Clinical Diagnostic Value Of GDF-15,CRP And IL-6 In Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:To explore the expression level and clinical significance of growth differentiation factor-15?GDF-15?,C-reactive protein?CRP?and interleukin-6?IL-6?in patients with acute exacerbation of chronic obstructive pulmonary disease?COPD?,so as to find effective serum biological indicators for the evaluat of AECOPD.Methods:?1?Collected 40 patients with stable chronic obstructive pulmonary disease?COPD?and 80 patients with acute exacerbation.Among them,there were 40 patients in Grade 1 and 2 of acute exacerbation?AE-1 group?,and 40 patients in grade 3 and 4 of acute exacerbation?AE-2 group?.Forty healthy people were assigned to the control group.?2?General data of each group were collected,blood routine and biochemical indexes of each group were detected,and forced expiratory volume in the first second as percentage of predicted volume?FEV₁%pred?was measured by pulmonary function instrument.Enzyme-linked immunosorbent assay?ELISA?was used to detect the concentration of GDF-15 and IL-6 in peripheral blood of each group,and immunofluorescence dry quantitative method was used to detect the concentration of CRP in peripheral blood of each group.?3?The expression levels of GDF-15,CRP and IL-6 in peripheral blood of each group were analyzed by one-way ANOVA.Pearson correlation analysis was used to analyze the correlation among GDF-15,CRP,IL-6 and FEV₁%pred.Meanwhile,the receiver operating characteristic?ROC?curve was depicted to evaluate the clinical diagnostic efficacy of GDF-15,CRP and IL-6 in patients with AECOPD.Results:?1?The expression levels of GDF-15,CRP and IL-6 in peripheral blood showed an upward trend in the control group,stable group,AE-1 group and AE-2 group,with significant difference between groups?P<0.05?.The expression levels of GDF-15,CRP and IL-6 in AECOPD patients were higher than those in stable group and control group,and the expression levels in AE-2 group were higher than those in AE-1 group,with significant difference between groups?P<0.05?.?2?The serum levels of GDF-15 were positively correlated with CRP?r=0.706,0.636,0.681;All P<0.001?and IL-6?r=0.662,0.548,0.684;All P<0.001?,while CRP was positively correlated with IL-6?r=0.565,0.431,0.610;All P<0.001?.The levels of GDF-15,CRP and IL-6 in peripheral blood of AECOPD patients were negatively correlated with FEV₁%pred?r=-0.478,-0.409,-0.382;All P<0.001?.?3?Analysis of ROC curve showed that the area under ROC curve?AUC?of GDF-15,CRP and IL-6 were 0.833,0.744 and 0.682 respectively in the diagnosis of AECOPD patients,suggesting that the diagnostic value of GDF-15 for AECOPD patients was better than that of CRP and IL-6.?4?The AUCs of patients with AECOPD diagnosed by GDF-15 and CRP,GDF-15 and IL-6,CRP and IL-6 and the combination of them were 0.832,0.830,0.750 and0.832,respectively.Their combined diagnosis is not superior to that of GDF-15 alone.Conclusion:?1?The expression levels of GDF-15,CRP and IL-6 in peripheral blood can reflect the severity of AECOPD patients,and the higher the expression levels of GDF-15,CRP and IL-6 with the increase of GOLD classification.?2?GDF-15 has higher clinical diagnostic value for AECOPD than CRP and IL-6,and has certain significance for evaluating acute exacerbation of COPD.