Effect of serum tumor necrosis factor receptor-6 level on prognosis of AECOPD patients with respiratory failure

Abstract

Objective To study the expression of serum tumor necrosis factor receptor-6 (TR6) [decoy receptor 3 (DcR3)] in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with respiratory failure, and to analyze its influence on prognosis. Methods 134 patients with AECOPD admitted to our hospital from March 2015 to March 2017 were selected as the study subjects. According to whether or not respiratory failure occurred, they were divided into respiratory failure group (65 cases) and non-respiratory failure group (69 cases). Another 60 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. Serum albumin (ALB), C-reactive protein (CRP), first-second forced breathing volume (FEV1%), first-second forced breathing volume (FEV1/FVC), arterial partial oxygen pressure (PaO2) and arterial partial carbon dioxide pressure (PaCO2) were collected. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α) and DcR3. Results The levels of ALB, FEV1, FEV1/FVC and PaO2 in respiratory failure group were significantly lower than those in non-respiratory failure group and control group (P<0.05), and those in non-respiratory failure group were significantly lower than those in control group (P<0.05); the levels of CRP, PaCO2, IL-8, TNF-α and DcR3 in respiratory failure group were significantly higher than those in non-respiratory failure group and control group (P<0.05). The survival rate of high DcR3 level group was significantly lower than that of low DcR3 level group (P<0.05). High levels of TNF-α and DcR3 were independent risk factors for adverse prognosis of AECOPD patients with respiratory failure (P<0.05). Conclusions The high expression of DcR3 in serum of AECOPD patients with respiratory failure is an independent risk factor for adverse prognosis. Key words: Tumor necrosis factor decoy receptors; Pulmonary disease, chronic obstructive; Respiratory insufficiency