| 慢性阻塞性肺疾病并发肺动脉高压患者血清CCL28，SDF-1 表达水平及临床意义 |
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| 引用本文： | 孙 澜,马吉芳,崔乃凡.慢性阻塞性肺疾病并发肺动脉高压患者血清CCL28，SDF-1 表达水平及临床意义[J].现代检验医学杂志,2023,0(1):140-146. |
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| 作者姓名： | 孙 澜 马吉芳 崔乃凡 |
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| 作者单位： | （辽阳中心医院检验科，辽宁辽阳 111000） |
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| 摘 要： | 目的 探讨慢性阻塞性肺疾病（chronic obstructive pulmonary disease ，COPD）并发肺动脉高压（pulmonaryhypertension ，PAH）患者血清CC 趋化因子配体28（CC chemokine ligand 28，CCL28）、基质细胞衍生因子-1（stromalcell-derived factor-1，SDF-1）表达水平及临床意义。方法 选取2019 年2 月～ 2021 年6 月辽阳中心医院收治的209例COPD 患者，分为PAH 组（n=39 例）和非PAH 组（n=170），根据平均肺动脉压（mean pulmonary artery pressure，mPAP）将PAH 组分为轻中度组（n=23）和重度组（n=16），选择同期53 例健康体检者为对照组。检测各组血清CCL28 和SDF-1 水平，采用 Logistic 回归分析COPD 并发PAH 发生的影响因素，受试者工作特征（ROC）曲线分析血清CCL28 和SDF-1 对COPD 并发PAH 的诊断价值。结果 PAH 组血清CCL28，SDF-1 水平分别为3.26±0.73pg/ml，135.26±23.16mg/L，高于非PAH 组（1.35±0.35pg/ml，68.12±17.14mg/L）和对照组（0.51±0.16pg/ml，21.02±6.59mg/L），差异均有统计学意义（F =539.772，525.459，均P ＜ 0.05）；重度组血清CCL28，SDF-1 水平分别为3.88±0.10pg/ml，140.88±10.05mg/L，高于轻中度组（2.83±0.26 pg/ml，131.35±6.43mg/L），差异有统计学意义（t=15.333，3.616，P ＜ 0.05）。Logistic 回归分析显示高COPD 急性发作次数、高mPAP 以及血清CCL28 和SDF-1 高表达是COPD 并发PAH的危险因素（P=0.000 ～ 0.003）。血清CCL28，SDF-1 诊断COPD并发PAH的曲线下面积（AUC）分别为0.697（95%CI:0.630 ～ 0.758），0.681（95%CI:0.614 ～ 0.744）；血清CCL28 和SDF-1 联合检测诊断COPD 并发PAH 的AUC 为0.937（95%CI:0.895 ～ 0.966），两者联合检测优于单独检测，差异有统计学意义（Z=6.116，5.562，P ＜ 0.001）。结论 COPD 并发 PAH 患者血清CCL28，SDF-1 水平均升高，是COPD 并发PAH 的危险因素，对于COPD 并发 PAH 的诊断具有重要参考价值。
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| 关 键 词： | 慢性阻塞性肺疾病 肺脉高压 趋化因子 基质细胞衍生因子-1 CC 趋化因子配体28 |
Expression of Serum CCL28 and SDF-1 in Patients with Chronic Obstructive Pulmonary Disease Complicated by Pulmonary Hypertension and Its Clinical Significance |
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| SUN Lan,MA Ji-fang,CUI Nai-fan.Expression of Serum CCL28 and SDF-1 in Patients with Chronic Obstructive Pulmonary Disease Complicated by Pulmonary Hypertension and Its Clinical Significance[J].Journal of Modern Laboratory Medicine,2023,0(1):140-146. |
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| Authors: | SUN Lan MA Ji-fang CUI Nai-fan |
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| Affiliation: | (Department of Clinical Laboratory，Liaoyang Central Hospital, Liaoning Liaoyang 111000, China) |
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| Abstract: | Objective To investigate the expression of CC chemokine ligand 28 (CCL28) and stromal cell-derived factor-1 (SDF-1) in patients with chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PAH) and their clinical significance. Methods 209 patients with COPD admitted to the Liaoyang Central Hospital from February 2019 to June 2021 were selected and divided into PAH group (n=39 ) and non PAH group (n=170 ). PAH group was divided into mild to moderate group (n=23 ) and severe group (n=16 ) according to the mean pulmonary artery pressure (mPAP). 53 healthy people in the same period were selected as the control group.The levels of serum CCL28 and SDF-1 were detected in each group. The influencing factors of COPD complicated with PAH were analyzed by logistic regression. The diagnostic value of serum CCL28 and SDF-1 for COPD complicated with PAH was analyzed by the ROC curve. Results Serum CCL28 and SDF-1 levels in PAH group were 3.26 ± 0.73pg/ml, 135.26 ± 23.16mg/L, respectively， higher than those in non PAH group (1.35±0.35pg/ml, 68.12±17.14mg/L) and control group (0.51±0.16pg/ml, 21.02±6.59mg/L), and the differences was statistically significant (F=539.772, 525.459, all P<0.05). Serum CCL28 and SDF-1 levels in severe group were 3.88 ± 0.10 pg/ml, 140.88 ± 10.05 mg/L, respectively，higher than those in mild and moderate group (2.83 ± 0.26 pg/ml, 131.35 ± 6.43 mg/L)，and the differences was statistically significant (t=15.333, 3.616, P<0.05).Logistic regression analysis showed that high number of acute exacerbations of COPD, high mPAP, high expression of serum CCL28 and SDF-1 were risk factors for COPD complicated with PAH (P=0.000 ～ 0.003).The area under the curve(AUC) of serum CCL28 and SDF-1 in diagnosis of COPD complicated with PAH was 0.697 (95%CI:0.630 ～ 0.758) and 0.681 (95%CI:0.614 ～ 0.744), respectively, The AUC of combined detection of serum CCL28 and SDF-1 in the diagnosis of COPD complicated with PAH was 0.937 (95%CI:0.895 ～ 0.966), and the combined detection was superior to the single detection, with a statistically significant difference (Z=6.116, 5.562, P<0.001).Conclusion The levels of serum CCL28 and SDF-1 in patients with COPD complicated with PAH were both elevated, which would be risk factors for COPD complicated with PAH and has important reference value for the diagnosis of COPD complicated with PAH. |
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