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慢性阻塞性肺疾病不同阶段β2-微球蛋白和电解质的变化及其在评估预后中的价值。

Changes of b2-microglobulin and electrolytes in different stages of COPD and their value in evaluating prognosis.

作者信息

Wang Lin, Yi Rong, Wei Lanlan, Xiong Jiali

机构信息

Central South University, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Department 2 of Respiratory and Critical Medicine, Zhuzhou, China.

出版信息

J Med Biochem. 2024 Nov 16;43(6):946-954. doi: 10.5937/jomb0-50905.

Abstract

BACKGROUND

To investigate the changes of b2-microglobulin and electrolyte in different stages of chronic obstructive pulmonary disease (COPD) and the value of evaluating prognosis.

METHODS

A retrospective study was undertaken on 120 patients diagnosed with COPD and treated at our respiratory department between February 1, 2020, and January 31, 2023. These patients were classified into three groups based on the GOLD classification: mild (FEV1 > 81%), moderate (51% < FEV1 ≤ 80%), and severe (FEV1 ≤ 50%). As a control group, 40 healthy individuals who had routine examinations during the same period were selected. The COPD patients were then followed up and divided into a good prognosis group (n = 67) and a poor prognosis group (n = 53). The levels of b2-microglobulin and electrolytes were measured in patients with different stages of the disease and different prognoses. Kendall's tau-b and ordered logistic regression were employed to analyze how the changes in b2-microglobulin and electrolyte levels correlated with disease severity. Furthermore, the prognostic value of b2-microglobulin and electrolyte levels in COPD was assessed using an ROC curve.

RESULTS

In comparison to the control group, the severity of COPD patients displayed a notable increase in b2microglobulin levels, while there was a significant decrease in levels of calcium, chlorine, potassium, and sodium. Kendall's tau-b correlation coefficient analysis indicated a positive correlation between COPD severity and b2microglobulin, and a negative correlation between COPD severity and levels of calcium, chlorine, potassium, and sodium. Logistic regression analysis revealed that there was a positive correlation between disease severity and b2microglobulin, and a negative correlation between disease severity and levels of calcium, chlorine, potassium, and sodium. Furthermore, the poor prognosis group exhibited a significant increase in b2-microglobulin levels, alongside a significant decrease in levels of calcium, chlorine, potassium, and sodium compared to the good prognosis group (P < 0.05). ROC curve analysis demonstrated that a combined detection of b2-microglobulin, calcium, chlorine, potassium, and sodium yielded significantly higher area under the curve, sensitivity, and specificity values compared to single detection methods, highlighting its significant predictive value for COPD prognosis.

CONCLUSIONS

Patients who presented with a more severe form of the disease exhibited elevated levels of b2microglobulin and reduced electrolyte levels. Prognostic accuracy was significantly enhanced when b2-microglobulin and electrolyte levels were analyzed together, offering a superior method for predicting patient outcomes.

摘要

背景

探讨慢性阻塞性肺疾病(COPD)不同阶段β2-微球蛋白和电解质的变化及其评估预后的价值。

方法

对2020年2月1日至2023年1月31日在我院呼吸科诊断并治疗的120例COPD患者进行回顾性研究。根据GOLD分级将这些患者分为三组:轻度(FEV1>81%)、中度(51%<FEV1≤80%)和重度(FEV1≤50%)。选取同期进行常规体检的40名健康个体作为对照组。然后对COPD患者进行随访,并分为预后良好组(n = 67)和预后不良组(n = 53)。测定不同疾病阶段和不同预后患者的β2-微球蛋白和电解质水平。采用肯德尔tau-b检验和有序逻辑回归分析β2-微球蛋白和电解质水平变化与疾病严重程度的相关性。此外,使用ROC曲线评估β2-微球蛋白和电解质水平在COPD中的预后价值。

结果

与对照组相比,COPD患者的β2-微球蛋白水平显著升高,而钙、氯、钾和钠水平显著降低。肯德尔tau-b相关系数分析表明,COPD严重程度与β2-微球蛋白呈正相关,与钙、氯、钾和钠水平呈负相关。逻辑回归分析显示,疾病严重程度与β2-微球蛋白呈正相关,与钙、氯、钾和钠水平呈负相关。此外,与预后良好组相比,预后不良组的β2-微球蛋白水平显著升高,钙、氯、钾和钠水平显著降低(P<0.05)。ROC曲线分析表明,与单一检测方法相比,联合检测β2-微球蛋白、钙、氯、钾和钠的曲线下面积、敏感性和特异性值显著更高,突出了其对COPD预后的显著预测价值。

结论

疾病形式更严重的患者β2-微球蛋白水平升高,电解质水平降低。联合分析β2-微球蛋白和电解质水平时,预后准确性显著提高,为预测患者预后提供了更好的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34a6/11771965/1aeb29897edb/jomb-43-6-2406946W_g001.jpg

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