Changes And Clinical Significance Of Endocan,SAA,NLR Levels In COPD Patients

ObjectiveThis article will explore the guiding value of these three inflammatory markers of endothelial cell specific molecule-1(endocan),serum amyloid A(SAA),and neutrophil-to-lymphocyte ratio(NLR)in the diagnosis and assessment of the severity of acute exacerbation of chronic obstructive pulmonary disease(AECOPD),as well as endocan,SAA,NLR in chronic obstructive pulmonary disease(Chronic obstructive pulmonary disease,COPD)stable expression and significance.MethodsFrom January 2019 to December 2019,the Fifth Affiliated Hospital of Zhengzhou University was selected to include 65 patients with AECOPD diagnosed in the respiratory department according to the inclusion and exclusion criteria,and 50 patients with stable COPD were included in the study.At the same time,50 healthy people who came to our hospital for medical examination were selected as the control group.Among them,the AECOPD group is divided into three groups according to the severity of the disease:grade ?,grade ? and grade ?.Collect the basic data of the sex,age,height and weight of the subjects in each group,collect the fasting venous blood of all the subjects,determine the levels of endocan,SAA,NLR.The LSD-t test was used to compare each group of patients in the three groups of AECOPD and the indicators of the three groups of AECOPD,COPD stable phase group,and control group.According to the receiver operating characteristic curve(ROC)area under the curve(AUC)to judge the diagnostic efficacy of endocan,SAA,NLR for AECOPDResults1.Baseline comparison.There were no statistically significant differences in gender,age,and body mass index between the groups(P>0.05).The baseline data was balanced and comparable.2.AECOPD patients were compared with each index.The levels of endocan and NLR in AECOPD groups were statistically significant(P<0.05),and increased with the clinical grade of AECOPD.SAA levels in AECOPD ? and ? were significantly higher than ?(P<0.05),There was no statistically significant difference in AECOPD grade ? and grade ?(P>0.05).3.Comparison of various indicators of subjects in each group.The levels of endocan and NLR in patients with COPD stable phase were higher than that in healthy group,the difference was statistically significant(P<0.05),and the level of SAA in patients with COPD stable period was higher than that in healthy group,with no statistically significant difference(P>0.05).The levels of endocan,SAA and NLR in AECOPD patients were higher than those in stable and healthy groups,and the differences between the groups were statistically significant(P<0.05).4.The diagnostic value of endocan,SAA and NLR for AECOPD.The AUC for the diagnosis of AECOPD with endocan,SAA,and NLR is 0.831,0.878,and 0.812;the optimal cutoff value of endocan is 0.930?g/L.The sensitivity(true positive rate,TPR)for the diagnosis of AECOPD is 75.4%,and the specificity(true negative rate,TNR)was 88.0%;the optimal cut-off value for SAA was 40.325mg/L and the TPR for diagnosis of AECOPD was 67.7%and TNR was 100%;the optimal cut-off value for NLR was 4.365,the TPR for diagnosis of AECOPD was 64.6%and TNR was 90.0%;The AUC for the diagnosis of AECOPD with combined detection of endocan,SAA,and NLR was 0.945,TPR was 87.7%,and TNR was 96%.Conclusions1.The levels of endocan,SAA,and NLR are helpful to assess the severity of AECOPD patients,and can provide an objective basis for patients to choose appropriate clinical treatment methods.2.COPD is still in a state of chronic inflammation during stable phase,and endocan and NLR are related to chronic inflammation in COPD's stable phase.3.The levels of endocan,SAA,and NLR are helpful for the diagnosis of AECOPD.SAA has a higher diagnostic value for AECOPD.In addition,the joint detection of three inflammatory markers can improve the accuracy and sensitivity of diagnosis.