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血浆壳三糖苷酶活性与 COPD 加重。

Chitotriosidase Activity in Plasma and COPD Exacerbations.

机构信息

Department of Pulmonary Diseases, University Medical Centre Ljubljana, Zaloška cesta 2, 1000, Ljubljana, Slovenia.

Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia.

出版信息

Lung. 2020 Apr;198(2):299-306. doi: 10.1007/s00408-020-00331-8. Epub 2020 Jan 25.

Abstract

INTRODUCTION

This study aimed to determine the association between plasma chitotriosidase activity and the clinical characteristics and exacerbation rate of COPD patients.

METHODS

The study comprised 97 patients with COPD. Their clinical characteristics and a history of exacerbations in the last 12 months were noted. Plasma chitotriosidase activity was determined. Patients were followed up for 12 months, and the number of moderate and severe exacerbations during this period was recorded.

RESULTS

Chitotriosidase activity positively correlated with patient age (rho = 0.217, p = 0.036) and inversely with CAT (rho = - 0.240, p = 0.020). There was no correlation with lung function. Chitotriosidase activity was significantly lower in patients with a history of ≥ 2 exacerbations compared to patients without a history of exacerbations (93 [38-312] vs. 264 [168-408] nmol/h/mL, p = 0.033). Overall, there was no difference in chitotriosidase activity between patients with or without observed exacerbations. Patients with a history of ≥ 1 exacerbation and ≥ 1 observed exacerbation had higher chitotriosidase activity compared to patients without further exacerbations (240 [144-456] vs. 52 [39-240] nmol/h/mL, p = 0.035). Multivariate analysis identified FEV (HR 0.976, 95% CI 0.956-0.996, p = 0.016) and blood eosinophil percentage (HR 1.222, 95% CI 1.048-1.424, p = 0.011) as independent predictors of future exacerbations in the total patient population, while in patients with a history of ≥ 1 exacerbation ,the only independent predictor was chitotriosidase activity (HR per 10 nmol/h/mL 1.028, 95% CI 1.002-1.055, p = 0.037).

CONCLUSION

While mixed associations between chitotriosidase activity and clinical outcomes were seen, chitotriosidase activity could be a predictor of future exacerbations in patients with a history of ≥ 1 exacerbation in the past  12 months.

摘要

简介

本研究旨在确定血浆壳三糖苷酶活性与 COPD 患者的临床特征和加重率之间的关系。

方法

本研究纳入了 97 例 COPD 患者。记录了他们的临床特征和过去 12 个月内的加重史。测定了血浆壳三糖苷酶活性。对患者进行了 12 个月的随访,记录了这段时间内中重度加重的次数。

结果

壳三糖苷酶活性与患者年龄呈正相关(rho=0.217,p=0.036),与 CAT 呈负相关(rho=-0.240,p=0.020)。与肺功能无相关性。与无加重史的患者相比,有≥2 次加重史的患者壳三糖苷酶活性显著降低(93[38-312]vs.264[168-408]nmol/h/mL,p=0.033)。总体而言,有或无观察到加重的患者之间的壳三糖苷酶活性无差异。有≥1 次加重史和≥1 次观察到加重的患者的壳三糖苷酶活性高于无进一步加重的患者(240[144-456]vs.52[39-240]nmol/h/mL,p=0.035)。多变量分析确定 FEV(HR0.976,95%CI0.956-0.996,p=0.016)和血嗜酸性粒细胞百分比(HR1.222,95%CI1.048-1.424,p=0.011)是全患者人群未来加重的独立预测因素,而在有≥1 次加重史的患者中,唯一的独立预测因素是壳三糖苷酶活性(每增加 10 nmol/h/mL 的 HR1.028,95%CI1.002-1.055,p=0.037)。

结论

虽然壳三糖苷酶活性与临床结局之间存在混合关联,但在过去 12 个月内有≥1 次加重史的患者中,壳三糖苷酶活性可能是未来加重的预测因素。

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