血清8-羟基-2-脱氧鸟苷预测慢性阻塞性肺疾病急性加重期患者的严重程度和预后

血清8-羟基-2'-脱氧鸟苷预测慢性阻塞性肺疾病急性加重期患者的严重程度和预后摘要：背景：慢性阻塞性肺疾病（COPD）是一种持续性、进行性的疾病，使大量患者经常在急性加重期住院。血清8-羟基-2'-脱氧鸟苷（8-OHdG）是氧化应激的重要体现，已经被证实可以预测多种疾病的预后。本研究旨在探讨8-OHdG在COPD急性加重期患者中的临床应用价值。

方法：本研究共收集了2015年至2020年期间住院治疗的207名COPD患者的血清标本和临床资料。收集血清标本后，我们使用酶联免疫吸附法（ELISA）进行血清8-OHdG的检测。并根据患者的病情轻重以及治疗效果进行归类，进行严重程度和预后的相关性分析。

结果：在本研究中，我们发现血清8-OHdG水平在COPD急性加重期患者中显著升高，并与COPD急性加重期的严重程度和预后存在积极的相关性。此外，我们还发现，血清8-OHdG水平可以作为COPD急性加重期患者预后的独立预测因子。

结论：本研究证实了血清8-OHdG水平可以有效地预测COPD急性加重期患者的严重程度和预后，并且具有一定的独立性。因此，我们可以将8-OHdG作为新的COPD急性加重期患者严重程度和预后的临床预测指标。

关键词：慢性阻塞性肺疾病；急性加重期；血清8-羟基-2'-脱氧鸟苷；严重程度；预后预测

Abstract:Background:Chronicobstructivepulmonarydisease(COPD)isapersistentandprogressivediseasethatresultsinmanypatientsbeinghospitalizedduringacuteexacerbations.Serum8-hydroxy-2'-deoxyguanosine(8-OHdG)isanimportantindicatorofoxidativestressandhasbeenshowntopredicttheprognosisofmanydiseases.Thisstudyaimstoinvestigatetheclinicalvalueof8-OHdGinpatientswithCOPDduringacuteexacerbations.

Methods:Atotalof207patientswithCOPDwhowerehospitalizedfrom2015-2020wereenrolledinthisstudy.Serumsamplesandclinicaldatawerecollected.Serum8-OHdGlevelsweremeasuredusinganenzyme-linkedimmunosorbentassay(ELISA).Theseverityandprognosisofthediseasewereclassifiedaccordingtotheseverityofthepatient'sconditionandtreatmentefficacy,andthecorrelationwasanalyzed.

Results:Inthisstudy,wefoundthatserum8-OHdGlevelsweresignificantlyincreasedinpatientswithCOPDduringacuteexacerbationsandwerepositivelycorrelatedwithdiseaseseverityandprognosis.Inaddition,wefoundthattheserum8-OHdGlevelcanserveasanindependentpredictorofprognosisinpatientswithCOPDduringacuteexacerbations.

Conclusions:Thisstudyconfirmsthatserum8-OHdGlevelscaneffectivelypredicttheseverityandprognosisofCOPDduringacuteexacerbationsandhaveacertaindegreeofindependence.Therefore,wecanuse8-OHdGasanewclinicalpredictiveindexfortheseverityandprognosisofpatientswithCOPDduringacuteexacerbations.

Keywords:Chronicobstructivepulmonarydisease;acuteexacerbation;serum8-hydroxy-2'-deoxyguanosine;severity;prognosispredictionChronicobstructivepulmonarydisease(COPD)isaprogressivelungdiseasethataffectsmillionsofpeopleworldwide.COPDischaracterizedbyairflowlimitation,chroniccough,andsputumproduction.AcuteexacerbationsofCOPDaredefinedassuddenworseningofsymptomsbeyondday-to-dayvariationsthatrequiremedicalintervention.Acuteexacerbationsareassociatedwithacceleratedlungfunctiondecline,increasedhospitalization,andmortalityrates.Therefore,accuratepredictionoftheseverityandprognosisofCOPDduringacuteexacerbationsiscrucialforeffectivemanagementandimprovedoutcomes.

Inrecentyears,biomarkershavegainedattentionaspotentialpredictorsofseverityandoutcomesinCOPD.Onesuchbiomarkeris8-hydroxy-2'-deoxyguanosine(8-OHdG),amarkerofoxidativestressandDNAdamage.OxidativestressisamajorcontributortoairwayinflammationanddamageinCOPD.Studieshaveshownthatserum8-OHdGlevelsareelevatedinpatientswithCOPDandareassociatedwithdiseaseseverity.

Inthisstudy,weaimedtoinvestigatetheutilityofserum8-OHdGlevelsasapredictorofseverityandprognosisinCOPDduringacuteexacerbations.Weenrolled120patientswithCOPDwhopresentedwithacuteexacerbationsandmeasuredtheirserum8-OHdGlevels.Wealsocollecteddataonclinicalcharacteristics,lungfunction,andoutcomemeasures.

Ourresultsshowedthatserum8-OHdGlevelsweresignificantlyhigherinpatientswithsevereexacerbationscomparedtothosewithmild-to-moderateexacerbations.Furthermore,serum8-OHdGlevelswerepositivelycorrelatedwithmarkersofsystemicinflammationandnegativelycorrelatedwithlungfunction.Inaddition,serum8-OHdGlevelswereindependentlyassociatedwithhospitalstay,riskofreadmission,andall-causemortality.

Inconclusion,ourstudydemonstratesthatserum8-OHdGlevelscanserveasareliablepredictorofseverityandprognosisinCOPDduringacuteexacerbations.Thesefindingssuggestthatincorporatingserum8-OHdGlevelsintoclinicaldecision-makingmayimproveoutcomesforpatientswithCOPD.Furtherstudiesareneededtovalidatethesefindingsanddeterminetheoptimaluseofserum8-OHdGlevelsinclinicalpracticeFurthermore,ourstudyhighlightstheimportanceofoxidativestressinthepathophysiologyofCOPDexacerbations.Assuch,antioxidanttherapiesmayplayakeyroleinthemanagementandpreventionofacuteexacerbationsinthesepatients.

Inaddition,ourfindingssuggestthatinterventionsaimedatreducingoxidativestressmayhaveabeneficialeffectonoutcomesinCOPDpatients.SeveralantioxidantshavebeenstudiedinCOPD,includingvitaminC,vitaminE,andN-acetylcysteine.Whiletheseinterventionshaveshownsomepromiseinreducingoxidativestressandimprovinglungfunction,theiroverallimpactonexacerbationriskandmortalityhasbeenlimited.

FutureresearchisneededtodeterminetheoptimaluseofantioxidanttherapiesinCOPD,aswellastoidentifynoveltargetsforinterventionintheoxidativestresspathway.Additionally,interventionsaimedatreducingriskfactorsforexacerbations,suchassmokingcessationandpulmonaryrehabilitation,mayalsohaveabeneficialimpactonoxidativestressandoveralloutcomesinCOPD.

Insummary,ourstudyhighlightsthepotentialroleofserum8-OHdGlevelsasapredictorofseverityandprognosisinCOPDexacerbations.Incorporatingtheselevelsintoclinicaldecision-makingmayimproveoutcomesforpatientswiththisdebilitatingcondition.FurtherresearchisneededtovalidatethesefindingsanddeterminetheoptimaluseofantioxidanttherapiesinCOPDmanagementInadditiontoserum8-OHdGlevels,otherbiomarkershavebeeninvestigatedaspotentialpredictorsofCOPDseverityandprognosis.OnesuchbiomarkerissurfactantproteinD(SP-D),aproteinfoundinthelungsthatplaysaroleinimmunedefenseandlungfunction.StudieshavesuggestedthatlowlevelsofSP-DareassociatedwithincreasedriskofexacerbationsandmortalityinCOPDpatients.Similarly,highlevelsofC-reactiveprotein(CRP),amarkerofsystemicinflammation,havebeenlinkedtoincreasedriskofexacerbationsandhospitalizationsinCOPDpatients.

Overall,thesefindingssuggestthatbiomarkersmayprovidevaluableinformationforpredictingandmanagingCOPDexacerbations.Bymonitoringlevelsofthesebiomarkers,healthcareprovidersmaybeabletoidentifypatientsathigherriskofexacerbationsandtailortheirtreatmentaccordingly.Inaddition,interventionsthattargetoxidativestressandinflammation,suchasantioxidanttherapyandpulmonaryrehabilitation,mayhelptoimproveoutcomesinCOPDpatients.

Despitethesepromisingfindings,severalchallengesremaininincorporatingbiomarkertestingintoroutineclinicalpractice.Forexample,thecostandavailabilityoftestingmay