Correlation of serum ET,suPAR,and CAR with pulmonary function,clinical symptoms and acute exacerbation in patients with chronic obstructive pulmonary disease complicated with bronchiectasis

ZHANG Yuan; YAN Jie

doi:10.3969/j.issn.1002-3429.2025.22.007

Abstract：Objective To investigate the correlations and clinical significance of serum endothelin(ET),soluble urokinase-type plasminogen activator receptor(suPAR),and C-reactive protein to albumin ratio(CAR)with pulmonary function,clinical symptoms,and acute exacerbation in patients with chronic obstructive pulmonary disease(COPD)complicated with bronchiectasis.Methods A total of 142 patients with COPD complicated with bronchiectasis who were admitted from September 2022 to June 2024 were selected as the observation group,and another 71 patients with simple COPD were selected at a ratio of 2∶1 as the control group.The observation group was divided into acute exacerbation subgroup and non-acute exacerbation subgroup according to whether it was in the acute exacerbation period.The levels of serum ET,suPAR and CAR in each group were compared.Pearson correlation analysis was used to analyze the correlations of serum ET,suPAR and CAR with pulmonary function and clinical symptoms in patients with COPD complicated with bronchiectasis.Multivariate logistic regression analysis was used to analyze the related influencing factors of acute exacerbation,and the receiver operating characteristic(ROC)curve was used to analyze the performance of serum ET,suPAR,and CAR alone and in combination in predicting acute exacerbation.Results The levels of serum ET,suPAR and CAR in the observation group were higher than those in the control group,which were also higher in the acute exacerbation subgroup than in the non-acute exacerbation subgroup(P＜0.01).Serum ET,suPAR,and CAR were negatively correlated with the percentage of forced expiratory volume in one second to the predicted value in patients with COPD complicated with bronchiectasis,and positively correlated with the number of acute exacerbations and the severity index score of bronchiectasis within the past one year(P＜0.05).Serum ET,suPAR and CAR were independent influencing factors of acute exacerbation of COPD complicated with bronchiectasis(P＜0.05),and the area under the ROC curve of the three indicators for the combined prediction of acute exacerbation was the largest.Conclusion Serum ET,suPAR and CAR levels increase in patients with COPD complicated with bronchiectasis,which are related to pulmonary function,clinical symptoms and acute exacerbation.The combined detection of the three can be used as an effective strategy for predicting the acute exacerbation of COPD complicated with bronchiectasis.