Factors Influencing Respiratory Syncytial Virus Infection in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Correlation with Serum Levels of HSP70,KLF5,MIP-2
10.12259/j.issn.2095-610X.S20251114
- VernacularTitle:慢性阻塞性肺疾病急性加重期患者并发呼吸道合胞病毒感染的影响因素及与血清HSP70、KLF5、MIP-2水平的相关性
- Author:
Xianbiao XU
1
;
Mingfang YANG
;
Ruidan LI
;
Li ZHANG
Author Information
1. 兵器工业总医院呼吸与危重症医学科,陕西 西安 710065
- Keywords:
Acute exacerbation of chronic obstructive pulmonary disease;
Respiratory syncytial virus;
Heat shock protein 70;
Krüppel like factor 5;
Macrophage inflammatory protein-2
- From:
Journal of Kunming Medical University
2025;46(11):107-115
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the factors associated with respiratory syncytial virus(RSV)infection in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and its correlation with serum levels of heat shock protein 70(HSP70),Krüppel-like factor 5(KLF5),and macrophage inflammatory protein-2(MIP-2).Methods A total of 195 AECOPD patients were prospectively enrolled and categorized into an RSV-infected group(n=95)and an uninfected group(n=100)based on RSV infection status.The infected group was further subdivided by disease severity into mild,moderate,and severe subgroups(31 cases,35 cases,29 cases),and by prognosis into poor prognosis(n=51)and good prognosis subgroups(n=44).ELISA method was used to measure the serum levels of HSP70,KLF5,and MIP-2 in each group,and their correlation with relevant clinical indicators was analyzed.Multivariate Cox regression analysis was used to explore risk factors for RSV infection in AECOPD patients.Relative risk analysis was used to explore the impact of high and low levels of HSP70,KLF5,and MIP-2 on the prognosis of AECOPD patients with RSV infection.Kaplan-Meier survival curves analyzed patient survival outcomes.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of serum HSP70,KLF5,and MIP-2 levels for the prognosis of AECOPD patients with RSV infection.Results The infected group had significantly higher proportions of respiratory failure,higher number of exacerbations within one year,and higher levels of CRP,HSP70,KLF5,and MIP-2 compared to the non-infected group(P<0.05),while FEV1%pred were significantly lower(P<0.05).Serum HSP70,KLF5,MIP-2 levels were positively correlated with respiratory failure,number of exacerbations within one year,and CRP levels(P<0.05),and negatively correlated with FEV1%pred(P<0.05).Multivariate Cox regression identified respiratory failure,number of AECOPD exacerbations within one year≥3 times,low FEV1%pred,and high levels of CRP,HSP70,KLF5,and MIP-2 as independent risk factors for RSV infection in AECOPD patients(P<0.05).As the condition worsens,the levels of serum HSP70,KLF5,and MIP-2 gradually increase(P<0.05).The poor prognosis subgroup had prominently higher serum levels than the good prognosis subgroup(P<0.05).Patients with high levels of HSP70,KLF5,and MIP-2 have a greater risk of poor prognosis and a lower 28-day progression-free survival rate(P<0.05).The areas under the ROC curve(AUC)predicted by the combination of the three indicators was significantly better than that predicted by a single indicator(P=0.015).Conclusion Respiratory failure,the number of AECOPD exacerbations within one year≥3 times,low FEV1%pred,high CRP level,and high serum levels of HSP70,KLF5,and MIP-2 are risk factors for RSV infection in AECOPD patients.Serum levels of HSP70,KLF5,MIP-2 are closely related to disease severity and prognosis in AECOPD patients with RSV infection.The combined detection of the three biomarkers has significant predictive value for patient prognosis,which is helpful for early clinical assessment and the formulation of intervention strategies.
