| 王泽凤,邱勤,谭建东,等.特发性间质性肺炎病人血清 STAT3和 FOXM1水平与病情程度及预后的关系研究[J].安徽医药,2025,29(1):69-74. |
| 特发性间质性肺炎病人血清 STAT3和 FOXM1水平与病情程度及预后的关系研究 |
| Study on the relationship between serum STAT3 and FOXM1 levels, severity and prognosis in patients with idiopathic interstitial pneumonia |
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| DOI：10.3969/j.issn.1009-6469.2025.01.013 |
| 中文关键词: 特发性间质性肺炎 信号转导及转录激活因子 3 叉头框转录因子 M1 病情程度 预后 相关性 |
| 英文关键词: Idiopathic interstitial pneumonia Signal transduction and transcription activating factor 3 Forkhead box transcription factor M1 Degree of illness Prognosis Correlation |
| 基金项目:成都医学院第一附属医院科研项目国临培专项( CYFY2018GLPHX06) |
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| 中文摘要: |
| 目的探讨特发性间质性肺炎( IIP)病人血清信号转导及转录激活因子 3(STAT3)、叉头框转录因子 M1(FOXM1)表达水平与其病情程度和预后的关系。方法选取 2017年 1月至 2022年 10月四川省建筑医院收治的 298例 IIP病人为 IIP组，选取同时期该院收治的 298例普通型间质性肺炎( UIP)病人为 UIP组，另选取同时期在该院体检的 280例健康人员为对照组。采用酶联免疫吸附测定( ELISA)检测血清 STAT3与 FOXM1表达水平，并采用全肺纤维化高分辨率 CT(HRCT)评分评价 IIP病情严重程度。分析三组受试者血清 STAT3与 FOXM1表达水平差异。对 IIP组病人随访 3个月，根据其生存情况分为预后良好组与预后不良组，分析预后不良与预后良好组 IIP病人血清 STAT3与 FOXM1表达水平差异，并采用 Spearman法分析 IIP病人血清 STAT3与 FOXM1表达水平与全肺纤维化 HRCT评分之间的关系。采用 logistic回归分析 IIP病人预后不良的影响因素，绘制受试者操作特征曲线( ROC曲线)评估血清 STAT3与 FOXM1表达水平对 IIP病人预后不良的预测效能。结果 IIP组、 UIP组、对照组血清 STAT3［( 1.50±0.39)ng/L、(1.32±0.31)ng/L、(1.01±0.27)ng/L］、 FOXM1［( 34.56±5.64)ng/L、(22.69±4.11)ng/L、(15.51± 3.94)ng/L］水平均依次降低( P<0.05)。 IIP病人随访 3个月共有 41例病人死亡，预后不良发生率为 13.76%(41/298)；预后不良组 IIP病人血清 STAT3、FOXM1水平均高于预后良好组( P<0.05)。 Spearman相关性分析表明， IIP病人血清 STAT3、FOXM1水平均与全肺纤维化 HRCT评分正相关( rs=0.65，rs=0.57；P<0.001)。另预后不良组年龄、 Ⅱ型肺泡细胞表面抗原( KL-6)、白细胞计数、红细胞沉降率( ESR)、 C反应蛋白( CRP)水平、全肺纤维化 HRCT评分均高于预后良好组( P<0.05)；第一秒用力呼气量(FEV1)、最大自主通气量( MVV)均低于预后良好组( P<0.05)。多因素 logistic回归分析显示，年龄、 KL-6、白细胞、 ESR、CRP、 STAT3、FOXM1水平、全肺纤维化 HRCT评分均是导致 IIP病人预后不良的危险因素( P<0.05)FEV1、MVV为保护因素( P<0.05)。 ROC分析结果表明，血清 STAT3、FOXM1水平联合预测 IIP病人预后的灵敏度高于 STAT3OXM1单独预测的灵敏度(χ2=8.10、6.12，P=0.002、0.008)；联合预测的曲线下面积( AUC)高于 STAT3、FOXM1单独预测的 AUC(Z=3.15、2.54，P=0.002、 、F，0.011)。结论 IIP病人血清 STAT3、FOXM1表达水平均上升，二者与 IIP病情程度正相关，均对 IIP病人预后具有良好的预测价值，且联合预测效能更高。 |
| 英文摘要: |
| Objective To investigate the expression levels of serum signal tranducers and activators of transcription 3 (STAT3) andforkhead box M1 (FOXM1) in patients with idiopathic interstitial pneumonia (IIP) and their relationship with severity and prognosis.Methods A total of 298 patients with IIP admitted to Sichuan Architectural Hospital from January 2017 to October 2022 were collect-ed as IIP group, another 298 usual interstitial pneumonia (UIP) patients admitted to our hospital at the same period were collected asthe UIP group, another 280 healthy individuals who underwent physical examination in our hospital were collected as the control group.The expression levels of serum STAT3 and FOXM1 were detected by enzyme linked immunosorbent assay (ELISA), the severity of IIPwas evaluated using a high resolution CT (HRCT) score for total pulmonary fibrosis. The differences in serum STAT3 and FOXM1 ex-pression levels among the three groups of subjects were analyzed. IIP patients were followed up for 3 months and were grouped into agood prognosis group and a poor prognosis group based on their survival. The differences in serum STAT3 and FOXM1 expression lev-els of IIP patients between the poor prognosis group and good prognosis groups were analyzed. Spearman method was applied to analyzethe relationship between the expression levels of serum STAT3 and FOXM1 in patients with IIP and the HRCT score of total pulmonaryfibrosis. Logistic regression was applied to analyze the influencing factors of poor prognosis in patients with IIP, and receiver operatingcharacteristic curve (ROC curve) was drawn to evaluate the predictive efficacy of serum STAT3 and FOXM1 expression levels for poorprognosis in patients with IIP.Results The serum levels of STAT3 [(1.50±0.39)ng/L, (1.32±0.31)ng/L, (1.01±0.27)ng/L] and FOXM1[(34.56±5.64)ng/L, (22.69±4.11)ng/L, (15.51±3.94)ng/L] in the IIP group, UIP group, and control group all decreased sequentially (P< 0.05). A total of 41 patients died during a 3-month follow-up, with a poor prognosis rate of 13.76% (41/298), and the serum levels ofSTAT3 and FOXM1 of IIP patients in poor prognosis group were higher than those in the good prognosis group (P<0.05). Spearman corre-lation analysis showed that serum STAT3 and FOXM1 levels in patients with IIP were positively correlated with HRCT score for totalpulmonary fibrosis (r=0.654, r=0.567; P<0.001). In addition, the age, type Ⅱ alveolar cell surface antigen (KL-6), white blood cell sscount (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, and HRCT scores of total pulmonary fibrosis in thepoor prognosis group were higher than those in the good prognosis group (P<0.05); the forced expiratory volume in first second (FEV1)and maximum voluntary ventilation volume (MVV) were lower in the good prognosis group (P<0.05). Multivariate Logistic regression analysis showed that age, KL-6, WBC, ESR, CRP, STAT3, FOXM1 levels, and HRCT score of total pulmonary fibrosis were risk factorsfor poor prognosis in patients with IIP (P<0.05), while FEV1 and MVV were protective factors (P<0.05). The results of ROC curve analy-sis showed that the sensitivity of serum STAT3 combined with FOXM1 levels in predicting the prognosis of patients with IIP was higherthan that of alone predicting STAT3 and FOXM1 levels (χ2=8.10,P=0.002; χ2=6.12, P=0.008). The area under the curve (AUC) predict-ed jointly was higher than the AUC predicted separately by STAT3 and FOXM1 (Z=3.15, P=0.002; Z=2.54, P=0.011). Conclusions The expression levels of serum STAT3 and FOXM1 in patients with IIP are both increased, which are positively correlated with the sever-ity of IIP. Both of them have good predictive value for the prognosis of IIP patients, and the combined predictive efficacy is higher. |
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