Study On The Diagnostic Value Of IL-33 And ST2 In AECOPD

BackgroundChronic obstructive pulmonary disease（COPD）is a lung disease that mainly affects the lung parenchyma and peripheral airways,resulting in a progressive and irreversible decline in lung function.Acute exacerbation of chronic obstructive pulmonary disease（AECOPD）is a major cause of poor prognosis in patients with COPD,so timely diagnosis and intervention can improve the therapeutic effect of patients.Therefore,timely diagnosis and intervention can improve the treatment effect of patients.Studies have shown that a variety of pro-inflammatory and anti-inflammatory factors play an important role in the pathogenesis of COPD.Suppression of tumorigenicity 2（ST2）combined to exacerbate the inflammatory response.At present,there are many researches on the pathogenesis of IL-33 and ST2 on COPD at home and abroad,but the impact on the progression of the disease and the diagnostic efficacy of AECOPD are less involved.ObjectivesBy detecting the expression levels of IL-33 and ST2 in Stable chronic obstructive pulmonary disease（SCOPD）and AECOPD,to analyze the correlation of IL-33 and ST2 with inflammatory indicators and lung function in SCOPD group and AECOPD group,and to further explore the risk factors of AECOPD,and finally evaluate the diagnostic efficacy of IL-33 and ST2 in AECOPD.Methods1.A total of 120 patients with COPD were collected from November 2019 to February 2021 in the Department of Respiratory and critical Care Medicine of the first people’s Hospital of Xinxiang City,including 40 in the SCOPD group and 80 in the AECOPD group.2.Collect general information of admitted patients,and improve white blood cells（WBC）,neutrophils,neutrophil-lymphocyte ratio（NLR）,C-reactive protein（CRP）,and erythrocyte sedimentation rate（ESR）,procalcitonin（PCT）,lung function and other tests before admission to drug treatment,and the serum was extracted during the same period to determine the content of IL-33 and ST2 by enzyme-linked immunosorbent assay（ELISA）.3.SPSS 25.0 software was used for statistical analysis of data by independent sample t test,Pearson correlation analysis,binary Logistic regression and Receiver Operating Characteristic（ROC）.Results1.The neutrophils,NLR,CRP,PCT,IL-33,ST2,FEV1/FVC,FEV1%pred of AECOPD group and SCOPD group had significant differences（P<0.05）.However,the differences in white blood cells and ESR were not statistically significant（P>0.05）.Compared with the SCOPD group,the numbers of neutrophils,NIR,CRP,PCT,IL-33 and ST2 in the AECOPD group were significantly increased,but FEV1/FVC and FEV1%pred were significantly decreased.2.In the SCOPD group,IL-33 was positively correlated with neutrophils,CRP,PCT,ST2,and the differences were all statistically significant（P<0.05）.ST2 was positively correlated with neutrophil,CRP,PCT and IL-33,and negatively correlated with FEV1/FVC,the differences were statistically significant（P < 0.05）.In the AECOPD group,IL-33 was positively correlated with neutrophils,NLR,CRP,PCT,and ST2,and negatively correlated with FEV1/FVC,and the differences were statistically significant（P<0.05）.ST2 was positively correlated with neutrophils,NLR,CRP,PCT,IL-33,and negatively correlated with FEV1/FVC,and the differences were statistically significant（P<0.05）.3.In COPD patients,IL-33 and ST2 are risk factors for AECOPD.For every 1 unit（pg/ml）increase in serum IL-33 content,the risk of acute exacerbation in COPD patients increases by 0.03 times,and for every 1 unit（pg/ml）increase in serum ST2 content,the risk of acute exacerbation in COPD patients increased by 5.25 times.FEV1/FVC is a protective factor for AECOPD,and the risk of acute exacerbation in COPD patients increases by 0.18 times for each unit of decrease in FEV1/FVC.4.ROC analysis,among COPD patients,the best diagnostic value of IL-33 for AECOPD is 288.96 pg/ml,in which the sensitivity is 93.8% and the specificity is 80.0%.The best diagnostic value of ST2 for AECOPD is 3.56 pg/ml,the sensitivity is 76.3%,and the specificity is 92.5%.Conclusions1.The neutrophils,NLR,CRP,PCT,IL-33 and ST2 of AECOPD patients are significantly higher than those of SCOPD patients,but FEV1/FVC and FEV1%pred are lower than those of SCOPD patients.2.In patients with AECOPD and SCOPD,IL-33 and ST2 have a good correlation with most inflammatory indexes.IL-33 and ST2 in patients with AECOPD have a good correlation with FEV1/FVC in pulmonary function,while in patients with SCOPD,only ST2 have a good correlation with FEV1/FVC in pulmonary function.3.In patients with COPD,FEV1/FVC is the protective factor of AECOPD,while IL-33 and ST2 are its risk factors.The detection of IL-33 and ST2 in patients with COPD can assist in the diagnosis of AECOPD with high sensitivity and specificity,which is helpful for early identification and timely intervention of AECOPD.