肺源性哮喘与心源性哮喘患者血清N末端脑钠肽前体和胱抑素C及克拉拉细胞蛋白16表达变化  

Changes of serum N-terminal pro-brain natriuretic peptide, cystatin C and Clara cell protein 16 in patients with pulmonary asthma and cardiogenic asthma

作　　者：霍凤玲 徐莉娜 杨亚敏 HUO Fengling;XU Lina;YANG Yamin(Department of Pulmonary Medicine,Kaifeng People’s Hospital,Kaifeng 475000,China)

机构地区：[1]开封市人民医院呼吸科,河南开封475000

出　　处：《中华实用诊断与治疗杂志》2020年第7期714-717,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省医学科技攻关计划项目(201806313)。

摘　　要：目的探讨血清N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide, NT-proBNP)、胱抑素C(cystatin C, CysC)、克拉拉细胞蛋白16(Clara cell protein 16, CC16)在肺源性哮喘(pulmonary asthma, PA)、心源性哮喘(cardiac asthma, CA)患者中的表达变化及临床意义。方法 PA患者98例为PA组(轻度29例、中度48例、重度21例),CA患者101例为CA组(轻度28例、中度50例、重度23例),同期体检健康者70例为对照组。采用ELISA法测定3组血清CysC水平,电化学发光法检测NT-proBNP水平,双抗体夹心法检测CC16水平;比较3组及不同病情严重程度PA、CA患者血清NT-proBNP、CysC及CC16水平差异;ROC曲线分析血清NT-proBNP、CysC及CC16诊断PA的效能。结果PA组、CA组血清NT-proBNP[(201.82±12.39)、(1 092.81±55.92)ng/L]、CysC[(1.75±0.41)、(2.01±0.57)mg/L]水平均高于对照组[(108.28±76.29)ng/L、(0.76±0.33)mg/L],CC16[(7.82±1.01)、(6.77±1.00)μg/L]水平均低于对照组[(43.39±12.10)μg/L](P<0.05);PA组血清NT-proBNP、CysC水平低于CA组,CC16水平高于CA组(P<0.05)。PA组轻、中、重度患者血清NT-proBNP[(178.89±18.82)、(202.38±17.71)、(232.21±18.69)ng/L]、CysC[(1.51±0.32)、(1.72±0.35)、(2.15±0.30)mg/L]水平均依次升高,CC16[(8.82±1.00)、(7.73±1.03)、(6.64±0.99)μg/L]水平依次降低(P<0.05);CA组轻、中、重度患者血清NT-proBNP[(824.63±49.20)、(1 093.57±53.39)、(1 257.34±71.25)ng/L]、CysC[(1.82±0.49)、(2.03±0.52)、(2.39±0.60)mg/L]水平均依次升高,CC16[(7.69±0.92)、(6.81±1.04)、(5.97±0.86)μg/L]水平依次降低(P<0.05);PA组轻、中、重度患者血清NT-proBNP、CysC水平低于CA组轻、中、重度患者,CC16水平高于CA组轻、中、重度患者(P<0.05)。ROC曲线分析结果显示,血清NT-proBNP、CysC及CC16分别以336.03 ng/L、2.05 mg/L、7.36μg/L为最佳截断值,诊断PA的AUC分别为0.900(95%CI:0.827~0.973,P<0.001)、0.700(95%CI:0.596~0.804,P=0.001)和0.772(95%CI:0.677~0.866,P<0.001)。结论 NT-proBNP、CysC及CC16均可Objective To investigate the expressions and clinical significances of serum N-terminal pro-brain natriuretic peptide(NT-proBNP),cystatin C(CysC)and Clara cell protein 16(CC16)in patients with pulmonary asthma(PA)and cardiogenic asthma(CA).Methods The levels of CysC,NT-proBNP and CC16 were detected by ELISA method,electrochemiluminescence method and double antibody sandwich method,respectively,in 98 patients with PA(PA group)including 29 mild,48 moderate and 21 severe PA patients,101 patients with CA(CA group)including 28 mild,50 moderate and 23 severe CA patients,and 70 healthy volunteers(control group).The levels of serum NT-proBNP,CysC and CC16 were compared among three groups as well as in PA and CA groups with different severity of diseases.ROC curve was used to analyze the efficacies of serum NT-proBNP,CysC and CC16 on the diagnosis of PA.Results The levels of NT-proBNP and CysC were higher in PA group((201.82±12.39)ng/L,(1.75±0.41)mg/L)and CA group((1092.81±55.92)ng/L,(2.01±0.57)mg/L)than those in control group((108.28±76.29)ng/L,(0.76±0.33)mg/L)(P<0.05),and the level of CC16 was lower in PA group((7.82±1.01)μg/L)and CA group((6.77±1.00)μg/L)than that in control group((43.39±12.10)μg/L)(P<0.05).The levels of NT-proBNP and CysC were lower in PA group than those in CA group(P<0.05),and the level of CC16 was higher in PA group than that in CA group(P<0.05).The levels of NT-proBNP((178.89±18.82),(202.38±17.71),(232.21±18.69)ng/L)and CysC((1.51±0.32),(1.72±0.35),(2.15±0.30)mg/L)increased gradually,and the level of CC16((8.82±1.00),(7.73±1.03),(6.64±0.99)μg/L)decreased gradually in turn in mild,moderate and severe PA patients(P<0.05).The levels of NT-proBNP((824.63±49.20),(1093.57±53.39),(1257.34±71.25)ng/L)and CysC((1.82±0.49),(2.03±0.52),(2.39±0.60)mg/L)increased gradually,and the level of CC16((7.69±0.92),(6.81±1.04),(5.97±0.86)μg/L)decreased gradually in turn in mild,moderate and severe CA patients(P<0.05).The levels of NT-ProBNP and CysC in mild,moderate and severe PA patient

关 键 词：肺源性哮喘 心源性哮喘 N末端脑钠肽前体 胱抑素C 克拉拉细胞蛋白16 

分 类 号：R562.25[医药卫生—呼吸系统]