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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
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