支气管肺泡灌洗液中CCL2水平对特发性肺纤维化患者预后的判断价值  

Prognostic value of CCL2 level in bronchoalveolar lavage fluid of patients with idiopathic pulmonary fibrosis

作　　者：王学 伊晴 刘小琴 张英为 周玉皆[1] WANG Xue;YI Qing;LIU Xiaoqin;ZHANG Yingwei;ZHOU Yujie(Department of Respiratory and Critical Care Medicine,Gulou Clinical Medical College,Nanjing University of Traditional Chinese Medicine,Nanjing 210008,China)

机构地区：[1]南京中医药大学鼓楼临床医学院呼吸与危重症医学科,江苏南京210008

出　　处：《南京医科大学学报（自然科学版）》2022年第9期1271-1278,共8页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金(81570055)。

摘　　要：目的:探究在临床实践中支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)中趋化因子CCL2[chemokine(C-C motif)ligand 2]和性别-年龄-生理学指标(gender-age-physiological index,GAP)评分对特发性肺纤维化(idiopathic pulmonary fibrosis,IPF)预后的判断价值以及两者之间的相关性。方法:回顾性分析了2017年1月—2019年12月在南京鼓楼医院住院确诊为IPF的患者35例,同期收集了因慢性咳嗽(chronic cough,CC)就诊、但无其他肺部疾病或其他器官疾病的门诊患者10例。比较两组患者的性别、年龄、用力肺活量占预计值百分比(percentage of predicted forced vital capacity,FVC%)、一氧化碳弥散量占预计值百分比(percentage of predicted diffusing capacity for carbon monoxide,DLCO%)(CC组除外)、血气分析等指标的差异,同时检测血清和BALF中CCL2的水平,分析不同GAP组间CCL2水平、生存时间的差异以及CCL2与GAP评分之间的相关性。结果:与CC组相比,IPF组血清和BALF中CCL2均升高。IPF组(Ⅰ、Ⅱ、Ⅲ期)与CC组4组间比较显示,氧合指数、FVC%、血清和BALF中CCL2水平差异均有统计学意义,IPF组(Ⅰ、Ⅱ、Ⅲ期)3组间比较显示DLCO%有差异。相关性方面,BALF中CCL2与FVC%、DLCO%均呈负相关,与GAP评分呈正相关。IPF组(Ⅰ、Ⅱ、Ⅲ期)3组间生存时间有差异。结论:本研究结果不仅验证了BALF中CCL2和GAP评分对预测IPF预后的价值,同时首次揭示了不同GAP分期患者BALF中CCL2水平具有差异性,且BALF中CCL2与GAP评分具有相关性。Objective:This study aims to explore the prognostic value of chemokine CCL2(C-C motif)in bronchoalveolar lavage fluid(BALF)and gender-age-physiological index(GAP)scores for idiopathic pulmonary fibrosis(IPF)in clinical practice and the correlation between them.Methods:Total 35 patients with IPF hospitalized in Nanjing Gulou Hospital from January 2017 to December 2019 were analyzed retrospectively.In the same period,10 outpatients with chronic cough(CC)but no other lung diseases or other organ diseases were collected.The differences of gender,age,percentage of predicted forced vital capacity(FVC%),percentage of predicted diffusing capacity for carbon monoxide(DLCO%)(except CC group),blood gas analysis and other indicators between the two groups were compared.At the same time,the level of CCL2 in serum and BALF was detected,and the differences of CCL2 level and survival time between different GAP groups and the correlation between CCL2 and GAP score were analyzed.Results:Compared with CC group,CCL2 in serum and BALF increased in IPF group.The comparison between IPF group(phaseⅠ,ⅡandⅢ)and CC group showed that there were differences in oxygenation index,FVC%,CCL2 level in serum and BALF,and there were significant differences in DLCO%among IPF group(phaseⅠ,ⅡandⅢ).In terms of correlation,CCL2 in BALF was negatively correlated with FVC%or DLCO%,and positively correlated with GAP score.The survival time of IPF group(stageⅠ,ⅡandⅢ)was different among the three groups.Conclusion:It is further verified in this stndy that CCL2 and GAP scores in BALF can predict the prognosis of IPF.At the same time,it is the first time to explore the differences of CCL2 level in BALF in different GAP stages,and there is a correlation between CCL2 and GAP scores in BALF.

关 键 词：特发性肺纤维化 支气管肺泡灌洗液 趋化因子CCL2 

分 类 号：R563.13[医药卫生—呼吸系统]