鸢尾素在慢性阻塞性肺疾病患者肺康复中的表达及预后评估价值

关键词：鸢尾素  慢性阻塞性肺疾病  肺康复治疗  预后评估

Keywords:irisin  chronic obstructive pulmonary disease  pulmonary rehabilitation  prognostic assessment

摘要：

      摘要 目的：比较鸢尾素（irisin）在慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）患者予以肺康复（pulmonary rehabilitation，PR）治疗前后表达水平的变化，分析irisin对COPD患者急性加重的预后评估价值。 方法：纳入2022年2月至2022年8月于河北医科大学第二医院呼吸与危重症医学科门诊就诊的COPD患者68例，健康体检者35例作为健康对照组。ELISA检测受试者血清中irisin的表达水平，比较COPD患者irisin表达水平与健康对照组的差异；研究COPD患者予以PR治疗前后irisin的变化；分析irisin与6min步行距离 （6 minutes walking distance 6MWD）、白介素-6（interleukin-6 IL-6）的相关性；应用K-M生存曲线探讨irisin低表达组与irisin高表达组1年累积无急性加重风险比率。 结果：①Irisin在COPD患者及健康对照组血清中表达分别为（16.79±5.83）ng/ml、（34.89±8.68）ng/ml（P<0.05，t=12.55），具有显著性差异。②Irisin在COPD患者PR治疗8周前以及8周后的表达分别为（17.72±4.56）ng/ml、（19.55±4.25）ng/ml（P<0.05，t=4.43），具有显著性差异。③Irisin表达水平与COPD患者6MW呈正相关（R=0.475，P<0.05）；与IL-16表达呈负相关（R=﹣0.39，P<0.05），差异具有显著性意义。④K-M生存分析提示，COPD患者irisin低水平组与高水平组中位无急性加重时间分别为（6.17±0.68）month、（9.58±0.82）month，1年累积无急性加重率分别为30.0%、68.12%（F=11.1，P<0.05），具有显著性差异。 结论：Irisin在COPD患者外周血表达水平低于健康对照组；COPD患者PR治疗后irisin表达升高；irisin表达水平降低是COPD患者急性加重的不良预后指标。

Abstract:

      Abstract Objective： To explore the alteration of irisin in chronic obstructive pulmonary disease （COPD） patients before and after pulmonary rehabilitation （PR） treatment and to analyze the prognostic value of irisin in COPD patients with acute exacerbations. Method： A total of 68 COPD outpatients from department of respiratory and critical care medicine in the Second Hospital of Hebei Medical University from February 2022 to August 2022 were enrolled and 35 healthy participants were admitted as controls. ELISA was applied to detect the expression of irisin in the serum of the patients. The difference between the COPD group and the health control group and the difference between before and after PR treatment were compared. The correlation analysis was used to analyze the relationship between irisin and 6MWD（6 minutes walking distance）and IL-6（interleukin-6）. In addition， K-M survival curve was used to differ the one-year cumulative risk of acute exacerbation-free risk ratio between the low irisin and the high irisin expression group. Result： ①The expression of irisin in serum of the COPD patients and the health control group were （16.79±5.83） ng/ml and （34.89±8.68） ng/ml， respectively （P<0.05， t=12.55）. ②The concentration of irisin in the COPD patients before and after 8 weeks of PR treatment were （17.72±4.56） ng/ml and（19.55±4.25） ng/ml （P<0.05， t=4.43）， respectively. ③The level of Irisin in the COPD patients was positively correlated with the 6MWD （R=0.475， P<0.05） and negatively related with IL-16 level （R=﹣0.39， P<0.05）. ④K-M survival curve demonstrated that the median time without AECOPD（acute exacerbations of chronic obstructive pulmonary disease） in the low-level irisin and high-level irisin groups were （6.17±0.68） month and （9.58±0.82） month， respectively. Moreover， the cumulative acute exacerbation-free rate in 1 year was 30.0% and 68.12%， respectively （F=11.1 P<0.05）. Conclusion： The expression of irisin in serum of the COPD patients was lower than that in the health control group and its level increased after PR treatment. The reduction of irisin might be a poor prognostic indicator for acute exacerbation in patients with COPD.