血清CCR5 CCR7联合预测支气管哮喘急性发作患者预后的价值

doi:10.3969/j.issn.1006-6233.2025.02.023

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Abstract Objective: To analyze the value of serum chemokine receptor 5 (CCR5) and chemokine receptor 7 (CCR7) combined in predicting the prognosis of patients with acute exacerbation of bronchial asthma (BA). Methods: A total of 128 patients with acute exacerbation of BA were enrolled as the study group, 64 BA patients without acute exacerbation as the BA control group, and 64 healthy subjects as the healthy control group from May 2022 to May 2023 at Nanjing Tongren Hospital, Affiliated to Southeast University Medical College. General data, lung function indicators (FEV1, FVC), and serum levels of CCR5 and CCR7 were compared among the three groups. The correlation between serum CCR5 and CCR7 levels and lung function indicators was analyzed in the study group. The study group was followed for one year after treatment, and based on prognosis, patients were divided into poor prognosis and good prognosis subgroups. Serum CCR5 and CCR7 levels at admission were compared between the two subgroups, and the effect of serum CCR5 and CCR7 on prognosis and their predictive value for poor prognosis were analyzed. Results: The serum levels of CCR5 and CCR7 in the study group at admission were higher than those in the BA control and healthy control groups, and the BA control group had higher levels than the healthy control group. FEV1 and FVC in the study group were lower than in the BA control and healthy control groups, and the BA control group had lower values than the healthy control group (P<0.05). Serum CCR5 and CCR7 levels at admission were negatively correlated with FEV1 and FVC (r = -0.681, -0.635, -0.549, -0.503, P<0.05). During follow-up, 3 patients were lost to follow-up. Among the remaining patients, the serum CCR5 and CCR7 levels in the poor prognosis subgroup at admission were higher than those in the good prognosis subgroup (P<0.05). Independent risk factor analysis by logistic regression showed that high serum CCR5 and CCR7 levels at admission were independent risk factors for poor prognosis in BA acute exacerbation patients (Exp(B) = 1.452, 1.332, P<0.05). The areas under the curve (AUC) for predicting poor prognosis in BA acute exacerbation patients at admission for serum CCR5, CCR7, FEV1 and FVC were 0.760, 0.766, 0.739 and 0.723, respectively. There was no significant difference between the AUC for serum CCR5, CCR7, and FEV1, FVC (P>0.05). The AUC for the combined prediction of CCR5 and CCR7 was 0.858, which was higher than the AUC for either alone, and the difference was statistically significant (Z = 2.013, 1.975, P<0.05). Conclusion: High serum levels of CCR5 and CCR7 at admission are independent risk factors for poor prognosis in patients with acute exacerbation of BA. Combined detection of CCR5 and CCR7 provides a reliable clinical basis for predicting prognosis.

Key words： Bronchial asthma Acute exacerbation Chemokine receptor 5 Chemokine receptor 7 Prognosis

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.02.023 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I2/306

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