血清肌肉生长抑制素和肌肉环指蛋白-1对慢性阻塞性肺疾病急性加重期并发肺动脉高压的预测价值

目的 观察慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)急性加重期并发肺动脉高压(pulmonary hypertension,PH)患者血清肌肉生长抑制素(myostatin,MSTN)和肌肉环指蛋白-1(muscle ring finger protein-...

Values of serum myostatin and MuRF-1 to the prediction of pulmonary hypertension in patients with acute exacerbation of chronic obstructive pulmonary disease

Objective To investigate the values of serum myostatin and muscle ring finger protein-1(MuRF-1)to the prediction of pulmonary hypertension(PH)in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD)by observing the expressions of myostatin and MuRF-1.Methods Totally 150 patients with chronic obstructive pulmonary disease(COPD)were divided into AECOPD group(n=72)and stable COPD group(n=78).According to the mean pulmonary artery pressure(mPAP),AECOPD group was redivided into PH group(mPAP≥20 mm Hg,n=34)and no-PH group(mPAP<20 mm Hg,n=38).Another 100 healthy volunteers were as controls(control group).ELISA was used to detect the levels of serum myostatin and MuRF-1.Multivariate logistic regression analysis was used to evaluate the risk factors of PH in patients with AECOPD.ROC was drawn to assess the predictive values of serum myostatin and MuRF-1 levels to PH in AECOPD patients.Results The levels of myostatin and MuRF-1 were higher in AECOPD group((297.79±30.86),(397.52±26.71)ng/L)than those in stable COPD group((244.19±20.88),(359.11±24.14)ng/L)and control group((190.70±25.26),(283.06±28.45)ng/L)(P<0.05),higher in stable COPD group than those in control group(P<0.05),and higher in PH group((315.77±14.29),(418.46±15.47)ng/L)than those in no-PH group((274.47±21.73),(376.01±16.29)ng/L)(P<0.05).Myostatin≥295.87 ng/L and MuRF-1≥395.32 ng/L were the independent risk factors of PH in AECOPD patients(OR=1.053,95%CI:1.007-1.100,P=0.022;OR=1.034,95%CI:1.002-1.068,P=0.038).When the optimal cut-offvalues of myostatin and MuRF-1 were 297.03 and 395.48 ng/L,the AUCs of detections of myostatin,MuRF-1 and myostatin+MuRF-1 for predicting PH were 0.908(95%CI:0.851-0.948,P<0.001),0.879(95%CI:0.817-0.925,P<0.001)and 0.946(95%CI:0.898-0.976,P<0.001),the sensitivities were 89.48%,70.56%and93.89%,and the specificities were 80.56%,86.10%and 88.71%,respectively.The AUCof myostatin+MuRF-1 was significantly larger than that of either myostatin or MuRF-1(P<0.05).Conclusion The serum myostatin and MuRF-1 levels elevate obviously in AECOPD patients with PH,both of which are the independent risk factors of PH.The combined detection of myostatin and MuRF-1 can improve the predictive value to PH in AECOPD patients.