Diagnostic value of serum α 1-antitrypsin and progranulin in acute exacerbation of chronic obstructive pulmonary disease
Objective To investigate the diagnostic value of serum α 1-antitrypsin and progranulin in acute exacerbation of chronic obstructive pulmonary disease.Methods 103 patients with acute exacer-bation of chronic obstructive pulmonary disease in Zhumadian central hospital and Henan Provincial chest hospital from June 2020 to June 2023 were selected as the observation group,and 103 patients with stable chronic obstructive pulmonary disease in our hospital were selected as the control group.Venous blood was drawn from the two groups in the morning,and the changes of serum α1-antitrypsin and progranulin levels in the control group and the observation group were measured.The patients with acute exacerbation of chronic obstructive pulmonary disease were divided into mild,moderate and severe according to the Simplified Acute Physiology Score Ⅱ.The changes of serum α1-antitrypsin and progranulin levels were compared;According to whether the patients developed respiratory failure,the patients were divided into respiratory failure group and no respiratory failure group,and the changes of serum α1-antitrypsin and progranulin levels were com-pared.The relationship between serum α1-antitrypsin and progranulin levels and respiratory failure was ana-lyzed by receiver operating curve.Independent sample t-test was used for inter group measurement data.Results The serum levels of α1-antitrypsin and progranulin in the control group[(6.18±1.52)mg/L,(159.90±41.57)μg/L]were significantly lower than those in the observation group[(9.86±2.85)mg/L,(200.20±46.26)μg/L,t=11.550,6.251,P＜0.05].The serum levels of α1-antitrypsin and progranu-lin in patients with mild chronic obstructive pulmonary disease at acute exacerbation stage[(6.98±0.82)mg/L,(148.51±16.70)μ g/L]were significantly lower than those in moderate patients[(9.43±0.78)mg/L,(201.54±19.75)μ g/L,t=12.360,11.820,P＜0.05].The serum levels of α1-antitryp-sin and progranulin in patients with acute exacerbation of moderate chronic obstructive pulmonary disease[(9.43±0.78)mg/L,(201.54±19.75)µ g/L]were significantly lower than those in severe patients[(13.01±1.80)mg/L,(249.42±17.76)µ g/L,t=10.150,10.440,P＜0.05].The serum levels ofα 1-antitrypsin and progranulin in patients with acute exacerbation of chronic obstructive pulmonary disease without respiratory failure[(7.98±1.50)mg/L,(167.68±30.17)µ g/L]were significantly lower than those in patients with respiratory failure[(12.37±2.23)mg/L,(243.81±21.27)μ g/L,t=14.290,11.920,P＜0.05].The area under the curve of serum α 1-antitrypsin level in predicting respiratory fail-ure was 0.891(95％:0.847,0.974),the sensitivity was 82.1％(95％:0.785,0.974),and the speci-ficity was 78.9％(95％:0.722,0.894);The area under the curve of serum progranulin level in predic-ting respiratory failure was 0.859(95％:0.801,0.946),the sensitivity was 78.9％(95％:0.729,0.889),and the specificity was 85.6％(95％:0.804,0.924).The area under the curve of combined di-agnosis of serum α1-antitrypsin and progranulin for respiratory failure was 0.915(95％:0.865,0.971),the sensitivity was 89.8％(95％:0.822,0.938),and the specificity was 94.7％(95％:0.877,0.976).Conclusion Serum α 1-antitrypsin and progranulin are significantly increased in the acute exac-erbation of chronic obstructive pulmonary disease,which are risk factors for disease exacerbation,and can be used as markers for the diagnosis of acute exacerbation of chronic obstructive pulmonary disease.
Serum α 1-antitrypsinProgranulinAcute exacerbation of chronic obstructive pulmonary disease
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