Chest:血清IgG水平和COPD住院风险

2020-05-22 MedSci原创 MedSci原创

低丙种球蛋白血症与较高的COPD住院风险有关。

低丙种球蛋白血症(血清免疫球蛋白G(IgG)水平<7.0 g/L)与COPD患者病情加重风险增加有关,但尚未表现出具有预测患者住院的可能性。近日,呼吸领域权威杂志chest上发表了一篇研究文章,该研究旨在明确COPD患者低丙种球蛋白血症与住院风险之间的关系。

研究人员测量四个COPD队列(n=2259)中受试者基线样本中血清IgG水平,这四个队列为:阿奇霉素预防AECOPD(MACRO,n=976);辛伐他汀预防AECOPD(STATCOPE,n=653);长期氧气治疗试验(LOTT,n=354)和COPD活动情况:血清素转运蛋白、细胞因子和抑郁症(CASCADE,n=276)。IgG水平通过免疫比浊法(MACRO; STATCOPE)或质谱(LOTT; CASCADE)来测定。研究人员使用累积的事件发生率和死亡(竞争风险)函数评估低血球蛋白血症对COPD患者住院风险的影响。对于每项研究,均进行了细灰色模型以获得与IgG水平相关的调整后的亚分布风险比(SHR),然后使用荟萃分析进行合并。根据IgG状况比较每人每年的COPD住院率。

低丙种球蛋白血症的总发生率为28.4%。IgG水平低的参与者与正常水平的参与者相比,COPD住院的发生率估计更高(Gray检验,P<0.001);合并SHR(Meta分析)为1.29(95%CI为1.06-1.56,P=0.01)。在既往有COPD入院的患者中(n=757),合并SHR增加至1.58(95%CI为1.20–2.07,P<0.01)。既往没有住院的患者中,IgG组之间COPD住院的风险相似:合并SHR=1.15(95%CI为0.86–1.52,P=0.34)。低丙种球蛋白血症组的人均COPD住院率也显著提高(0.48±2.01 vs. 0.29±0.83,P<0.001)。

由此可见,低丙种球蛋白血症与较高的COPD住院风险有关。

原始出处:

Fernando Sergio Leitao Filho.et al.Serum IgG Levels and Risk of COPD Hospitalization: A Pooled Meta-Analysis.chest.2020.https://journal.chestnet.org/article/S0012-3692(20)31409-4/fulltext

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    2020-06-27 Smile2680
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