摘要
目的检测慢阻肺患者支气管肺泡灌洗液中组织蛋白酶S的水平及与慢阻肺患者肺功能和高分辨CT表型的相关性研究。方法收集2014年1月至2018年1月在我院门诊治疗的稳定期慢阻肺患者72例,根据FEV 1占预计值%和FEV 1/FVC数值对患者进行GOLD分级,GOLDⅠ级17例、GOLDⅡ级25例、GOLDⅢ级21例、GOLDⅣ级9例,以及同期来我院就诊的并进行纤维支气管镜和BALF检测的健康志愿者23例;酶联免疫吸附试验检测BALF中组织蛋白酶S和γ-干扰素的水平;高分辨CT测量患者低衰减区域(LAA)占全肺体积的百分比(LAA%)、管壁面积占总横截面积比(WA)和2倍气道壁厚度与气道直径比(2T/D);组织蛋白酶S水平与患者肺功能指标和HRCT指标之间的相关性采用Pearson分析。结果对照组、GOLDⅠ级、GOLDⅡ级、GOLDⅢ级和GOLDⅣ级患者BALF中组织蛋白酶S的水平分别为(0.4±0.1)μg/L、(2.1±0.7)μg/L、(2.9±1.0)μg/L、(3.7±1.2)μg/L和(5.7±1.5)μg/L,组间比较差异具有统计学意义(F=12.47,P=0.000),且随着GOLD等级的增加而逐渐升高;对照组、GOLDⅠ级、GOLDⅡ级、GOLDⅢ级和GOLDⅣ级患者的肺功能检测指标FEV 1占预计值%、FEV 1/FVC、RV/TLC、DLCO和HRCT参数LAA%、2T/D和WA数值之间均有统计学差异;组织蛋白酶S水平与FEV 1占预计值%、FEV 1/FVC和DLCO占预计值的数值成负相关,(P<0.001)。组织蛋白酶S水平与RV/TLC、LAA、2T/D、WA和γ-干扰素的水平呈正相关,(P<0.001)。结论组织蛋白酶S的水平反应慢阻肺患者气流受限程度和肺气肿的表型,可能通过γ-干扰素参与慢阻肺的发生发展,有望成为慢阻肺的潜在标记物。
Objective To detect the level of cathepsin S in bronchoalveolar lavage fluid of patients with COPD and its correlation with lung function and CT phenotype in patients with COPD.Methods A total of 72 patients with stable COPD who were treated in our hospital from January 2014 to January 2018 were enrolled.According to the predicted value of FEV 1 and the FEV 1/FVC value,the patient's GOLD was graded,17 cases of GOLD grade I,25 cases of GOLD gradeⅡ,21 cases of GOLD gradeⅢ,9 cases of GOLD grade IV,and during the same period,23 healthy volunteers were selected as the control group tested by fiberoptic bronchoscope and BALF.The levels of cathepsin S andγ-interferon in BALF were detected by enzyme-linked immunosorbent assay.It used high-resolution CT to measure the percentage of patients with low attenuation(LAA)as a percentage of total lung volume(LAA%),wall area to total cross-sectional area(WA),and 2 times airway wall thickness to airway diameter ratio(2T/D).The correlation of protein S levels with lung function indicators and HRCT indicators was analyzed by Pearson analysis.Results The levels of cathepsin S in BALF of the control group,the GOLD grade I group,the GOLDⅡgrade group,the GOLD gradeⅢgroup and the GOLD grade IV group were(0.4±0.1)μg/L,(2.1±0.7)μg/L,(2.9±1.0)mg/L,(3.7±1.2)μg/L and(5.7±1.5)μg/L,the difference between the groups was statistically significant(F=12.47,P=0.000),and it gradually increased with the increase of GOLD grade raise.There were significant differences in FEV 1Pre%,FEV 1/FVC,RV/TLC,DLCO,and HRCT parameters LAA%,2T/D,and WA among the control group,the GOLD I group,the GOLDⅡgroup,the GOLDⅢgroup,and the GOLD IV group.The level of tissue proteinase S was negatively correlated with the predicted values of FEV 1/FVC,FEV 1/FVC and DLCO(P<0.001).The level of tissue proteinase S was positively correlated with the levels of RV/TLC,LAA,2T/D,WA,andγ-interferon(P<0.001).Conclusion The level of cathepsin S reflects the degree of airflow limitation and the phenotype of emphysema in patients with COPD.It may be involved in the development of COPD throughγ-interferon and is expected to be a potential marker for COPD.
作者
石广军
SHI Guang-jun(Department of Respiratory Medicine,Shangqiu Third People's Hospital,Shangqiu,Henan 476000,China)
出处
《临床肺科杂志》
2020年第4期560-564,共5页
Journal of Clinical Pulmonary Medicine
