血清8-羥基-2-脫氧鳥苷預(yù)測慢性阻塞性肺疾病急性加重期患者的嚴重程度和預(yù)后

血清8-羥基-2'-脫氧鳥苷預(yù)測慢性阻塞性肺疾病急性加重期患者的嚴重程度和預(yù)后摘要：背景：慢性阻塞性肺疾?。–OPD）是一種持續(xù)性、進行性的疾病，使大量患者經(jīng)常在急性加重期住院。血清8-羥基-2'-脫氧鳥苷（8-OHdG）是氧化應(yīng)激的重要體現(xiàn)，已經(jīng)被證實可以預(yù)測多種疾病的預(yù)后。本研究旨在探討8-OHdG在COPD急性加重期患者中的臨床應(yīng)用價值。

方法：本研究共收集了2015年至2020年期間住院治療的207名COPD患者的血清標本和臨床資料。收集血清標本后，我們使用酶聯(lián)免疫吸附法（ELISA）進行血清8-OHdG的檢測。并根據(jù)患者的病情輕重以及治療效果進行歸類，進行嚴重程度和預(yù)后的相關(guān)性分析。

結(jié)果：在本研究中，我們發(fā)現(xiàn)血清8-OHdG水平在COPD急性加重期患者中顯著升高，并與COPD急性加重期的嚴重程度和預(yù)后存在積極的相關(guān)性。此外，我們還發(fā)現(xiàn)，血清8-OHdG水平可以作為COPD急性加重期患者預(yù)后的獨立預(yù)測因子。

結(jié)論：本研究證實了血清8-OHdG水平可以有效地預(yù)測COPD急性加重期患者的嚴重程度和預(yù)后，并且具有一定的獨立性。因此，我們可以將8-OHdG作為新的COPD急性加重期患者嚴重程度和預(yù)后的臨床預(yù)測指標。

關(guān)鍵詞：慢性阻塞性肺疾??；急性加重期；血清8-羥基-2'-脫氧鳥苷；嚴重程度；預(yù)后預(yù)測

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