| Objective:This study was designed to observe the change of serum suPAR and peripheral blood NLR before and after treatment in patients with AECOPD and to analyze the relationship between them and the common inflammatory markers CRP,fibrinogen level and COPD Assessment Test scores.The aim of this study is to explore the value of suPAR and NLR in predicting the acute exacerbation of COPD and evaluating the clinical therapeutic effect of AECOPD.Methods: The observation group was selected from 30 patients with AECOPD who were hospitalized with respiratory diseases in Gansu Provincial People's Hospital from November 2016 to March 2017 due to respiratory symptoms were significantly worse than the steady-state.After admission to give low-flow oxygen(ventilator-assisted breathing if necessary),antibiotics to control infection,bronchodilator bronchodilator and other treatment.The healthy control group consisted of 30 healthy people from the Health Examination Center of Gansu Provincial People's Hospital from November 2016 to March 2017.Collect serum from observation group patients on the day of admission and after 7 days of treatment,collect serum from control group.Enzyme-linked immunosorbent assay(ELISA)was used to determine the expression level of serum suPAR.NLR,CRP,FIB,and general clinical data were collected in the observation group before,after receiving treatment,and in the control group.The CAT scores of the observation group was also collected before the treatment.The expression of suPAR,NLR in AECOPD and the correlation between suPAR,NLR and CRP,FIB,CAT scores were analyzed.A receiver operating characteristic curve(ROC curve)was used to analyze the value of suPAR and NLR in the prediction of AECOPD.Results:(1).Compared with the healthy control group,the general information(age,gender,BMI,smoking status)in the observation group was not statistically significant(P > 0.05).(2).The level of suPAR,NLR,CRP and FIB in the observation group beforetreatment were all higher than those in the healthy control group(P <0.05).The suPAR,NLR and CRP level in the observation group were significantly higher than those in the healthy control group.The FIB level in observation group was higher than that in healthy control group,but the difference was not significant(P > 0.05).(3).The suPAR,NLR,CRP and FIB level in the observation group were significantly higher than those before treatment(P <0.05).(4).The suPAR of patients with AECOPD before treatment was positively correlated with the levels of CRP,FIB and CAT before treatment(r = 0.647,r = 0.461,r = 0.482,P <0.05)(R = 0.505,r = 0.414,P <0.05),but there was no significant correlation bitween suPAR and CAT score(r = 0.327,P = 0.078).(5).There was a positive correlation between suPAR and CRP,FIB after treatment(r = 0.452,r = 0.447,P <0.05).There was a positive correlation between NLR and CRP after treatment(r = 0.568,P <0.05),There was no significant correlation bitween NLR and FIB(r = 0.334,P = 0.063).(6).In the ROC analysis,the area under the suPAR curve was 0.807(95%confidence interval [CI]: 0.685-0.898,P <0.05).When the cut-off value was3.12ng/mL,the sensitivity of predicting acute exacerbation of COPD was 85.4%,and the specificity was 76.7%.The area under the NLR curve was 0.746(95% confidence interval [CI]: 0.617-0.849,P <0.05).When the cut-off value was 3.9,the sensitivity and specificity of predicting acute exacerbation of COPD were 78.1% and 71.9%respectively.Conclusions:1.Serum suPAR,peripheral blood NLR in AECOPD were significantly higher than normal people,There was a correlation between the two markers and CRP,FIB.In the ROC analysis,the area of the two curves was 0.807 and 0.746 respectively.It is suggested that both can be used as indicators for predicting acute exacerbation of COPD.2.The serum suPAR and peripheral blood NLR of AECOPD patients were significantly lower than those before treatment.It is suggested that both of them can be an important marker for evaluating the effect of treatment in AECOPD. |
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