老年COPD患者重症呼吸衰竭对外周血HMGB1-Th17/IL-17炎症轴的影响分析
摘要] 目的 探讨老年慢性阻塞性肺疾病（COPD）患者重症呼吸衰竭对外周血HMGB1-Th17/IL-17炎症轴的影响。方法 选取2020年4月～2023年4月我院120例老年COPD合并重症呼吸衰竭患者作为观察组，另选取同期收治120例老年COPD患者作为对照组。比较两组HMGB1-Th17/IL-17炎症轴相关因子HMGB1、IL-17水平，分析其对老年COPD患者重症呼吸衰竭发病风险的影响；比较观察组不同预后患者基线资料、HMGB1、IL-17水平，分析HMGB1、IL-17与APACHEⅡ评分的相关性，评价HMGB1、IL-17对预后的预测价值。结果 观察组HMGB1-Th17/IL-17炎症轴相关因子HMGB1、IL-17均高于对照组（P＜0.05）；老年COPD患者血清HMGB1、IL-17高水平时，重症呼吸衰竭发生风险分别是低水平的3.286倍、2.870倍；病死患者APACHEⅡ评分及血清HMGB1、IL-17水平均高于生存患者（P＜0.05）；老年COPD合并重症呼吸衰竭患者血清HMGB1、IL-17与APACHEⅡ评分呈极显著相关系（P＜0.05）；血清HMGB1、IL-17预测预后的曲线下面积（AUC）值分别为0.778、0.797，均在0.7以上，具有一定预测效能；血清HMGB1、IL-17联合预测AUC值为0.932，明显高于各指标单独预测（P＜0.05）。结论 老年COPD患者重症呼吸衰竭发生后，HMGB1-Th17/IL-17炎症轴中关键因子HMGB1、IL-17水平明显升高，且二者可通过调节肺部炎症反应影响患者预后。
bstract] Objective To investigate the effects of severe respiratory failure on HMGB1-Th17/IL-17 inflammatory axis in peripheral blood of elderly patients with chronic obstructive pulmonary disease (COPD). Methods 120 elderly patients with COPD combined with severe respiratory failure from April 2020 to April 2023 were selected as the observation group, and another 120 elderly patients with COPD were selected as the control group. The levels of HMGB1-TH17 /IL-17 inflammation-axis related factors HMGB1 and IL-17 were compared between the two groups, and their effects on the risk of severe respiratory failure in elderly COPD patients were analyzed. The baseline data, HMGB1 and IL-17 levels of patients with different prognosis were compared in the observation group, and the correlation between HMGB1 and IL-17 and APACHE score was analyzed to evaluate the predictive value of HMGB1 and IL-17 for prognosis. Results HMGB1-TH17 /IL-17 inflammatory axis related factors HMGB1 and IL-17 in the observation group were higher than those in the control group (P < 0.05). The risk of severe respiratory failure in elderly COPD patients with high levels of serum HMGB1 and IL-17 was 3.286 times and 2.870 times higher than that of low levels, respectively. The APACHE score and serum HMGB1 and IL-17 levels of dead patients were higher than those of surviving patients (P < 0.05). Serum HMGB1 and IL-17 were significantly correlated with APACHE scores in elderly COPD patients with severe respiratory failure (P < 0.05). The area under the curve (AUC) values of serum HMGB1 and IL-17 for predicting prognosis were 0.778 and 0.797, respectively, both above 0.7, showing certain predictive efficacy. The AUC value predicted by the combination of serum HMGB1 and IL-17 was 0.932, which was significantly higher than that predicted by each index alone (P < 0.05). Conclusion After the occurrence of severe respiratory failure in elderly COPD patients, the levels of HMGB1 and IL-17, the key factors in the inflammation axis of HMGB1-TH17 /IL-17, are significantly increased, and they can affect the prognosis of patients by regulating the pulmonary inflammatory response.
王艳杰、潘春香、鹿敏、孙如坤、胡祥坤
内科学临床医学基础医学
慢性阻塞性肺疾病重症呼吸衰竭HMGB1-Th17/IL-17炎症轴HMGB1IL-17
hronic obstructive pulmonary diseaseSevere respiratory failureHMGB1-Th17/IL-17 inflammation axisHMGB1IL-17
王艳杰,潘春香,鹿敏,孙如坤,胡祥坤.老年COPD患者重症呼吸衰竭对外周血HMGB1-Th17/IL-17炎症轴的影响分析[EB/OL].(2023-08-08)[2025-08-10].https://chinaxiv.org/abs/202308.00185.点此复制
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