Study on the Correlation between Changes in Serum Glycerophospholipid Metabolites LPC18∶3 and LPE 16∶1 Levels and Their Clinical Prognosis in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Study on the Correlation between Changes in Serum Glycerophospholipid Metabolites LPC18∶3 and LPE 16∶1 Levels and Their Clinical Prognosis in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Objective To explore the expression levels of serum glycerophospholipid metabolites lysophosphatidylcholine(LPC)18∶3 and lysophosphatidylethanolamine(LPE)16∶1 in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and their correlation with clinical prognosis.Methods A total of 112 AECOPD patients diagnosed and treated in Tangshan People's Hospital from January 2019 to January 2022 were selected as the AECOPD group.According to the 3-month follow-up prognosis of the AECOPD group patients,they were divided into survival group(n=90)and death group(n=22).During the same period,60 stable COPD patients were selected as the stable period group,while 60 healthy individuals in the same period were selected as the control group.High performance liquid chromatography tandem mass spectrometry(HPLC-MS/MS)was used to detect serum LPC18∶3 and LPE16∶1 levels in each group.Pearson method was used to analyze their correlation.Logistic regression analysis was used to analyze factors affecting the prognosis of AECOPD patients.Receiver operating characteristic curve was drawn to evaluate the prognostic value of LPC18∶3 and LPE16∶1 in AECOPD patients.The prognosis of AECOPD patients with different serum LPC18∶3 and LPE16∶1 expression groups was compared by K-M curve.Results Serum LPC18∶3(21.67±4.35 μ mol/L),LPE16∶1(16.20±5.17 µ mol/L),PEF％pred,FEV1％pred,and FEV1/FVC％in AECOPD group were lower than those of stable phase group(43.24±6.17 μ mol/L,32.19±5.98 μmol/L)and the control group(68.14±8.78 μ mol/L,44.82±7.44 μ mol/L),with significant differences(F=461.240～1 102.534,all P＜0.05).The serum LPC18:3 and LPE16:1 levels in the AECOPD group were positively correlated with lung function indicators such as PEF％pred,FEV1％pred,and FEV1/FVC％(r=0.603～0.756,allP＜0.05).The course of COPD and PCT of AECOPD patients in the death group were higher than those in the survival group(t=3.961,2.509),while the PEF％pred,FEV1％pred,FEV1/FVC％,serum LPC18∶3(17.20±4.11µ mol/L),and LPE16∶1(10.15±3.03 µ mol/L)in the death group were lower than those in the survival group(22.76±4.35 μ mol/L,17.68±5.22 μ mol/L),with significant differences(t=4.141～6.490,all P＜0.05).Serum LPC18∶3(OR=0.691,95％CI:0.519～0.920)and LPE16∶1(OR=0.586,95％CI:0.382～0.901)were independent protective factors,while the course of COPD(OR=1.510,95％CI:1.203～1.895)and procalcitonin(OR=1.759,95％CI:1.159～2.671)were risk factors affecting the prognosis of AECOPD patients.The area under the curve(95％CI)of combined serum LPC18∶3 and LPE16∶1 for prognosis evaluation of AECOPD patients was better than that of serum LPC18∶3 and LPE16∶1 predicted separately[0.866(0.822～0.907)vs 0.794(0.748～0.830),0.786(0.739～0.836)](Z=3.957,4.195,P=0.002,＜0.001).The mortality risk of AECOPD patients in the low expression group of LPC18∶3 and LPE16∶1 was higher than that in the high expression group of LPC18∶3 and LPE16∶1(log rankx2=4.475,5.763,P=0.034,0.016).Conclusion The serum levels of glycerophospholipid metabolites LPC18∶3 and LPE16∶1 in AECOPD patients were decreased,which were related to lung function status.The combination of the two may effectively evaluate the prognosis of AECOPD patients.
关键词
慢性阻塞性肺疾病急性加重期/溶血磷脂酰胆碱18∶3/溶血磷脂酰乙醇胺16∶1
Key words
acute exacerbation of chronic obstructive pulmonary disease/LPC 18∶3/LPE 16∶1
维普
万方数据