探讨TGFβ1、PDGF、VEGF对特发性肺纤维化诊断及病情评估的临床意义

目的探讨分泌转化生长因子-β、血小板衍生生长因子、血管内皮生长因子在特发性肺纤维化(IPF)患者支气管肺泡灌洗液(BALF)和血清中的表达水平及评估病情进展的临床意义。 方法选择2014年1月至2018年12月在我院呼吸科诊治的35例IPF患者作为观察组，18例肺结节病患者(Ⅰ期)作为对照组；采用免疫印迹观察TGFβ1、PDGF、VEGF在IPF患者血清中是否存在表达；用酶联免疫吸附法(ELISA)观察2组患者BALF和血清中TGFβ1、PDGF、VEGF的表达水平；最后分析IPF患者BALF和血清中TGFβ1、PDGF、VEGF表达水平与肺功能及血氧饱和度的相关性。 结果TGFβ1、PDGF、VEGF细胞印在IPF患者血清存在表达；与对照组相比，BALF及血清中的TGFβ1、PDGF、VEGF表达上调(P<0.05)；IPF组患者BALF及血清中TGFβ1、PDGF、VEGF表达水平与肺功能中FVC%、FEV₁%和DLCO%呈负性相关(P<0.05)；与血氧饱和度也呈显著负相关(P<0.05)。 结论IPF患者BALF和血清中TGFβ1、PDGF、VEGF的表达水平明显升高；TGFβ1、PDGF、VEGF与患者的肺功能及血氧饱和度呈负相关，可作为评估IPF患者病情的临床评价指标。

Clinical significance of transforming growth factor beta 1,platelet-derived growth factor and vascular endothelial growth factor in diagnosis and evaluation of idiopathic pulmonary fibrosis

Objective To investigate the expression and clinical significance of transforming growth factor beta 1(TGFβ1),platelet-derived growth factor(PDGF)and vascular endothelial growth factor(VEGF)in the patients with idiopathic pulmonary fibrosis(IPF).Methods A total of 35 IPF patients were selected who were admitted in our hospital from January 2014 to December 2018 as the IPF group and 18 patients with pulmonary sarcoidosis of StageⅠwho were admitted in our hospital at the same period were taken as the control group.Firstly,Western blotting method was employed to observe whether the TGFβ1,PDGF and VEGF expressed in the serum.Secondly,the expression levels of TGFβ1,PDGF and VEGF in the bronchoalveolar lavage fluid(BALF)and in the serum were detected by enzyme-linked immunosorbent assay.Finally,the correlations of TGFβ1,PDGF and VEGF with the pulmonary functions and the blood oxygen saturation were analyzed.Results Expression of TGFβ1,PDGF and VEGF exists in the serum of the IPF patients.The expression levels of TGFβ1,PDGF and VEGF in the BALF and in the serum were significantly higher in the IPF group than the control group(P<0.05).The expression levels of TGFβ1,PDGF and VEGF in the BALF and in the serum were negatively correlated with FVC%,FEV 1% and DLCO% pred in the IPF group,while they were negatively correlated with the degree of blood oxygen saturation.Conclusion The expression levels of TGFβ1,PDGF and VEGF in the serum and in the BALF increase in the IPF patients.They are negatively correlated with the pulmonary functions and the degree of blood oxygen saturation,which can be used as a clinical effective marker for disease monitoring and severity evaluation.