摘要
目的探究赖氨酰氧化酶样蛋白2(lysyl oxidase-like 2,LOXL2)、甲壳质酶蛋白40(chitinase protein 40,YKL-40)在结缔组织病合并肺间质病变(CTD combined with ILD,CTD-ILD)患者血清中的表达及临床意义。方法选择2022年7月-2023年4月我院收治的CTD患者182例(CTD-ILD组85例、CTD-NILD组97例)及对照组(同期健康体检者91例)。三组受检者检测血清LOXL2、YKL-40水平。分析其与肺功能、HRCT评分的相关性,并通过Logistic回归及受试者工作特征(receiver operating characteristic,ROC)曲线评估预测价值。结果CTD-ILD组、CTD-NILD组血清LOXL2、YKL-40水平均高于对照组,且CTD-ILD组高于CTD-NILD组(P<0.05)。与CTD-NILD组相比,CTD-ILD组年龄更大(P<0.05),类风湿关节炎患者占比、血红蛋白、维生素D、血钙均更低(P<0.05),红细胞沉降率、C-反应蛋白均更高(P<0.05)。血清LOXL2、YKL-40与肺一氧化碳弥散量占预计值百分比、肺总量占预计值百分比、用力肺活量占预计值百分比均呈负相关(P<0.05),与肺部高分辨率CT评分均呈正相关(P<0.05)。二元Logistic回归分析结果显示,LOXL2、YKL-40是CTD-ILD独立危险因素(P<0.05),维生素D是CTD-ILD独立保护因素(P<0.05)。血清LOXL2、YKL-40水平预测CTD-ILD的截断值分别是391.80 pg/mL、1868.95 pg/mL,曲线下面积(area under curve,AUC)值分别是0.730(95%CI:0.646~0.834)、0.719(95%CI:0.634~0.822),二者联合预测CTD-ILD的AUC值为0.825(95%CI:0.731~0.908)。二者联合的AUC大于LOXL2(Z值=2.937,P值=0.003)和YKL-40(Z值=3.218,P值=0.001)。可见,二者联合预测CTD-ILD的价值更高。结论LOXL2、YKL-40在CTD-ILD患者中异常高表达,可作为早期预测及风险分层的潜在生物标志物。
Objective To investigate the expression and clinical significance of lysyl oxygenase-like protein 2(LOXL2)and chitinase protein 40(YKL-40)in the serum of patients with connective tissue disease complicated with lung interstitial disease(CTD-ILD).Methods A total of 182 CTD patients(85 CTD-ILD group,97 CTD-NILD group)and control group(91 healthy subjects)were selected from July 2022 to April 2023 in our hospital.Serum LOXL2 and YKL-40 levels were detected in 3 groups.The correlation with lung function and HRCT score was analyzed,and the predictive value was evaluated by Logistic regression and receiver operating characteristic(ROC)curve.Results Serum LOXL2 and YKL-40 levels in the CTD-ILD group and CTD-NILD group were higher than those in the control group,and those in CTD-ILD group were higher than those in CTD-NILD group(P<0.05).Compared with CTD-NILD group,CTD-ILD group was older(P<0.05),the proportion of patients with rheumatoid arthritis,hemoglobin,vitamin D and blood calcium were lower(P<0.05),erythrocyte sedimentation rate and C-reactive protein were higher(P<0.05).Serum LOXL2 and YKL-40 were negatively correlated with pulmonary carbon monoxide diffusion as a percentage of predicted value,total lung volume as a percentage of predicted value and forced vital capacity as a percentage of predicted value(P<0.05),and positively correlated with lung high-resolution CT scores(P<0.05).Binary Logistic regression analysis showed that LOXL2 and YKL-40 were independent risk factors(P<0.05),and vitamin D was independent protective factor(P<0.05).The area under the curve(AUC)(95%CI)values of serum LOXL2 and YKL-40 levels for predicting CTD-ILD were 0.730(0.646~0.834)and 0.719(0.634~0.822),respectively.The AUC(95%CI)value of CTD-ILD was 0.825(0.731~0.908),and the value of CTD-ILD was higher(Z=-2.921,-3.259,P<0.05).Conclusion LOXL2 and YKL-40 are abnormally high expressed in CTD-ILD patients,which can be used as potential biomarkers for early prediction and risk stratification.
作者
赵悦
杨金良
罗寰
席文秀
王珺璐
郑学军
ZHAO Yue;YANG Jinliang;LUO Huan;XI Wenxiu;WANG Junlu;ZHENG Xuejun(Department of Rheumatology and immunology,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)
出处
《临床肺科杂志》
2025年第8期1202-1207,共6页
Journal of Clinical Pulmonary Medicine
基金
河北省卫生健康委科研项目(20231416)。
关键词
赖氨酰氧化酶样蛋白2
甲壳质酶蛋白40
结缔组织病
肺间质病变
预测价值
Lysyl oxidase-like protein 2
Chitinase protein 40
Connective tissue disease
Pulmonary interstitial disease
Predictive value
