低剂量呼气相CT联合外周血特异性标志物的表达对肺小气道病变的临床诊断研究  

Study on the clinical diagnosis of low-dose expiratory CT combined with the expression peripheral bloodspecific markers on small airway lesions of lung

作　　者：冯光[1] 杨灵芝 郑浩[3] 王新举[1] 刘树芳[1] FENG Guang;YANG Ling-zhi;ZHENG Hao(Department of Radiology,Hebei Province Thoracic Hospital,Shijiazhuang 050041,China)

机构地区：[1]河北省胸科医院放射科,河北石家庄050041 [2]河北省直属机关第一门诊部,河北石家庄050000 [3]河北省胸科医院功能科,河北石家庄050041

出　　处：《中国医学装备》2020年第2期45-48,共4页China Medical Equipment

基　　金：河北省医学科学研究重点课题计划(20130132)“低剂量呼气相CT评价肺小气道病变的价值”

摘　　要：目的:研究低剂量呼气相CT联合外周血特异性标志物的表达对肺小气道病变的临床诊断效果。方法:选取在医院就诊的90例肺小气道病变患者,将其纳入观察组,同期另选90名健康体检者,将其纳入健康对照组。采用Western blot法检测两组外周血单核细胞(PBMCs)中核苷酸结合寡聚化结构域(NOD)样受体热蛋白结构域相关蛋白3(NLRP3)和沉默信息调节因子2相关酶1(Sirt-1)的表达,采用酶联免疫吸附(ELISA)法测定两组血清中白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)及转化生长因子β1(TGF-β1)的含量。根据低剂量CT特征将观察组患者再分有无磨玻璃样密度影组、有无空气潴留组和有无小叶中心肺气肿组,分别测定其外周血特异性标志物的表达水平,并分析其表达与低剂量CT特征的相关性,推断二者联合对肺小气道病变的临床诊断效果。结果:PBMCs中NLRP3、Sirt-1蛋白及血清中IL-8、TNF-α和TGF-t-β1在观察组中表达水平显著高于健康对照组,差异有统计学意义(t=4.186,t=7.122,t=24.279,t=43.318,t=37.346;P<0.05)。观察组再分组后有无磨玻璃样密度影、有无空气潴留、有无小叶中心肺气肿等组间的外周血特异性标志物水平,差异均有统计学意义(tIL-8=43.146,t=40.624,t=60.734;tTNF-α=37.938,t=50.031,t=76.728;tTGF-β1=56.721,t=37.230,t=64.944;P<0.05)。经Pearson相关分析显示,磨玻璃样密度影、空气潴留、小叶中心肺气肿等低剂量CT特征与NLRP3、Sirt-1、IL-8、TNF-α和TGF-β1表达水平均呈显著正相关(r均>0.08,P<0.05)。结论:将低剂量CT特征与特异性标记物表达联合,可提高肺小气道病变的临床诊断效果。Objective:To study the clinically diagnostic effect of low-dose expiratory CT combined with the expression peripheral blood-specific markers on small airway lesions of lung.Methods:90 patients with small airway lesions who received diagnosis in hospital were selected and were divided into observation group,and 90 healthy subjects who received physical examination were selected and were divided into control group.Western blotting(WB)was used to detect the expressions of nucleotide binding oligomerization domain(NOD)-like receptor pyrin domain containing 3(NLRP3)and silent information regulator factor 2 related enzyme 1(Sirt-1)in peripheral blood mononuclear cells(PBMCs).The serum concentrations of IL-8,TNF-αand TGF of two groups were determined by enzyme-linked immunosorbent assay(ELISA).The patients of observation group were subdivided into ground glass density shadow group and non-ground glass density shadow group,air retention group and non-air retention group,centrilobular emphysema group and non-centrilobular emphysema group according to low-dose CT characteristics.The expression levels of peripheral blood-specific markers were measured respectively.And the correlation between the expression of these markers and the characteristics of low-dose CT was analyzed.And then,the clinically diagnostic effect of the combination of the two methods on small airway lesion of lung was further deduced.Results:The expression levels of NLRP3,Sirt-1 protein of PBMCs and serum IL-8,TNF-αand TGF-β1 of observation group were significantly higher than those of control group(t=4.186,t=7.122,t=24.279,t=43.318,t=37.346,P<0.05).The differences of the expression levels of peripheral blood-specific markers between ground glass density shadow group and non-ground glass density shadow group,and between air retention group and non-air retention group,and between centrilobular emphysema group and non-centrilobular emphysema group were significant(tIL-8=43.146,t=40.624,t=60.734,tTNF-α=37.938,t=50.031,t=76.728,tTGF-β1=56.721,t=37.230,t=

关 键 词：低剂量呼气相CT 外周血特异性标志物 肺小气道病变 临床诊断 

分 类 号：R816.4[医药卫生—放射医学]