血清白介素-6、血管内皮细胞黏附分子1、E-选择素在慢性阻塞性肺疾病合并侵袭性肺曲霉病中的表达及意义  

Expression and significance of serum IL-6,VCAM-1 and E-Selectin in COPD patients with invasive pulmonary aspergillosis

作　　者：韩俊垒[1] 边红芝[1] 胡建平[1] HAN Junlei;BIAN Hongzhi;HU Jianping(Department of Respiratory and Critical Care Medicine,Henan Chest Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]河南省胸科医院呼吸与危重症医学科,河南郑州450000

出　　处：《安徽医药》2022年第5期946-950,共5页Anhui Medical and Pharmaceutical Journal

基　　金：河南省医学科技攻关计划联合共建项目(2018020549)。

摘　　要：目的探究慢性阻塞性肺疾病(COPD)合并侵袭性肺曲霉病(IPA)病人血清白介素-6(IL-6)、血管内皮细胞黏附分子1(VCAM-1)、E-选择素(E-Selectin)表达水平及与半乳甘露聚糖(GM)值的相关性。方法选取2017年1月至2019年1月河南省胸科医院收治的COPD病人136例,根据其是否合并IPA分为COPD合并IPA组47例,COPD未合并IPA组89例。采用酶联免疫吸附(ELISA)法检测血清中IL-6、VCAM-1、E-Selectin水平及GM抗原。采用Pearson法分析COPD合并IPA病人血清IL-6、VCAM-1、E-Selectin表达水平与GM值相关性;采用logistic回归模型分析COPD合并IPA发生的影响因素;采用受试者工作特征曲线(ROC)分析血清IL-6、VCAM-1、E-Selectin水平及GM值对COPD合并IPA的诊断价值。结果COPD合并IPA组病人血清IL-6[(59.57±16.43)ng/L比(6.31±2.05)ng/L]、VCAM-1[(716.93±232.09)μg/L比(364.28±156.41)μg/L]、E-Selectin表达水平[(76.52±24.05)μg/L比(41.34±15.36)μg/L]及GM值[(0.92±0.19)比(0.37±0.15)]均明显高于COPD未合并IPA组(P<0.05)。COPD合并IPA病人血清IL-6、VCAM-1、E-Selectin表达水平与GM值均呈正相关(P<0.05)。血清IL-6、VCAM-1、E-Selectin、GM值高水平均是COPD合并IPA发生的危险因素(P<0.05)。血清E-Selectin表达水平对COPD合并IPA发生诊断的曲线下面积、灵敏度、特异度均为最高。结论COPD合并IPA病人血清IL-6、VCAM-1、E-Selectin表达水平明显升高,与GM值均呈正相关,可能作为生物标志物,用于评估COPD合并IPA发生。Objective To investigate the expression levels of serum interleukin-6(IL-6),vascular endothelial cell adhesion mole⁃cule-1(VCAM-1),E-Selectin and their correlation with galactomannan(GM)value in patients with chronic obstructive pulmonary dis⁃ease(COPD)and invasive pulmonary aspergillosis(IPA).Methods One hundred and thirty-six patients with COPD who admitted to Henan Chest Hospital from January 2017 to January 2019 were selected and assigned into COPD combined with IPA group(47 cases)and COPD without IPA group(89 cases)according to whether they were combined with IPA.The levels of serum IL-6,VCAM-1,E-Se⁃lectin and GM antigen were detected by enzyme linked immunosorbent assay(ELISA).Pearson's method was used to analyze the corre⁃lation between serum IL-6,VCAM-1,E-Selectin levels and GM value in COPD patients with IPA.Logistic regression model was used to analyze the influencing factors of COPD combined with IPA,and receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of serum IL-6,VCAM-1,E-Selectin and GM value in COPD with IPA.Results The levels of serum IL-6[(59.57±16.43)ng/L vs.(6.31±2.05)ng/L],VCAM-1[(716.93±232.09)μg/L vs.(364.28±156.41)μg/L],E-Selectin[(76.52±24.05)μg/L vs.(41.34±15.36)μg/L]and GM value[(0.92±0.19)vs.(0.37±0.15)]in COPD combined with IPA group were significantly higher than those in COPD without IPA group(P<0.05).The levels of serum IL-6,VCAM-1 and E-Selectin were positively correlated with GM val⁃ue in COPD patients with IPA(P<0.05).The high levels of serum IL-6,VCAM-1,E-Selectin and GM value were the risk factors of COPD complicated with IPA(P<0.05).The area under the curve,sensitivity and specificity of serum E-Selectin expression were the highest in the diagnosis of COPD complicated with IPA.Conclusions The levels of IL-6,VCAM-1 and E-Selectin in patients with COPD complicated with IPA are significantly increased.They are positively correlated with GM value,and may be used as biomarkers to evaluate the occurrence of COPD complicated

关 键 词：肺疾病 慢性阻塞性 侵袭性肺曲霉病 白介素-6 血管内皮细胞黏附分子1 E-选择素 半乳甘露聚糖 相关性 

分 类 号：R563.9[医药卫生—呼吸系统] R519[医药卫生—内科学]