Establishment and clinical application evaluation of early warning diagnostic model for acute exacerbation of chronic obstructive pulmonary disease by combined detection of IL-5,IL-17A and IFN-α
Objective This study aims to establish an early warning diagnosis model for acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and to provide a simple,rapid,and accurate auxiliary diagnosis basis for clinical practice.Methods The sample bank of subjects(patients admitted to the Eighth Medical Center of the PLA General Hospital from September 10,2021,to July 25,2023)was constructed,including the model establishment cohort[SCOPD group 49,42 males and 7 females,(69.71±11.16)years old;AECOPD group 53,49 males and 4 females,(72.60±10.19)years old]and the model validation cohort[SCOPD group 35,28 males and 7 females,(69.97±10.40)years old;AECOPD group 35,33 males and 2 females,(71.43±9.67)years old].Fasting peripheral blood samples were collected,and the expression levels of IL-5,IL-17A,and IFN-α were detected by flow cytometry.Different expression levels were analyzed by Mann-Whitney U test.Binary logistic regression analysis was used to screen the related risk factors of COPD patients in acute exacerbation.The diagnostic efficacy of the model was evaluated by the receiver operating characteristic(ROC)curve.Results The levels of IL-5[1.64(0.60,2.86)pg/ml],1L-17A[1.42(0.88,2.29)pg/ml],and IFN-α[0.91(0.59,1.81)pg/ml]in the SCOPD group were significantly decreased compared with the AECOPD group IL-5[4.68(2.34,9.40)pg/ml,Z=-5.033,P＜0.001],IL-17A[2.33(1.59,4.62)pg/ml,Z=-3.919,P＜0.001],IFN-α[2.83(0.91,3.75)pg/ml,Z=-4.127,P＜0.01]in the cohort of model establishment.The results of binary logistic regression analysis between SCOPD and AECOPD groups showed that IL-5,IL-17A,and IFN-α were independent risk factors for acute exacerbation of patients with COPD(P＜0.05).And the regression equation is Y=-2.861+0.364×IL-5+0.385×IL-17A+0.445×IFN-α.The AUC value of IL-5,IL-17A,IFN-α and combined detection was 0.866(P＜0.001).Compared to the SCOPD group and the AECOPD group in the cohort of model validation,the receiver operating characteristic(ROC)curve showed that the combined model of three(AUC=0.858,P＜0.001)could be used to diagnose the AECOPD.And the Kappa value was 0.773(P＜0.05).Conclusion The combined detection of IL-5,IL-17A,and IFN-α has high diagnostic efficacy for patients with acute exacerbation of COPD.This method provides a new potential tool for the clinical diagnosis of AECOPD and has the value of further exploration and optimization,promotion,and application.
万方数据
维普
