非严重性COPD患者血清人附睾蛋白4与左室舒张功能不全的关系研究  

Relationship between Serum Human Epididymis Protein 4 and Left Ventricular Diastolic Dysfunction in Patients with Non-severe COPD

作　　者：许郭华 付庆萍 梅馨方 成军霞 XU Guohua;FU Qingping;MEI Xinfang;CHENG Junxia(Department of Respiratory and Critical Care Medicine,Sichuan University West China Guang'an Hospital,Guang'an People's Hospital,Guang'an 638001,Sichuan,China)

机构地区：[1]四川大学华西广安医院、广安市人民医院呼吸与危重症医学科,广安市638001

出　　处：《中国分子心脏病学杂志》2022年第5期4924-4930,共7页Molecular Cardiology of China

摘　　要：目的分析非严重性慢性阻塞性肺疾病(COPD)患者血清人附睾蛋白4(HE4)表达水平与应激性左心室舒张功能不全(LVDD)的关系。方法选取2020年5月至2021年4月我院103例非严重COPD患者(支气管扩张术后第1秒用力呼气容积/用力肺活量<70%,FEV1>50%),根据心肺运动试验(CPET)后的超声心动图参数将患者分为LVDD组(n=67)及无LVDD组(n=36)。采用电化学发光免疫分析法检测血清HE4水平。结果LVDD组患者的血清HE4水平显著高于无LVDD组[162.53(92.92,326.17)pmol/L vs 90.27(63.82,138.52)pmol/L,P<0.001]。经Spearman秩相关系数和多元线性回归分析,血清HE4水平与CPET后E/e’呈正相关性(P<0.05)。经多因素logistic回归分析,血清HE4水平为COPD患者发生应激性LVDD的独立预测因子(P<0.05)。经受试者工作特征曲线分析,血清HE4水平诊断COPD患者应激性LVDD的曲线下面积为0.724(95%CI:0.628~0.820)。结论在非重度COPD劳累性呼吸困难患者中,而血清HE4水平升高可能是预测应激性LVDD的有力因子。Objective To analyze the relationship between the serum human epididymal protein 4(HE4)level and stress left ventricular diastolic dysfunction(LVDD)in patients with non-severe chronic obstructive pulmonary disease(COPD).Methods From May 2020 to April 2021,103 patients with non-severe COPD(forced expiratory volume in one second[FEV1]/forced vital capacity[FVC]<70%,FEV1>50%after bronchiectasis)in our hospital were selected and divided into LVDD group(n=67)and non-LVDD group(n=36)according to echocardiography parameters after cardio-pulmonary exercise testing(CPET).Serum HE4 level was detected by electrochemiluminescence immunoassay.Results The serum HE4 level in LVDD group was significantly higher than that in non-LVDD group[162.53(92.92,326.17)pmol/L vs 90.27(63.82,138.52)pmol/L,P<0.001].By Spearman rank correlation coefficient and multiple linear regression analysis,serum HE4 level was positively correlated with E/e’after CPET(P<0.05).Multivariate Logistic regression analysis showed that serum HE4 level was an independent diagnostic factor for stress LVDD in COPD patients(P<0.05).According to the analysis of receiver operating characteristic curve,the area under the curve of serum HE4 level for diagnosing stress LVDD in COPD patients was 0.724(95%CI:0.628-0.820).Conclusion Elevated serum HE4 level may be a strong predictor of stress LVDD in non-severe COPD patients with exertional dyspnea.

关 键 词：慢性阻塞性肺疾病 附睾蛋白4 左室舒张功能不全 心肺运动试验 超声心动图 

分 类 号：R563.9[医药卫生—呼吸系统]