不同类型特发性间质性肺炎患者胶原与血管生成相关因子的表达差异  

Collagen and angiogenesis related factors in different type of idiopathic interstitial pneumonia

作　　者：张曙[1] 代华平[1] 王同德[2] 班承均 

机构地区：[1]北京呼吸疾病研究所,北京市呼吸与肺循环疾病重点实验室,首都医科大学附属北京朝阳医院呼吸与危重症医学科,100020 [2]北京垂杨柳医院,100020

出　　处：《实用医学杂志》2017年第5期713-717,共5页The Journal of Practical Medicine

基　　金：国家自然科学基金(编号:81270123);北京市自然科学基金重点项目(编号:7131008)

摘　　要：目的:分析不同类型特发性间质性肺炎(IIP)患者胶原与血管生成相关因子的表达差异。方法:收集2003年1月至2014年11月间,北京朝阳医院呼吸与危重症医学科住院确诊的187例IIP患者,分为特发性肺纤维化118例(IPF组),除IPF外的其他类型IIP 69例(nIPF-IIP组)两个亚组,其中nIPF-IIP组包括NSIP 30例,COP 29例;RB-ILD 10例。对照组68例,为男38例,女30例。收集患者及对照组支气管肺泡灌洗液(BALF)和血清,应用酶联免疫吸附法(ELISA)分别检测BALF及血清中I型前胶原(PCI)、Ⅲ型前胶原(PCⅢ)、人上皮细胞衍生中性粒细胞激活肽-78(ENA-78)和人γ干扰素诱导的蛋白-10(IP-10)的含量,对所测指标进行组间比较。结果:IPF患者组及nIPF-IIP组的BALF和血清中PCⅢ含量(ng/mL)均显著高于对照组[BALF:4.65±0.06,2.90±0.40 vs.1.31±0.16,均P<0.05;血清:11.49±0.98,3.37±0.16vs.1.98±0.09,均P<0.05)在IPF患者组升高尤为明显。而3组间BALF和血清中PC I含量差异均无统计学意义(均P>0.05)。BALF中ENA-78含量(ng/mL)在IPF组和nIPF-IIP组均较正常对照组升高(17.85±0.44,18.89±0.45 vs.14.86±0.63,均P<0.05;),但在二组之间无明显差异(P=0.139)。而BALF中IP-10含量(ng/mL)在IPF组和nIPF-IIP组均较对照组降低(0.25±0.01,0.21±0.01 vs.0.35±0.03,均P<0.05),且在nIPF-IIP患者的降低幅度较IPF患者大(P=0.040)。BALF中ENA-78含量与IP-10含量负相关(r=-0.378,P=0.02)。而血清ENA-78及IP-10变化不明显。结论:IPF患者较nIPF-IIP患者存在更明显的胶原代谢异常;IPF和nIPF-IIP患者肺脏的血管生成活性均增加。Objective To investigate and compare the expression of collagen and angiogenesis related factors in patients with idiopathic interstitial pneumonia （IIP） in different type of idiopathic interstitial pneumonia. Methods There were 187 consecutive IIP patients including 118 patients with idiopathic pulmonary fibrosis （IPF） and 69 patients with nlPF-IIP including non-specific interstitial pneumonia （NSIP, n = 30）, cryptogenic organizing pneumonia （COP, n = 29） , respiratory bronchiolitis interstitial lung disease （RB-ILD, n = 10）. The controls includes 38 males and 30 females. Bronchoalveolar lavage fluid （BALF） and serum were collected. The levels of pro- collagens Ⅰ （PCI） and pro-collagens Ⅲ （PCⅢ ）, ENA - 78 and IP-10 in BALF and serum were measured by ELISA assays. Results The levels of PC Ⅲ in BALF and serum were increased in patients with IPF and nIPF- IIP compared with controls （P 〈 0.01 ）, and PC Ⅲ in IPF was much higher than in nlPF-IIP （P = 0.00）. PCI levels had no difference among three groups （P 〉 0.05）. The levels of ENA-78 in BALF were significantly higher in patients with IIP than controls （P 〈 0.01）, and with no significant difference between IPF and nlPF- lip （P 〉 0.05）. The concentration of IP-10 in BALF were significantly lower in patients with IIP than controls （P 〈 0.01 ）, and patients with nIPF-IIP is lower than in IPF （P = 0.049）. In IIP patients, the concentrations of ENA-78 and IP-10 in BALF had a negative correlation （r = -0.378 P = 0.02）. In peripheral blood, the concentrations of ENA-78 and IP-10 hadno significant difference among the group between IPF, nIPF-IIP and control （P 〉 0.05）. Conclusions Collagen synthesis increase much more in patients with IPF than nIPF-IIP, angiogenesis activities are increased in patients with IIP.

关 键 词：特发性肺纤维化 非特异性间质性肺炎 隐原性机化性肺炎 趋化因子 血管生成 

分 类 号：R563.1[医药卫生—呼吸系统]