The detection of serum protein C for the bronchial asthma patients condition and prognosis assess / 中华检验医学杂志

ABSTRACT

Objective To study the assessment value of serum protein C activity ( PC∶A) test in the patient′s condition and prognosis in bronchial asthma.Methods 202 bronchial asthma patients were selected from the Tianjin medical university general hospital from 2010 to 2012 for this retrospective cohort study, 77 males and 125 females with a mean age of 41.2 ±11.4 years.the level of PC∶A were analysed by IL ACL TOP 700 coagulation analyzer.Receiver operating characteristic curve ( ROC) was used to analyze the diagnosis performance of PC∶A, χ2 test was used to analyze the relevance between PC∶A and clinical pathological factors , Cox regression analysis model was used to evaluate the effect on prognosis , Kaplan-Meier curve to implement survival analysis.Results The elevels of PC∶A werecontrol group ( 102.2 ± 13.6)%, intermittent attack group (104.8 ±11.9)%, mild persistent group (136.3 ±15.8)%, moderate persistent group ( 129.0 ±13.5 )% and severe persistent ( 126.8 ±14.7 )% respectively , and there was significantly difference among the all groups ( F =7.15, P <0.01 ).Compared the control group and intermittent attack group with other groups , the PC∶A level was higher in mild persistent group ( q=16.83, q=15.54, P<0.05), moderate persistent group (q=19.94,q=12.15, P<0.05), and severe persistent group(q=11.37,q=10.66, P<0.05).The PC∶A level was lower in moderate and severe persistent group than mild persistent group ( q =3.82, q =4.30, P <0.05 ).After undergoing regular treatment for six months, the PC∶A level was higher in partly controlled group and uncontrolled group than complete controlled group (q=12.45, q=9.91,P<0.05).The optimum cut-off point of PC∶A (after undergoing regular treatment for six months ) for asthma condition with uncontrolled was 118.0%, the area under ROC curve was 0.892 ( 95% confidence interval0.851-0.936 ).The χ2 test results showed that there was the relevance between the serum PC∶A level and the eosinocyte , total serum IgE , complicated allergic rhinitis and lung function ( FEV1%) ( P<0.01 ).The Cox analysis and survival analysis showed that the serum PC∶A level ( after undergoing regular treatment for six months ) was the independent assessment parameter for asthma acute attack in 7th-12th month, the cumulative probability of acute attack was increased obviously in the patients who with PC∶A level over the cut-off value.Conclusions The serum PC∶A level was increased obviously in asthma patients , and was related to patient′s condition, level of asthma control and severe attacks risk , which could be used as an effective indicator for assessment of disease progression and asthma control in asthma patients.