血浆NGAL对哮喘慢阻肺重叠的诊断价值研究  

Diagnostic value of plasma neutrophil gelatinase-associated lipocalin in patients with asthma-COPD overlap

作　　者：吕化杰 王静[1] 罗壮[2] 邓世英[3] 江德鹏[1] 蒋幼凡[1] Lü Huajie;Wang Jing;Luo Zhuang;Deng Shiying;Jiang Depeng;Jiang Youfan(Department of Respiratory Medicine,The Second Clinical Hospital of Chongqing Medical University;Department of Respiratory Medicine,The First Clinical Hospital of Kunming Medical College;Department of Laboratory Medicine,The Second Clinical Hospital of Chongqing Medical University)

机构地区：[1]重庆医科大学附属第二医院呼吸内科,重庆400010 [2]昆明医科大学附属医院呼吸内科,昆明650032 [3]重庆医科大学附属第二医院检验科,重庆400010

出　　处：《重庆医科大学学报》2020年第2期263-267,共5页Journal of Chongqing Medical University

基　　金：国家自然科学基金资助项目(编号:81650003);重庆市卫计委2016年医学科研计划资助项目(编号:2016HBRC004)。

摘　　要：目的:探讨血浆中性粒细胞明胶酶相关载脂蛋白(neutrophil gelatinase-associated lipocalin,NGAL)水平对哮喘慢阻肺重叠的诊断价值。方法:选择哮喘-慢阻肺重叠(asthma-COPD overlap,ACO)患者30例,哮喘患者35例,慢性阻塞性肺病(chromic obstructive pulmonary disease,COPD)患者60例及健康未吸烟者(对照)25例。收集受试者一般资料,完善肺功能检查,应用ELISA法检测受试者血浆NGAL水平。单因素方差分析评价血浆NGAL水平在ACO组、哮喘组、COPD组和对照组中的表达差异,分析NGAL与各混杂因素的相互关系,应用受试者操作特征曲线评价血浆NGAL水平对于区分ACO和非ACO的诊断学价值。结果:①ACO组和COPD组的血浆NGAL水平分别为(110.50±22.81)ng/mL和(127.40±27.57)ng/mL,均高于哮喘组[(85.79±20.02)ng/mL]和对照组[(86.54±23.46)ng/mL]。血浆NGAL水平在ACO组和哮喘组、ACO组和COPD组之间均有统计学差异(P=0.000,P=0.015)。②血浆NGAL水平与药后一秒钟用力呼气容积(forced expiratory volume in one second,FEV1)呈负相关(r=-0.422,P=0.000),与吸烟指数呈正相关(r=0.500,P=0.000)。③血浆NGAL水平的AUC为0.565(P=0.273)。结论:血浆NGAL对于ACO、哮喘和COPD的鉴别有一定的参考价值,可能是ACO潜在的生物标志物。Objective:To explore the diagnostic value of plasma neutrophil gelatinase-associated lipocalin(NGAL) in patients with asthma-COPD overlap(ACO). Methods:A total of 30 patients with ACO,35 patients with bronchial asthma(asthma),60 patients with chronic obstructive pulmonary disease(COPD) and 25 healthy nonsmokers(control) were enrolled in this study. Their general data were collected and their pulmonary function was completed. Levels of plasma NGAL were determined by ELISA;univariate analysis of variance was used to evaluate the expressive difference of plasma NGAL levels in the ACO group,the asthma group,the COPD group and the control group;the relationship of NGAL and confounding factors was analyzed;the receiver operating characteristic curve(ROC) was used to assess the diagnostic value of NGAL on differentiating ACO and non-ACO. Results:Plasma NGAL levels in the ACO group and the COPD group were(110.50±22.81) ng/mL and(127.40±27.57) ng/mL,respectively,which were higher than those of(85.79±20.02) ng/mL in the asthma group and(86.54±23.46) ng/mL in the control group. Plasma NGAL levels were statistically different between ACO group and asthma group(P=0.000),as well as between ACO group and COPD group(P=0.015). Plasma NGAL levels were negatively correlated with forced expiratory volume in one second(FEV1)(r=-0.422,P=0.000),and were positively correlated with smoking(r =0.500,P =0.000). The area under ROC curve(AUC) was 0.565(P =0.273). Conclusion:Plasma NGAL may have a certain value to differentiate ACO,asthma,as well as COPD,and may be a potential biomarker for ACO.

关 键 词：中性粒细胞明胶酶相关载脂蛋白 哮喘慢阻肺重叠 生物标志物 

分 类 号：R563.3[医药卫生—呼吸系统]