体积描记法联合血清单核细胞趋化蛋白-1水平预测急性下呼吸道感染患者合并哮喘的效能分析

Predictive efficacy of body plethysmography combined with serum MCP-1 levels for asthma in patients with acute lower respiratory tract infection

摘要:

目的 探究体积描记法联合血清单核细胞趋化蛋白-1（MCP-1）对急性下呼吸道感染患者合并哮喘的预测价值。方法 回顾性分析2019年6月—2022年12月青海省人民医院收治的188例急性下呼吸道感染患者的病历资料。根据患者住院期间是否并发哮喘分为合并组（48例）和非合并组（140例）。收集并整理所有受试者的人口学资料和实验室检测指标（体积描记法相关参数：肺总量、残气量、残气率，血清MCP-1水平）。比较两组患者临床资料的差异，分析肺总量、残气量与功能残气量（FRC）、MCP-1的相关性，分析影响急性下呼吸道感染患者并发哮喘的相关因素，以及FRC、MCP-1对急性下呼吸道感染患者并发哮喘的预测价值。结果 合并组FRC、肺总量、残气量、残气率、MCP-1水平均高于非合并组（P <0.05）。FRC与肺总量、残气量水平均呈正相关（r =0.681和0.671，均P =0.001）；MCP-1与肺总量、残气量水平均呈正相关（r =0.669和0.654，均P =0.001）。多因素逐步Logistic回归分析结果显示：FRC ［O^R=2.450（95% CI：1.239，4.840）］、MCP-1 ［O^R=2.995（95% CI：1.516，5.918）］是急性下呼吸道感染患者并发哮喘的危险因素（P <0.05）。受试者工作特征曲线结果分析显示，FRC、MCP-1及联合预测急性下呼吸道感染患者并发哮喘的敏感性分别为72.92%（95% CI：0.579，0.842）、83.33%（95% CI：0.692，0.920）、79.17%（95% CI：0.645，0.890），特异性分别为81.43%（95% CI：0.737，0.873）、70.71%（95% CI：0.623，0.779）、81.43%（95% CI：0.737，0.873）。结论 体积描记法和血清MCP-1水平可用于评估急性下呼吸道感染患者肺功能，且血清MCP-1与体积描记法检测的FRC对急性下呼吸道感染患者并发哮喘的预测效能良好。

Abstract:

Objective To explore the predictive value of body plethysmography combined with serum levels of monocyte chemoattractant protein-1 (MCP-1) for asthma in patients with acute lower respiratory tract infection.Methods The medical records of 188 patients with acute lower respiratory tract infection admitted to Qinghai Provincial People's Hospital from June 2019 to December 2022 were retrospectively analyzed. According to whether the patients were complicated with asthma during hospitalization, they were divided into the combined group (48 cases) and the non-combined group (140 cases). The demographic data and laboratory indicators, including parameters measured via body plethysmography such as total lung capacity (TLC), residual volume (RV) and RV/TLC ratio as well as the serum level of MCP-1, of all subjects were collected and sorted out. The differences in the clinical data were compared between the two groups of patients, and the correlations of TLC and RV with the functional residual capacity (FRC) and the serum level of MCP-1 were analyzed. In addition, relevant factors affecting the occurrence of asthma in patients with acute lower respiratory tract infection and the predictive value of FRC combined with the serum level of MCP-1 for asthma in patients with acute lower respiratory tract infection were determined.Results The FRC, TLC, RV, RV/TLC ratio and the serum level of MCP-1 in the combined group were higher than those in the non-combined group (P < 0.05). FRC was positively correlated with TLC and RV (r =0.681 and 0.671, both P =0.001), while the serum level of MCP-1 was positively correlated with TLC and RV (r =0.669 and 0.654, both P =0.001). The results of multivariable Logistic regression analysis showed that high FRC [O^R = 2.450 (95% CI: 1.239, 4.840) ] and serum level of MCP-1 [O^R = 2.995 (95% CI: 1.516, 5.918) ] were risk factors for asthma in patients with acute lower respiratory tract infection (P < 0.05). The receiver operating characteristic curve analysis demonstrated that the sensitivities of FRC, the serum level of MCP-1 and their combination in predicting asthma in patients with acute lower respiratory tract infection were 72.92% (95% CI: 0.579, 0.842), 83.33% (95% CI: 0.692, 0.920) and 79.17% (95% CI: 0.645, 0.890), with the specificities being 81.43% (95% CI: 0.737, 0.873), 70.71% (95% CI: 0.623, 0.779) and 81.43% (95% CI: 0.737, 0.873).Conclusions Body plethysmography and the serum level of MCP-1 can be used to evaluate the lung function of patients with acute lower respiratory tract infection. Serum MCP-1 and FRC measured via body plethysmography exhibit great predictive efficacy for asthma in patients with acute lower respiratory tract infection.