The expression of serum CD59 and Gremlin-1 in patients with acute exacerbation of idiopathic interstitial pneumonia and their correlation with recent prognosis

Fu Yan; Jin Chaohui; Wang Wei; Min Rui; Xiao Xuefei

doi:10.3969/j.issn.1671-6450.2023.12.006

Abstract：Objective To study the serum levels of CD59 and Gremlin-1 in patients with acute exacerbation of idio-pathic interstitial pneumonia(ⅡP)and their correlation with recent prognosis.Method Ninety patients with acute exacerba-tion stage ⅡP diagnosed and treated in the Respiratory Department of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from March 2020 to February 2022 were selected as the research subjects(acute exacerbation stage group).60 stable stage ⅡP patients diagnosed and treated at the same time were selected as the stable stage group,and 60 healthy individuals examined at the same time were selected as the healthy control group.According to the 3-month follow-up survival status of patients with acute exacerbation stage ⅡP,they were divided into survival subgroup(n=59)and death subgroup(n=31).Enzyme linked immunosorbent assay was used to detect serum levels of CD59 and Gremlin-1.Pearson correlation analysis of the correlation between serum CD59,Gremlin-1 and clinical indicators in patients with acute exacerbation of ⅡP.Multivariate logistic regression analysis of factors affecting the prognosis of death in patients with acute exacerbation of ⅡP.The predictive value of serum CD59 and Gremlin-1 in predicting the prognosis of death in patients with acute exacerbation of ⅡP by analyzing the working characteristic curve of subjects.Results The levels of serum CD59 and Gremlin-1 in the acute exacerbation group were higher than those in the stable stage group and the healthy control group(t=30.916,47.431,34.379,54.420,P＜0.001).The ESR and HRCT scores,serum CD59 and Gremlin-1 levels in the death sub-group were significantly higher than those in the survival subgroup(t/P=2.580/0.012、4.546/＜0.001、26.388/＜0.001、20.842/＜0.001).The levels of serum CD59 and Gremlin-1 in patients with acute exacerbation of ⅡP were positively correlated with ESR and HRCT scores(r=0.621,0.736,0.705,0.689,all P＜0.001).HRCT score,CD59,and Gremlin-1 are high risk factors for mor-tality prognosis in patients with acute exacerbation of ⅡP[OR(95％CI)=1.589(1.258-2.006),1.593(1.252-2.028),1.733(1249-2.404)].The AUC of HRCT score,serum CD59,Gremlin-1,and combined detection for evaluating the prognosis of acute exacerbation stage ⅡP patients were 0.807,0.779,0.752,and 0.867,respectively.The AUC of combined detection was the highest(Z=5.183,4.349,5.127,P＜0.001).Conclusion The elevated levels of serum CD59 and Gremlin-1 in patients with acute exacerbation of ⅡP are influencing factors for the prognosis of death in patients with acute exacerbation.The combined detection of HRCT score,serum CD59,and Gremlin-1 has high evaluation value for the prognosis of death in pa-tients with acute exacerbation of ⅡP.