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Relationship between Serum Levels of CIRBP and Notch1 with Disease Severity and Prognosis in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease |
GAO Lihua, LI Yannan, YU Ling, et al |
Nanjing Central Hospital, Jiangsu Nanjing 210018, China |
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Abstract Objective: To investigate the relationship between serum levels of cold-inducible RNA-binding protein (CIRBP) and notch receptor 1 (Notch1) with disease severity and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: A total of 157 AECOPD patients (AECOPD group), 70 stable COPD patients (COPD stability group), and 70 healthy volunteers (control group) treated at our hospital from February 2023 to January 2024 were included. According to disease severity, the AECOPD patients were categorized into a mild AECOPD group (60 cases), moderate AECOPD group (55 cases), and severe AECOPD group (42 cases). Based on 6-month follow-up outcomes, they were further divided into a poor prognosis group (50 cases) and a good prognosis group (107 cases). Serum levels of CIRBP and Notch1 were measured by enzyme-linked immunosorbent assay, and the receiver operating characteristic curve(ROC) was drawn to evaluate their predictive efficacy for prognosis. Results: Serum levels of CIRBP and Notch1 progressively increased across the control, COPD stability, and AECOPD groups, with significant differences (F=172.36, 104.024, all P<0.001). Similarly, CIRBP and Notch1 levels rose significantly across the mild, moderate, and severe AECOPD groups (F=64.686, 54.409, all P<0.05). At the 6-month follow-up, the incidence of poor prognosis in 157 AECOPD patients was 31.85% (50/157). CIRBP and Notch1 levels were significantly higher in the poor prognosis group than in the good prognosis group (t=7.261, 6.956, all P<0.05). Independent risk factors for poor prognosis in AECOPD patients included increased disease severity (OR=4.012, 95%CI: 1.996 to 8.067), elevated CIRBP (OR=1.012, 95%CI: 1.005 to 1.020), and elevated Notch1 (OR=1.014, 95%CI: 1.007 to 1.022) (all P<0.05). The combined prediction using serum CIRBP and Notch1 levels yielded an area under the curve (AUC) of 0.871 for poor prognosis in AECOPD patients, which was significantly greater than the AUCs for CIRBP (0.793) or Notch1 (0.798) alone (Z=2.833, 2.696, all P<0.05). Conclusion: Elevated levels of serum CIRBP and Notch1 in AECOPD patients were associated with increased disease severity and poor prognostic turnover, and the combination of serum CIRBP and Notch1 levels had high energy efficiency in predicting poor prognostic turnover in AECOPD patients.
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