特发性肺动脉高压患者血清骨保护素及其受体的变化及临床意义

目的探讨特发性肺动脉高压（idiopathic pulmonary arterial hypertension，IPAH）患者肺动脉压力和血清骨保护素（osteoprotegerin，OPG）及其受体（核因子-κβ受体活化因子配体，RANKL）水平的关系及临床意义。方法纳入IPAH患者28例，同期纳入性别和年龄匹配的健康体检者28例作为对照组。采用酶联免疫吸附法（ELISA）检测所有入组人员血清OPG/RANKL水平、N末端脑钠肽前体（NT-proBNP）水平；对IPAH组患者采用右心漂浮导管测定肺动脉压力的水平，并对肺动脉压和OPG/RANKL水平进行相关性分析。结果与正常对照组相比，IPAH患者血清中OPG、RANKL和NT-proBNP水平均更高OPG：（190.91±43.39）pg/mL vs.（122.59±41.20）pg/mL；RANKL：（194.05±50.31）pg/mL vs.（117.73±39.89）pg/mL；NT-proBNP：（1894.78±591.97）pg/mL vs.（224.18±60.11）pg/mL]，差异均有统计学意义（P＜0.05）。直线相关分析显示血清中OPG/RANKL水平和肺动脉压力呈正相关，相关系数分别为r=0.525（P＜0.05）和r=0.419（P＜0.05）。结论骨保护素及其受体轴（OPG/RANKL）可能参与肺动脉高压的形成，且与肺动脉压力有一定的相关性。

Changes and clinical significance of serum osteoprotegerin and its receptor in patients with idiopathic pulmonary arterial hypertension

Objective To study the relationship between pulmonary arterial pressure and the levels of serum osteoprotegerin （OPG） and its receptor （RANKL） and clinical significance in the patients with idiopathic pulmonary arterial hypertension （IPAH）. Methods IPAH patients were chosen as IPAH group （n=28） and other health persons with the same sex and age were chosen as control group （n=28）. The levels of serum OPG, RANKL and NT-proBNP were detected by using enzyme-linked immunosorbent assay （ELISA）, and the level of pulmonary arterial pressure was detected by applying right heart catheterization. The correlation between pulmonary arterial pressure and OPG and RANKL levels was analyzed. Results The levels of OPG, RANKL and NT-proBNP were higher in IPAH group than those in control group OPG：（190.91±43.39） pg/mL vs. （122.59±41.20） pg/mL;RANKL：（194.05 ±50.31） pg/mL vs. （117.73±39.89） pg/mL;NT-proBNP：（1894.78±591.97） pg/mL vs. （224.18±60.11） pg/mL, P〈0.05]. Linear correlation analysis showed that OPG and RANKL levels were positively correlated to pulmonary arterial pressure （r=0.525, P〈0.05 and r=0.419, P〈0.05）. Conclusion OPG and RANKL levels may take part in the incidence of IPAH and are correlated to pulmonary arterial pressure.