]and serum TGF-β1/Smads signaling path-way protein levels were compared between the two groups.And the risk factors affecting PH in elderly COPD patients were analyzed by multi-fac-tor Logistic regression.The efficacy of serum TGF-β1/Smads signaling pathway in assessing PH in elderly COPD patients was evaluated by draw-ning receiver operating characteristic(ROC)curve.Results TGF-β1,Smad2 and Smad3 in the PH combined group were significantly higher than those in the non-PH combined group,while Smad6 and Smad7 were significantly lower than those in the non-PH combined group(P＜0.05).Multiple Logistic regression analysis confirmed that the activation of TGF-β1/Smads signaling pathway was a risk factor affecting the com-bined PH of elderly COPD patients(P＜0.05).ROC analysis confirmed that serum TGF-β1,Smad2,Smad3,Smad6 and Smad7 could be used to evaluate PH in elderly patients with COPD,and the areas under the curve were 0.804,0.908,0.851,0.898 and 0.872,respectively,with the P values less than 0.05.Conclusion The combined PH risk of elderly COPD patients is closely related to the activation of TGF-β1/Smads signaling pathway,and TGF-β1,Smad2,Smad3,Smad6 and Smad7 can be used as markers to evaluate the condition and PH of patients,providing a reference for clinical treatment and prognosis.
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