KL-6、IGFBP-4在特发性肺纤维化患者支气管肺泡灌洗液和血清中的表达及意义  

Expression and significance of IGFBP-4 and KL-6 in bronchoalveolar lavage fluid and serum of patients with idiopathic pulmonary fibrosis

作　　者：李志杰[1] 杨爽[2] LI Zhi-jie;YANG Shuang(RICU,the First People＇ s Hospital of Shangqiu,Shan-gqiu,Henan 476000,China)

机构地区：[1]商丘市第一人民医院RICU科,河南商丘476000 [2]新乡医学院第三附属医院呼吸内科,河南新乡453000

出　　处：《临床肺科杂志》2018年第7期1289-1292,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨涎液化糖链蛋白6(KL-6)、胰岛素样生长因子结合蛋白4(IGFBP-4)在特发性肺纤维化(IPF)患者支气管肺泡灌洗液和血清中的表达水平及临床意义。方法选择2012年1月-2015年12月我院诊治的37例IPF患者作为IPF组,19例Ⅰ期肺结节病患者作为对照组,采用酶联免疫吸附法检测2组患者支气管肺泡灌洗液和血清中的KL-6与IGFBP-4水平,分析2组患者肺功能、细胞学计数的差异及KL-6与IGFBP-4水平与肺功能的相关性。结果 IPF患者肺支气管肺泡灌洗液(BLAF)中巨噬细胞百分数明显高于对照组(P<0.05);淋巴细胞百分数明显少于对照组(P<0.05);IPF组患者BALF中的KL-6、IGFBP-4水平均明显高于对照组(P<0.05);IPF组患者血清中的KL-6水平明显高于对照组(P<0.05),但IGFBP-4水平与对照组无明显差异(P>0.05);IPF组患者血清KL-6水平与FVC%和DLCO%pred均呈负相关(r=-0.426,P<0.05;r=-0.541,P<0.05);IPF组患者BALF中IGFBP4水平与FEV_1%、FVC%呈显著负相关(r=-0.549,P<0.05;r=-0.517,P<0.05),血清中IGFBP4水平与FEV_1%呈显著正相关(r=0.461,P<0.05)。IPF组患者的BLAF和血清KL-6、IGFBP-4水平与巨噬细胞百分比无明显相关性。结论 IPF患者BALF和血清中KL-6、IGFBP-4水平均增高,且与患者的肺功能相关,KL-6、IGFBP-4之间呈现正相关关系,可作为IPF患者病情监测及疗效判断的评价指标。Objective To investigate the expression and significance of salivary liquefied sugar chain protein 6（ KL-6） and insulin-like growth factor binding protein 4（ IGFBP-4） in idiopathic pulmonary fibrosis（ IPF） patients.Methods 37 cases of IPF were selected in our hospital from January 2012 to December 2015 as the IPF group,19 cases of pulmonary sarcoidosis were taken as the control group. The levels of IGFBP-4 and KL-6 in bronchoalveolar lavage fluid and serum were detected by enzyme-linked immunosorbent assay. The difference of pulmonary function and cytological count,and the correlation of KL-6 and IGFBP-4 with pulmonary function were analyzed. Results The percentage of macrophages in BALF was significantly higher,and lymphocyte percentage was significantly lower in the IPF group than in the control group（ P〈0. 05）. The levels of KL-6 and IGFBP-4 in BALF and the level of KL-6 in serum were significantly higher in the IPF group than in the control group（ P〈0. 05）,but the level of IGFBP-4 in serum had no significant difference（ P〈0. 05）. The level of KL-6 in BALF was negatively correlated with FVC% and DLCO%pred in the IPF group（ r =-0. 426,P〈0. 05; r =-0. 541,P〈0. 05）. The level of IGFBP4 in BALF was negatively correlated with FEV_1% and FVC% in the IPF group（ r =-0. 549,P〈0. 05; r =-0. 517,P〈0. 05）. The level of IGFBP4 in serum was positively correlated with FEV_1% in the IPF group（ r = 0. 461 P〈0. 05）. There was no significant correlation between the levels of KL-6 and IGFBP-4 in serum and BALF and the percentage of macrophages. Conclusion The levels of KL-6 and BALF in serum and BALF increase in IPF patients,and they are positively correlated with pulmonary function,which can be used as a clinical diagnosis index for disease monitoring and severity evaluation.

关 键 词：涎液化糖链蛋白 胰岛素样生长因子结合蛋白 特发性肺纤维化 

分 类 号：R563[医药卫生—呼吸系统]