Expression And Clinical Significance Of GDF-15, MUC5AC In Patients With AECOPD

Objective: To detect the expression of serum growth differentiation factor-15(GDF-15)and mucin-5AC(MUC5AC)before and after treatment in patients with AECOPD(acute exacerbation of chronic obstructive pulmonary disease).The levels of C-reactive protein(CRP),plasma fibrinogen(FIB)and forced vital capacity in the first second(FEV1)in AECOPD patients were analyzed.Correlation of(CAT)scores in chronic obstructive pulmonary disease assessment test,To analyze the sensitivity and specificity of GDF-15 and MUC5 AC in AECOPD diseases,and to explore their value in auxiliary diagnosis and curative effect evaluation in clinical application.Methods: A prospective study was conducted on 35 AECOPD patients hospitalized in the Department of Respiratory and critical Care Medicine,Gansu Provincial people’s Hospital from November 2017 to March 2018(observation group).The patients with chronic obstructive pulmonary disease were treated with AECOPD before treatment(before treatment)and after one week of treatment with AECOPD(after treatment in observation group)when they did not receive any treatment on the day of admission.The control group was selected from the healthy people in the health examination center of our hospital at the same time.Serum samples were collected from AECOPD patients before and after treatment and healthy controls.the levels of serum GDF-15 and MUC5 AC were detected by enzyme-linked immunosorbent assay(ELISA).The correlation between GDF-15 and MUC5 AC in plasma and their correlation with CRP,FIB,FEV1 and CAT scores were compared.Results:1.The levels of GDF-15,MUC5 AC,CRP and CAT in the observation group were higher than those in the healthy control group(P < 0 01),and the levels of FEV1 in the observation group were lower than those in the healthy control group(P < 0 01).Before treatment,FIB in the observation group was higher than that in the healthy control group(P < 0 01).After treatment,the level of FIB in the observation group was higher than that in the healthy control group,but the difference was notstatistically significant(P > 0.05).The levels of GDF-15,MUC5 AC,CRP,FIB and CAT before treatment in the observation group were higher than those after treatment(P < 0 01),and the levels of FEV1 before treatment in the observation group were lower than those after treatment(P < 0 01).2.In the observation group,GDF-15 was positively correlated with MUC5 AC before and after treatment(r=0.917,r=0.779,P < 0.05),and GDF-15 was positively correlated with CRP,FIB and CAT scores before and after treatment(r=0.856,r=0.857,r= 0.924,P < 0.05).MUC5 AC was positively correlated with CRP,FIB and CAT scores before treatment(r =0.760,r =0.782,r =0.841,P < 0.05).There was a negative correlation between GDF-15 and MUC5 AC and FEV1 levels before treatment(r =-0.881,r =-0.830,P < 0.05),and a positive correlation between GDF-15 and CRP,FIB and CAT scores after treatment(r =0.824,r =0.54,r =0.752,P < 0.05).After treatment,MUC5 AC was positively correlated with CRP,FIB and CAT scores(r =0.683,r =0.583,r =0.647,P < 0.05).After treatment,the levels of GDF-15,MUC5 AC and FEV1 were negatively correlated(r =-0.576,r =-0.612,P < 0.05).3.The results of ROC curve analysis showed that when the Jordan index was equal to 0.69,the sensitivity and specificity of 1048.99 pg/mL,GDF-15 in the diagnosis of AECOPD were 80.6% and 88.2%,respectively.The area under the curve was 0.87(95% confidence interval [CI]: 0.791-0.958,P < 0.05);When the Jordan index is equal to 0.54,The sensitivity and specificity of AECOPD were 80.6% and73.5%,respectively.the area under the curve was 0.77(95% confidence interval [CI]:0.653-0.887,P < 0.05).Conclusions:1.The expression of GDF-15 and MUC5 AC in plasma of patients with AECOPD was significantly higher than that of healthy people,and there was a close correlation between them and the scores of CRP,FIB,FEV1 and CAT,which were common indexes of AECOPD,respectively.It can provide a new reference index for the auxiliary diagnosis of AECOPD.2.Plasma GDF-15 and MUC5 AC decreased significantly after treatment inpatients with AECOPD,indicating that they are novel biological indicators for evaluating the therapeutic effect of AECOPD.