利用可溶性尿激酶型纤溶酶原激活物受体及纤维蛋白原表达水平评估慢性阻塞性肺疾病病情程度的临床意义  

Clinical significance of expression levels of soluble urokinase-type plasminogen activator receptor and fibrinogen in the assessment of the severity of chronic obstructive pulmonary disease

作　　者：张友兰[1] 黎伟[1] 罗麟洁 杨利萍[1] 刘霞[1] 赵春燕 郭删 余芋鹃 唐凤鸣[1] ZHANG You-Lan;LI Wei;LUO Lin-jie;YANG Li-ping;LIU Xia;ZHAO Chun-yan;GUO Shan;YU Yu-juan;TANG Feng-ming(Department of Respiratory and Critical Care Medicine, Wenjiang District People’ s Hospital, Chengdu 611130, China)

机构地区：[1]成都市温江区人民医院呼吸与危重症医学科,四川成都611130

出　　处：《实用医院临床杂志》2022年第4期75-78,共4页Practical Journal of Clinical Medicine

基　　金：四川省医学会科研基金资助项目(编号:S18046)。

摘　　要：目的分析慢性阻塞性肺疾病(COPD)患者外周血中可溶性尿激酶型纤溶酶原激活物受体(suPAR)及纤维蛋白原(Fg)表达水平及其评估病情程度的临床意义。方法我院就诊的147例COPD患者,根据症状体征和辅助检查结果分为稳定期COPD组(sCOPD)109例和急性加重期COPD组(AECOPD)38例,选取同期体检健康人群104例为对照组,三组均于入组第1 d完成肺功能、影像学及实验室检查,分析血清suPAR和Fg表达水平与功能指标的相关性及其对COPD病情严重程度的鉴别诊断价值。结果AECOPD组和sCOPD组第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)%、FEV_(1)/FVC均较对照组降低,且AECOPD组各项指标低于sCOPD组(P<0.05);血清suPAR、Fg水平均较对照组升高,且AECOPD组血清suPAR和Fg水平高于sCOPD组(P<0.05);COPD患者血清suPAR和Fg水平与FEV_(1)%和FEV_(1)/FVC均呈负相关(P<0.05);血清suPAR、Fg及两者联合诊断COPD病情严重程度的AUC分别为0.862、0.810和0.930,敏感度分别为84.21%、73.68%和94.74%,特异度分别为76.15%、81.65%和76.15%。结论COPD患者血清suPAR和Fg水平明显升高,且与肺功能存在相关性,两者联合用于AECOPD和sCOPD鉴别诊断具有良好参考价值。Objective To analyze the expression levels of soluble urokinase-type plasminogen activator receptor(suPAR)and fibrinogen(Fg)in peripheral blood of patients with chronic obstructive pulmonary disease(COPD)and their clinical significance in the evaluation of the disease severity.Methods One hundred and forty-seven patients with COPD treated in our hospital were divided into a stable COPD(sCOPD)group(n=109)and an acute exacerbation COPD(AECOPD)group(n=38)according to the symptoms and signs and the auxiliary examination results.In addition,104 healthy people who underwent physical examination during the same period were enrolled as a control group.All three groups completed the pulmonary function,imaging and laboratory examinations on the 1st day of enrollment.The correlation between the expression levels of serum suPAR and Fg and the functional indicators was analyzed.Their differential diagnostic value for COPD severity was also evaluated.Results The forced expiratory volume in 1 second(FEV_(1)),forced vital capacity(FVC),percentage of expected value of FEV_(1)(FEV_(1)%)and FEV_(1)/FVC in the AECOPD group and sCOPD group were reduced when compared with those in the control group,and the indicators in the AECOPD group were lower than those in the sCOPD group(P<0.05).The levels of serum suPAR and serum Fg in the COPD patients were enhanced when compared to the control group,and the levels of serum suPAR and Fg were higher in the AECOPD group than those in the sCOPD group(P<0.05).Serum suPAR and Fg levels in patients with COPD were negatively correlated with FEV_(1)%and FEV_(1)/FVC(P<0.05).The areas under curve(AUCs)of serum suPAR,Fg and their combination in the diagnosis of the severity of COPD were 0.862,0.810 and 0.930,respectively.The sensitivities were 84.21%,73.68%and 94.74%and the specificities were 76.15%,81.65%and 76.15%,respectively.Conclusion The levels of serum suPAR and Fg in patients with COPD are significantly increased,and the indicators are correlated with pulmonary function.The combination of the two

关 键 词：慢性阻塞性肺疾病 急性加重期 可溶性尿激酶型纤溶酶原激活物受体 纤维蛋白原 肺功能 

分 类 号：R563[医药卫生—呼吸系统]