背景:慢性阻塞性肺疾病(COPD)是一种以急性加重和肺功能降低为特征的呼吸系统疾病。这项研究调查了血清标志物(免疫球蛋白M(IgM)和免疫球蛋白A(IgA))之间的联系,胸部计算机断层扫描(CT)扫描结果,和这些发作期间的肺功能指标,旨在提高我们的认识并确定新的诊断指标。
方法:河北北方学院附属第一医院,我们选择了89例过去两年内急性加重的COPD患者作为急性加重组(AG).同时,96例COPD患者,最初在同一家医院接受治疗,目前认为稳定,被选入稳定组(SG)。两组均行血清IgM和IgA检测,胸部CT检查,和肺功能评估。
结果:在AG组中,血清IgM水平略低于稳定组(SG),尽管差异无统计学意义(p=0.097)。相反,AG中的血清IgA水平显着低于SG(p<0.001)。AG还显示肺体积明显减少,吸气性肺密度,与SG相比,肺功能指标和肺气肿指数(EI)和空气捕集指数(ATI)的值高得多(均p<0.001)。Pearson相关分析显示,肺容积,平均吸气肺密度,IgA水平与1秒用力呼气量(FEV1)有很强的正相关性,FEV1/强制肺活量(FVC),和弥漫性一氧化碳(DLCO)(各自的r值为0.824、0.841和0.829;所有p<0.001)。相比之下,EI和ATI与FEV1、FEV1/FVC呈显著负相关,和DLCO(r值范围为-0.837至-0.885;所有p<0.001)。
结论:血清IgA结合胸部CT参数的评估为诊断和评估COPD急性加重提供了有价值的见解。提出了一个简单的临床效用。
Chronic Obstructive Pulmonary Disease (COPD) is a respiratory condition characterized by acute exacerbations and reduced lung function. This study investigates the link between serum markers (Immunoglobulin M (IgM) and Immunoglobulin A (IgA)), thoracic computed tomography (CT) scan findings, and pulmonary function indexes during these episodes, aiming to improve our understanding and identify new diagnostic indicators.
From the First Affiliated Hospital of Hebei North University, we selected 89 COPD patients experiencing acute exacerbation within the past two years for our Acute Exacerbation Group (AG). Meanwhile, 96 COPD patients, initially treated at the same hospital and currently deemed stable, were chosen for the Stable Group (SG). Both groups underwent serum IgM and IgA tests, thoracic CT examinations, and pulmonary function assessments.
In the AG Group, the serum IgM levels were marginally lower than in the Stable Group (SG), though the difference wasn\'t statistically significant (p = 0.097). Conversely, serum IgA levels in the AG were significantly lower than in the SG (p < 0.001). The AG also showed markedly reduced lung volume, inspiratory lung density, and pulmonary function indexes compared to the SG while having considerably higher values for emphysema index (EI) and air trapping index (ATI) (all p < 0.001). Pearson correlation analysis revealed that lung volume, average inspiratory lung density, and IgA levels had strong positive correlations with one-second forced expiratory volume (FEV1), FEV1/forced vital capacity (FVC), and diffuse carbon monoxide (DLCO) (with respective r-values of 0.824, 0.841, and 0.829; all p < 0.001). In contrast, EI and ATI exhibited significantly negative correlations with FEV1, FEV1/FVC, and DLCO (with r-values ranging from -0.837 to -0.885; all p < 0.001).
The assessment of serum IgA combined with thoracic CT parameters offers valuable insights for diagnosing and evaluating acute exacerbations of COPD, presenting a straightforward clinical utility.