血浆组织蛋白酶S和胱抑素C作为慢阻肺急性加重的潜在生物标志物的临床研究  

Clinical study of plasma cathepsin S and cystatin C as potential biomarkers for acute exacerbation of COPD

作　　者：徐辉[1] 蔡宇星 陈凯[1] 张春峰[1] 张和平[1] XU Hui;CAI Yu-xing;CHEN Kai;ZHANG Chun-feng;ZHANG He-ping(Department of Respiratory Medicine,Baoji Central Hospital,Baoji,Shaanxi 721006,China)

机构地区：[1]宝鸡市中心医院呼吸内科,陕西宝鸡721006

出　　处：《临床肺科杂志》2018年第4期678-681,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的分析慢性阻塞性肺疾病(慢阻肺)患者血浆组织蛋白酶S和胱抑素C的表达水平,探讨其与慢阻肺的关系以及对慢阻肺患者气流受限的影响。方法选择2013年1月-2014年12月我院收治的因慢性阻塞性肺疾病(慢阻肺)住院治疗患者150例,作为研究组;选择同期在我院体检中心进行健康体检的136名健康人群作为对照组。检测研究对象血浆组织蛋白酶S和胱抑素C水平。记录研究对象年龄、性别、BMI、吸烟饮酒史、伴随疾病(糖尿病、高血压、脑血管疾病等)以及用吸入性糖皮质激素治疗情况,血肌酐水平,肺功能检测指标等。结果研究组患者血浆组织蛋白酶S、胱抑素C和组织蛋白酶S/胱抑素C均显著高于对照组(P<0.05)。血浆组织蛋白酶S、胱抑素C、组织蛋白酶S/胱抑素C作为慢阻肺生物学标志的ROC曲线如图1所示。三者的曲线下面积分别为0.938,0.974,0.755。多因素Logistic回归分析结果显示高龄,男性,吸烟,慢性病程超过10年,血浆组织蛋白酶S、血清胱抑素C和血浆组织蛋白酶S/胱抑素C均是影响患者严重气流受限的危险因素,而吸入性糖皮质激素治疗则是影响患者严重气流受限的保护因素。结论血浆组织蛋白酶S和血清胱抑素C可以作为慢阻肺急性加重的潜在生物标志物。Objective To analyze the expression of cathepsin S and cystatin C in patients with chronic obstructive pulmonary disease(COPD),and to investigate their relationship with COPD and influence on airflow limitation of COPD patients.Methods It selected 150 patients from January 2013 to December 2014 as the study group and 136 healthy subjects at the same period as the control group.Their serum cathepsin S and cystatin C levels were measured.We also recorded their age and sex,BMI,smoking and drinking history,accompanying diseases(diabetes,hypertension,cerebrovascular disease,etc.)and the use of inhaled corticosteroids,serum creatinine level,and pulmonary function tests etc.Results The serum levels of cathepsin S,Cystatin C and cathepsin S/Cystatin C were significantly higher in the study group than in the control group(P<0.05).ROC curve suggested that the plasma cathepsin S,Cystatin C,cathepsin S/Cystatin C may serve as biological markers for COPD,as shown in figure 1.The area under the curve of the three was 0.938,0.974,0.755,respectively.Logistic regression analysis showed that the risk factors of COPD patients with severe airflow limitation included age,male,smoking,chronic disease for more than 10 years,plasma cathepsin S,plasma cystatin C and cathepsin S/cystatin C,and the protective factor was inhaled corticosteroid therapy for COPD patients with severe airflow limitation.Conclusion Plasma cathepsin S and serum cystatin C can be as potential biomarkers for acute exacerbation of COPD.

关 键 词：慢性阻塞性肺疾病 组织蛋白酶S 胱抑素C 气流受限 

分 类 号：R563.9[医药卫生—呼吸系统]