特发性肺纤维化预后标志物的研究进展  

Prognostic Biomarkers in Idiopathic Pulmonary Fibrosis:a Recent Review

作　　者：徐莉莉 洪赟晢 李智慧 于宁霞 邸家琪 杨曙光 林青青 余学庆[2,3] XU Lili;HONG Yunzhe;LI Zhihui;YU Ningxia;DI Jiaqi;YANG Shuguang;LIN Qingqing;YU Xueqing(The First Clinical Medical College,Henan University of Chinese Medicine,Zhengzhou 450046,China;Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases co-constructed by Henan Province&Education Ministry of P.R.China,Henan University of Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学第一临床医学院,河南省郑州市450046 [2]河南中医药大学第一附属医院呼吸与危重症医学科,河南省郑州市450000 [3]河南中医药大学呼吸疾病中医药防治省部共建协同创新中心,河南省郑州市450046

出　　处：《中国全科医学》2023年第3期372-379,共8页Chinese General Practice

基　　金：国家自然科学基金面上项目(82174307,81973779);河南省首批中医药拔尖人才培养项目(2019ZYBJ02)。

摘　　要：特发性肺纤维化(IPF)是一种纤维化型间质性肺疾病,该疾病进展快、预后差、中位生存期短,严重危害患者健康。在病程早期准确评估IPF患者预后,有助于加强疾病管理、改善患者结局,因此IPF的预后评估是该病诊疗的重要一环。近年来与IPF预后相关的标志物不断涌现,良好的预后标志物能够协助判断IPF患者的危险分层与结局。因此本文从蛋白、基因、微生物菌落、细胞等方面总结了既往研究中发现的IPF可能的预后标志物,提示基质蛋白酶7(MMP-7)、端粒长度(TL)和纤维细胞是较为可靠的IPF预后标志物。涎液化糖链抗原6(KL-6)、表面活性蛋白A(SP-A)、MUC5B基因启动子单核苷酸多态性(SNP)等生物标志物的预后价值存在争议,有待进一步研究。潜在转化生长因子结合蛋白2(LTBP-2)、血管生成素2(Ang-2)、TOLLIP启动子SNP、微生物菌落等预后标志物的研究相对较少,预后作用有待验证。本文能够为临床早期识别高危患者、及时把握干预时机提供更加客观的指标,为今后IPF的预后研究提供参考。Idiopathic pulmonary fibrosis(IPF)is a fibrotic interstitial lung disease characterized by rapid progression,poor prognosis,and short median survival,seriously endangering patients'health.Early accurate prediction of the prognosis is an important part of the diagnosis and management process of IPF,which is conducive to the improvement of management and prognosis in IPF.A growing number of prognostic biomarkers for IPF have been discovered recently,and those with a high prognostic value could help to stratify prognostic risks and assess outcomes.We reviewed the latest literature about potential prognostic biomarkers of IPF,involving proteins,genes,microbial colonies and cells,and considered matrix metalloproteinase-7,telomere length and fibrocytes to be more reliable,while the prognostic values of Krebs von den lungen-6,surfactant protein A,and MUC5B promoter single nucleotide polymorphism are controversial and need to be further studied,and those of latent-transforming growth factorβ-binding protein-2,angiopoietin-2,TOLLIP promoter SNP and microbial colony remain to be verified due to little evidence.It is hoped that our review could provide a reference for clinical selection of objective indicators for early identifying high-risk patients and timely initiating treatment,as well as future prognostic research on IPF.

关 键 词：特发性肺纤维化 肺纤维化 肺疾病 间质性 生物标记 端粒 预后 综述 研究进展 

分 类 号：R563.9[医药卫生—呼吸系统]