Department of Respiration, The First Affiliated Hospital of Harbin Medical University, 150001 Harbin City, Heilongjiang Province, China.
Comput Math Methods Med. 2022 Apr 30;2022:3555982. doi: 10.1155/2022/3555982. eCollection 2022.
To explore the correlation of serum IL-18, BDNF, and IL-1 with depression and prognosis after acute exacerbation of chronic obstructive pulmonary disease (COPD).
By means of retrospective analysis, the data of 240 patients at the acute exacerbation of COPD treated in our hospital (February 2018-February 2021) were analyzed. All patients received conventional treatment 1 d after admission, patients' serological indicators were measured before treatment, and after 30 d of follow-up, the patients were divided into the survival group (SG) and death group (DG) according to their clinical outcomes, the Beck's Depression Inventory (BDI) scores of the surviving patients were investigated, the correlation of IL-18, BDNF, and IL-1 levels with depression was analyzed by R analytics, and the correlation of IL-18, BDNF, and IL-1 levels with prognosis was analyzed by ROC curve analysis.
The results of 30 d follow-up showed that 220 patients survived (91.7%) and 20 patients died (8.3%). Among the surviving patients, 95 patients had depression and 125 patients did not have depression; the BDI scores of the depressed subjects and the nondepressed subjects were 10.35 ± 1.25 points and 2.06 ± 0.76 points, respectively; significant differences in IL-18, BDNF, and IL-1 levels between SG and DG were observed ( < 0.05); significant differences in IL-18, BDNF, and IL-1 levels between the depressed subjects and the nondepressed subjects were observed (538.43 ± 19.02 vs. 515.32 ± 9.65, 7.54 ± 0.56 vs. 12.11 ± 2.41, and 8.70 ± 0.98 vs. 8.12 ± 0.87; < 0.001); among the depressed patients, the IL-18 and IL-1 levels were positively correlative with the BDI scores ( = 0.781, = 0.2583, < 0.001, = 0.012), and the BDNF level was negatively correlative with the BDI scores ( = -0.3277, = 0.001) before treatment; according to the ROC analysis, the AUC (95% CI) of IL-18, BDNF, and IL-1 in predicting prognosis was 0.8770 (0.8281-0.9260), 0.7723 (0.6879-0.8567), and 0.7165 (0.6080-0.8250) ( < 0.05), respectively.
In regard to the depression in COPD patients after acute exacerbation, IL18 and IL-1 show positive correlation, and BDNF presents negative correlation. All three indicators have predictive value for patient outcome.
探讨血清白细胞介素-18（IL-18）、脑源性神经营养因子（BDNF）和白细胞介素-1（IL-1）与慢性阻塞性肺疾病（COPD）急性加重后抑郁及其预后的相关性。
采用回顾性分析，分析我院（2018 年 2 月-2021 年 2 月）收治的 240 例 COPD 急性加重患者的临床资料。患者入院后第 1 天接受常规治疗，在治疗前检测患者的血清学指标，在随访 30 d 后，根据患者的临床结局将患者分为存活组（SG）和死亡组（DG），对存活患者的贝克抑郁量表（BDI）评分进行调查，采用 R 分析对 IL-18、BDNF 和 IL-1 水平与抑郁的相关性进行分析，并采用 ROC 曲线分析对 IL-18、BDNF 和 IL-1 水平与预后的相关性进行分析。
30 d 随访结果显示，220 例患者存活（91.7%），20 例患者死亡（8.3%）。在存活患者中，95 例患者出现抑郁，125 例患者未出现抑郁；抑郁患者和非抑郁患者的 BDI 评分分别为 10.35±1.25 分和 2.06±0.76 分；SG 和 DG 之间的 IL-18、BDNF 和 IL-1 水平差异有统计学意义（ < 0.05）；抑郁患者和非抑郁患者的 IL-18、BDNF 和 IL-1 水平差异有统计学意义（538.43±19.02 比 515.32±9.65、7.54±0.56 比 12.11±2.41 和 8.70±0.98 比 8.12±0.87； < 0.001）；在抑郁患者中，IL-18 和 IL-1 水平与 BDI 评分呈正相关（ = 0.781、 = 0.2583； < 0.001、 = 0.012），BDNF 水平与 BDI 评分呈负相关（ = -0.3277； = 0.001）；根据 ROC 分析，IL-18、BDNF 和 IL-1 预测预后的 AUC（95%CI）分别为 0.8770（0.8281-0.9260）、0.7723（0.6879-0.8567）和 0.7165（0.6080-0.8250）（ < 0.05）。
在 COPD 急性加重后抑郁患者中，IL18 和 IL-1 呈正相关，BDNF 呈负相关。这三个指标对患者的预后均有预测价值。
