外周血胶原和弹力蛋白转化的生物标志物水平预测慢性阻塞性肺疾病急性加重风险的意义  

Significance of biomarker levels of peripheral blood collagen and elastin transformation in predicting risk of acute exacerbation of chronic obstructive pulmonary disease

作　　者：汪群智[1] 盛美玲[1] 宋昱晨[1] WANG Qunzhi;SHENG Meiling;SONG Yuchen(Department of Respiratory Medicine,Jinhua People′s Hospital in Zhejiang Province,Jinhua 321000,China)

机构地区：[1]浙江省金华市人民医院呼吸内科,浙江金华321000

出　　处：《中国现代医生》2022年第3期4-8,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2019KY746);浙江省公益技术应用研究计划项目(LGF19H010004);浙江省金华市科技计划项目(2019-4-028,2018-3-022)。

摘　　要：目的评估外周血胶原和弹力蛋白转化的生物标志物水平对预测慢性阻塞性肺疾病患者病情急性加重风险的意义,为临床早期识别、干预高危患者提供依据。方法选取2019年1—4月在浙江省金华市人民医院就诊的稳定期慢阻肺患者183例作为研究对象,检测其外周血胶原和弹力蛋白转化的生物标志物C3M、C6M、Pro-C3、Pro-C6和EL-NE水平,对所有患者随访12个月,统计所有患者随访期间的急性加重发生率及死亡情况等。采用ROC曲线评估相关指标预测慢性阻塞性肺疾病急性加重风险的最佳阈值以及相应敏感度和特异度。结果慢性阻塞性肺疾病急性加重组患者外周血C3M、C6M、Pro-C3、Pro-C6水平明显高于非急性加重组(P<0.001),两组血EL-NE水平比较,差异无统计学意义(P>0.05)。急性加重组患者1年内死亡率高于非急性加重组(P<0.05)。血Pro-C3水平预测慢性阻塞性肺疾病急性加重风险的ROC曲线下面积为0.873(95%CI:0.818~0.927),最佳截断值11.53 ng/ml时敏感度为75.0%,特异度为88.3%,Youden指数为0.63。血Pro-C6水平预测慢性阻塞性肺疾病急性加重风险的ROC曲线下面积为0.906(95%CI:0.857~0.952),最佳截断值8.15 ng/L时敏感度为85.0%,特异度为81.6%,Youden指数为0.67。而血C3M、C6M、EL-NE水平预测慢性阻塞性肺疾病急性加重风险的敏感度和特异度较低。结论外周血Pro-C3、Pro-C6水平可以作为稳定期慢性阻塞性肺疾病患者急性加重风险预测的生物学指标。Objective To evaluate the significance of biomarker levels of peripheral blood collagen and elastin transformation in predicting the risk of acute exacerbation in patients with chronic obstructive pulmonary disease(COPD),and to provide evidence for early clinical identification and intervention of high-risk patients.Methods A total of 183 patients with stable chronic obstructive pulmonary disease treated in Jinhua People′s Hospital in Zhejiang Province from January 2019 to April 2019 were selected.The levels of peripheral blood collagen and elastin biomarkers,including C3M,C6M,Pro-C3,Pro-C6 and EL-NE were assessed.All patients were followed up for 12 months to analyze the incidence of acute exacerbations and deaths during follow-up.The ROC curve was used to evaluate the optimal threshold and corresponding sensitivity and specificity for predicting the risk of acute exacerbation of chronic obstructive pulmonary disease.Results The levels of peripheral blood C3M,C6M,Pro-C3,and Pro-C6 in the acute exacerbation group were significantly higher than those in the non-acute exacerbation group(P<0.001).There was no significant difference in blood EL-NE level between the two groups(P>0.05).The 1-year mortality rate in the acute exacerbation group was higher than that in the non-acute exacerbation group(P<0.05).The area under the ROC curve for the blood Pro-C3 level for predicting the risk of acute exacerbation of COPD was 0.873(95%CI:0.818-0.927),best cut-off value was 11.53 ng/ml,sensitivity was 75.0%,specificity was 88.3%,and Youden index was 0.63.The area under the ROC curve for the blood Pro-C6 level for predicting the risk of acute exacerbation of COPD was 0.906(95%CI:0.857-0.952),best cut-off value was 8.15 ng/L,sensitivity was 85.0%,specificity was 81.6%,and Youden index was 0.67.The blood C3M,C6M,and EL-NE levels have low sensitivity and specificity in predicting the risk of acute exacerbation of COPD.Conclusion The levels of peripheral blood Pro-C3 and Pro-C6 can be used as biological indicators for predicting t

关 键 词：胶原和弹力蛋白 生物标志物 慢性阻塞性肺疾病 急性加重风险 

分 类 号：R563[医药卫生—呼吸系统]