痰中性粒细胞弹性酶活性对老年支气管扩张症稳定期患者严重度的评估价值

The value of sputum neutrophil elastase activity in evaluating severity of stable bronchiectasis in elderly patients

中文关键词: 老年  支气管扩张症  稳定期  痰中性粒细胞弹性酶  活性  严重度

英文关键词: elderly  bronchiectasis  stable period  sputum neutrophil elastase  activity  severity

中文摘要:

      目的 通过检测老年支气管扩张症稳定期患者痰中性粒细胞弹性酶(neutrophil elastase,NE)的活性,评估患者疾病严重度,为该病的诊治提供参考.方法 选取2022 年1 月—2022 年10 月在上海市浦东新区浦南医院就诊的支气管扩张症稳定期老年患者80 例,测定患者痰NE活性、痰培养、肺CT、肺功能及mMRC评分,根据支气管扩张症严重度评分(E-FACED)分为轻度(观察A组)、中度(观察B组)、重度(观察C组);比较3 组间痰NE活性的差异,分析痰NE活性与FEV1%、mMRC评分、E-FACED评分的相关性,绘制痰NE活性用于评价支扩严重度的ROC曲线.结果 观察C组痰NE活性明显高于观察A组和观察B组(P＜0.01),观察B组也显著高于观察A组(P＜0.01).痰NE活性与FEV1%呈负相关性(r =-0.464,P＜0.05),与 mMRC 评分、E-FACED 评分呈正相关性(r 值分别为 0.531、0.658,P 均＜0.05);痰NE活性评价支扩严重度的敏感性为87.5%,特异性为76.4%(曲线下面积为 0.83).结论 痰NE活性与老年支气管扩张症稳定期患者的严重度呈正相关,敏感度和特异度较高,对于评估其严重度具有一定的临床价值.

英文摘要:

      Objective To evaluate the severity of stable bronchiectasis in elderly patients according to sputum neutrophil elastase (NE) activity, and provide reference for the diagnosis and treatment of the disease. Methods A total of 80 elderly patients with stable bronchiectasis treated in Punan Hospital from January 2022 to October 2022 were selected. Sputum NE ac? tivity was measured, and sputum culture, lung CT, lung function examination and mMRC score were performed. According to the severity score of bronchiectasis (E?FACED), the patients were divided into mild (observed group A), moderate (observed group B) and severe (observed group C). The differences of sputum NE activity among the 3 groups were compared, and the correlation of sputum NE activity with FEV1 % , mMRC score and E?FACED score was analyzed. The ROC curve of sputum NE activity was drawn to evaluate the severity of bronchiectasia. Results The sputum NE activity of the group C was signifi? cantly higher than that of the group A and group B (P <0. 01), and group B was also significantly higher than group A (P < 0?? 01). The sputum NE activity was negatively correlated with FEV1 % (r = -0. 464, P <0. 05) and positively correlated with mMRC score and E?FACED score (r =0. 531, 0. 658, P <0. 05). The sensitivity and specificity of sputum NE activity in evalua? ting the severity of bronchiectasis were 87. 5% and 76. 4% (area under the curve was 0. 83), respectively. Conclusion Sputum NE activity is positively correlated with the severity of stable bronchiectasis in elderly patients, with high sensitivity and speci? ficity, which has certain clinical value for evaluating the severity of patients.