| Objective:This study examined changes in serum chemokine-like factor 1(CKLF1)concentration,exhaled nitric oxide(FeNO)level,and FEV1 predicted value% in patients with chronic obstructive pulmonary disease(COPD)in the acute exacerbation stage,stable stage,and healthy people.Moreover,the role of FeNO in the pathogenesis of COPD,and the relationship between CKLF1,FeNO and FEV1% was analyzed.In summary,this paper investigated the role of serum CKLF1 and FeNO in the diagnosis and evaluation of COPD,and to provided further theoretical support for the diagnosis and treatment of COPD.Methods:1.50 patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)who were treated in the Department of Respiratory and Critical Care Medicine of the First Affiliated Hospital of Jiamusi University from November 2018 to May2019 were collected in the AECOPD group.The above 50 patients were stably converted to COPD group after treatment.The control group consisted of 50 patients with similar age and random physical examination.Collecting the basic information of all samples including: gender,age,height,weight,etc.2.The lung function,FeNO,and fasting serum samples were collected in the control group.The experimental group collected lung function,FeNO,and fasting serum samples before and after treatment.3.According to FEV1% of lung function before and after treatment,the AECOPD group and COPD groups were classified into four grades(mild,moderate,severe,and extremely severe).4.Serum samples were stored frozen in-80 ℃refrigerator.The serum CKLF1 concentration was detected by ELISA method in strict accordance with the kit instructions.5.Statistical methods: The SPSS 21.0 statistical software was used for data analysis and sorting.Counting data was expressed by number of cases and percentage(%);Measurement data was expressed as mean ± standard deviation(x ± s).The t test was analyzed for comparison between two groups.F-test analysis of variance was for multi-groups,and pairwise comparisons between groups were performed using the LSD-t method;Pearson analysis was employed to test the correlation between two indicators.The difference was statistically significant at P < 0.05.Results:I.Baseline comparison between the two groups: There was no significant difference in gender and age between the experimental group and the control group(P> 0.05),that is,the baseline data of the two groups were consistent and comparable.Ⅱ.The changes in CKLF1 and FeNO in COPD patients: the comparison of the detection results of FeNO and CKLF1 in each group was statistically significant(P < 0.05).Overall FeNO levels in each group: acute exacerbation group(32.74 ± 10.48),stable group(25.56 ±8.20)and control group(6.66 ± 3.75);Overall CKLF1 levels in each group: acute exacerbation group(36.84 ± 3.28),stable group(33.56 ± 3.27)and control group(23.23 ± 3.79).The pairwise comparison results were obtained between two groups.The levels of FeNO and serum CKLF1 were both higher in the acute exacerbation group than in the stable and control groups.Ⅲ.Acute exacerbation subgroup relationship: the differences of serum CKLF1 and FeNO in patients with different degrees of COPD acute exacerbation were statistically significant(P <0.05).The FeNO value of each subgroup in the acute exacerbation period: Mild(38.29 ± 2.87),moderate(34.54 ± 9.80),severe(29.77 ± 10.65)and extremely severe(25.50 ± 14.40);The CKLF1 levels in each subgroup during the acute exacerbation period: Mild(32.78 ± 1.27),moderate(35.40 ± 1.75),severe(39.18 ± 1.35)and extremely severe(42.27 ± 1.57).Pairwise comparison results between groups were available: CKLF1 showed extremely severe group >severe group > moderate group > mild group;FeNO showed extremely severe group < severe group < moderate group < mild group.Ⅳ.Stable subgroup relations: There were statistically significant differences in serum CKLF1 and FeNO between patients with different degrees of stabilization(P < 0.01).FeNO value of each subgroup in stable period: mild(30.53 ± 6.87),moderate(24.72 ± 8.52),severe(21.17 ± 5.65)and extremely severe(17.00 ± 3.00);The CKLF1 level in each subgroup of stable period: mild(29.88 ± 1.01),moderate(33.77 ± 1.12),severe(37.01 ± 1.06)and extremely severe(39.33 ± 0.72).The results of pairwise comparison between groups were obtained,CKLF1 showed extremely severe group > severe group > moderate group > mild group;FeNO showed extremely severe group < severe group < moderate group < mild group.Ⅴ.Correlation analysis: 1.Correlation analysis of CKLF1 and FeNO in patients with COPD: there was a positive correlation between FeNO and CKLF1 in acute exacerbation group(r = 0.606,P < 0.01)and a positive correlation between FeNO and CKLF1 in stable period(r =0.798,P < 0.01).2.Correlation analysis of FeNO and FEV1% in COPD patients: there was no significant correlation between FeNO and FEV1% in acute exacerbation group and stable period group(P > 0.05).3.Correlation analysis of FEV1% and CKLF1 in COPD: FEV1% and CKLF1 in acute exacerbation group were negatively correlated(r =-0.283,P < 0.05);FEV1%and CKLF1 in stable group were negatively correlated(r =-0.329,P < 0.05).Conclusions:: 1.The level of serum CKLF1 in patients with COPD was significantly higher than that in patients with stable COPD,and CKLF1 was positively correlated with FEV1%.It was suggested that CKLF1 played an important role in the pathogenesis of COPD.2.The overall level of FeNO in patients with COPD in acute aggravation stage was higher than that in control group,but there was no correlation between FeNO change and FEV1%.3.This study shows that there is a negative correlation between serum CKLF1 and FeNO in COPD patients,which may plays a synergistic role in COPD. |
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