COPD血清生物标志物水平和在气流受限中的作用

目的 探讨血清生物标志物在COPD中的变化和在气流受限中的作用.方法 选取稳定期COPD患者41例为COPD组,另外选取健康吸烟者35例为对照组,采用ELISA和多因子流式分析方法,测定2组人群血清肺表面活性蛋白D (pulmonary surfactant protein D,SP-D)、基质金属蛋白酶2、3、9(matrix metalloprotease-2、3、9,MMP-2、3、9)、CXC趋化因子配体10 (CXCchemokine ligand-10,CXCL10)、Clara细胞蛋白16 (Clara cell protein 16,CC16)、可溶性晚期糖基化终产物受体(soluble receptor for advanced glycation end products,sRAGE)含量,完善肺功能检查并进行统计分析.结果 稳定期COPD患者血清MMP-2水平较对照组减低(t=19.960,P＜0.05),MMP-3(t=44.592,P＜0.05)、CXCL10(z=-0.263,P＜0.05)较对照组升高;2组SP-D、CC 16、sRAGE、MMP 9差异无统计学意义(P值均＞0.05).多因素Logistic回归分析校正年龄、吸烟量等因素后显示MMP-3与COPD相关(OR=l 368,P=0.045,95％ CI:1.008～1.858).在COPD患者中偏相关性分析发现MMP-3与FVC％ pred、FEV1％ pred、FEV1/FVC、MMEF％均无相关件(P值均＞0.05).随着疾病加重血清MMP 3水平变化差异无统计学意义(P＞0.05).结论 血清MMP-3可能在气流受限中起作用,有可能对COPD有诊断价值,但本研究中与COPD患者气流受限程度关系不大.

Levels of serum biomarkers in COPD and the association with airflow limitation

Objective To investigate the changes of serum biomarkers in chronic obstructive pulmonary disease (COPD) and their role in airflow limitation.Methods Forty-one patients with COPD were selected as COPD group and 35 healthy smokers were selected as control group.We quantified serum levels of pulmonary surfactant protein D (SP-D),matrix metalloproteinase 2,3,9 (MMP-2,3,9),CXC chemokine ligand 10 (CXCL10),Clara cell protein 16 (CC16),soluble receptor for advanced glycation end products (sRAGE) and pulmonary function.Results The level of serum MMP-2 in patients with stable COPD was lower than that in control group(P ＜0.05),MMP-3 and CXCL10 were higher than those in the control group(both P ＜0.05),SP-D,CC1 6,sRAGE and MMP-9 were not statistically significant (all P ＞0.05).Multivariate logistic regression analysis showed that MMP-3 was associated with COPD after adjustment for age,smoking and other factors (OR =1.368,P =0.045,95％ CI:1.008-1.858).The correlation analysis showed that MMP-3 had no correlation with FVC％ pred,FEV1 ％ pred,FEV1/FVC and MMEF％ (all P ＞0.05).There was no significant difference in serum MMP-3 level with the increase of disease (P ＞0.05).Conclusions Serum MMP 3 may play a role in airflow limitation and may have diagnostic value for COPD,but this study has little to do with the degree of airflow limitation in COPD patients.