SCNN1B基因表达和PCT与COPD急性加重期细菌感染患者肺动脉高压和肺功能损害的关系  

Relationship between SCNN1B gene, PCT and pulmonary hypertension, pulmonary function damage in acute exacerbation of COPD patients with bacterial infection

作　　者：周凌燕[1] 姚国丽 苏钰 祝晓萍 孙宁 ZHOU Ling-yan;YAO Guo-li;SU Yu;ZHU Xiao-ping;SUN Ning(Huzhou Cent Hosp,Af filiated Cent Hosp HuZhou University,Huzhou,Zhejiang313000,China)

机构地区：[1]湖州市中心医院湖州师范学院附属中心医院呼吸与危重症医学科,浙江湖州313000

出　　处：《中华医院感染学杂志》2023年第1期40-44,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81602003);浙江省科技计划基金资助项目(2017C37155)。

摘　　要：目的 分析阿米洛利敏感钠离子通道蛋白1B(SCNN1B)基因表达和降钙素原(PCT)与慢性阻塞性肺疾病急性加重期(AECOPD)细菌感染患者肺动脉高压(PH)和肺功能损害的关系。方法 选择2018年1月-2020年12月湖州市中心医院收治的AECOPD细菌感染患者62例为研究对象,根据是否合并PH分成PH组30例和非PH组32例,实时荧光定量PCR(qRT-PCR)检测患者外周血SCNN1B基因相对表达量,免疫化学发光法检测血浆PCT水平;受试者工作特征(ROC)曲线分析SCNN1B和PCT预测AECOPD细菌感染患者发生PH和肺功能损害的价值。结果 AECOPD感染病原菌主要为铜绿假单胞菌(26.32%)、鲍氏不动杆菌(17.11%)和大肠埃希菌(11.84%);PH组患者SCNN1B基因表达水平低于非PH组,PCT水平高于非PH组(P<0.05);有吸烟史、缺氧的PH患者SCNN1B基因表达水平明显降低,PCT水平明显升高(P<0.05);随患者肺功能损害程度加重SCNN1B基因表达水平降低,PCT水平升高(P<0.05);SCNN1B基因表达和PCT水平联合预测患者发生PH和重度、极重度肺功能损伤的曲线下面积(AUC)为0.859和0.896。结论 SCNN1B和PCT水平与AECOPD细菌感染患者PH和肺功能损害严重程度具有相关性。OBJECTIVE To observe the relationship between expression of amiloride-sensitive sodium channel protein 1B(SCNN1B) gene, procalcitonin(PCT) and pulmonary hypertension(PH), pulmonary function damage in acute exacerbation of chronic obstructive pulmonary disease(AECOPD) patients with bacterial infection. METHODS A total of 62 AECOPD patients with bacterial infection who were treated in Huzhou Central Hospital from Jan 2018 to Dec 2020 were recruited as the study subjects and divided into the PH group with 30 cases and the non-PH group with 32 cases according to the status of complication with PH. The relative expression level of peripheral blood SCNN1B gene was detected by means of real-time fluorescent quantitative PCR(PCR), the level of plasma PCT was detected by immunochemiluminometric assay, and the value of SCNN1B and PCT in prediction of PH and pulmonary function damage was analyzed by receiver operating characteristic(ROC) curves. RESULTS Among the pathogens isolated from the patients with AECOPD, Pseudomonas aeruginosa accounted for 26.32%, Acinetobacter baumannii accounted for 17.11%, and Escherichia coli accounted for 11.84%. The expression level of SCNN1B gene of the PH group was lower than that of the non-PH group, while the PCT level of the PH group was higher than that of the non-PH group(P<0.05). The expression level of SCNN1B gene of the PH patients with smoking history and anoxia was significantly reduced, while the PCT level was significantly elevated(P<0.05). The expression level of SCNN1B gene was decreased with the aggravation of pulmonary function damage, while the PCT level was elevated(P<0.05). The area under curve(AUC) of SCNN1B combined with PCT was 0.859 in prediction of PH, 0.896 in prediction of severe, extremely severe pulmonary function damage. CONCLUSION The levels of SCNN1B and PCT are associated with the PH and severity of pulmonary function damage.

关 键 词：慢性阻塞性肺疾病急性加重期 阿米洛利敏感钠离子通道蛋白1B 细菌感染 肺动脉高压 肺功能损害 

分 类 号：R563[医药卫生—呼吸系统]