COPD合并肺间质纤维化患者临床特点及血清TGF-β1、CTGF、TNF-α检测意义分析  

Clinical Characteristics of Patients with COPD and Pulmonary Fibrosis and Detection Significance of Serum TGF-β1,CTGF and TNF-α

作　　者：李宁[1] 陈谨[1] 何耀红[1] 朱婧[1] 呼玮[1] LI Ning;CHEN Jin;HE Yao-hong;ZHU Jing;HU Wei(Department of Respiratory Medicine,Fuxing Hospital Affiliated to Capital Medical University,Beijing,100040,China)

机构地区：[1]首都医科大学附属复兴医院呼吸科,北京100040

出　　处：《现代生物医学进展》2022年第24期4644-4647,4626,共5页Progress in Modern Biomedicine

摘　　要：目的:分析慢性阻塞性肺疾病(COPD)合并肺间质纤维化(PF)患者临床特点及血清转化生长因子-β1(TGF-β1)、结缔组织生长因子(CTGF)、肿瘤坏死因子-α(TNF-α)检测意义。方法:选取2020年1月~2022年1月我院收治的80例COPD患者为研究对象,根据是否合并PF分为COPD合并PF组(n=35)和COPD组(n=45),分析临床表现、肺功能、血气分析、胸部X线片、胸部CT及高分辨CT(HRCT)结果,检测血清TGF-β1、CTGF、TNF-α水平,并采用ROC曲线分析血清TGF-β1、CTGF、TNF-α水平对COPD合并PF的预测效能。结果:COPD合并PF患者的临床症状位于两种单病之间,肺功检查表现为混合性通气功能障碍,DIco弥散量多表现为中重度减低,血气分析显示低氧血症较明显,胸部X线片和胸部CT具有两病的特点。COPD合并PF组血清TGF-β1、CTGF、TNF-α水平均显著高于COPD组(P<0.05);ROC曲线分析显示,血清TGF-β1、CTGF、TNF-α水平联合诊断COPD合并PF的敏感度为96.00%,AUC为0.894,均高于单独检测(P<0.05)。结论:COPD合并PF患者具有COPD和PF临床表现融合的特点,使得原来单一的疾病表现不典型而有其独特的临床表现,为疾病诊断、治疗提供了依据,且其血清TGF-β1、CTGF、TNF-α水平呈高表达,对COPD合并PF具有一定预测价值。Objective:To analyze the clinical characteristics of patients with chronic obstructive pulmonary disease(COPD)and pulmonary fibrosis(PF),and the detection significance of serum transforming growth factor-β1(TGF-β1),connective tissue growth factor(CTGF)and tumor necrosis factor-α(TNF-α).Methods:A total of 80 patients with COPD admitted to the hospital from January2020 to January 2022 were selected as the study subjects.They were divided into COPD with PF group(n=35)and COPD group(n=45)according to the presence or absence of PF.The clinical manifestations,pulmonary function,blood gas analysis,chest X-ray film,chest CT and HRCT results were analyzed.Serum TGF-β1,CTGF and TNF-αlevels were detected.ROC curve was used to analyze the predictive performance of serum TGF-β1,CTGF and TNF-αlevels for PF in COPD.Results:The clinical symptoms of patients with COPD and PF were between the two diseases.Pulmonary function test showed mixed ventilation dysfunction,while DIco diffusing capacity showed moderate to severe reduction.Blood gas analysis showed obvious hypoxemia.Chest X-ray film and chest CT showed characteristics of the two diseases.Serum TGF-β1,CTGF and TNF-αlevels in the COPD with PF group were significantly higher than those in the COPD group(P<0.05).ROC curve analysis showed that the sensitivity and AUC of serum TGF-β1,CTGF and TNF-αlevels in combined diagnosis of COPD complicated with PF were 96.00%and 0.894,higher than those of single diagnosis(P<0.05).Conclusion:Patients with COPD and PF have clinical manifestations of both COPD and PF,which makes the manifestation of each disease atypical,forming unique clinical manifestation,thereby providing a basis for the diagnosis and treatment of the disease.Serum TGF-β1,CTGF and TNF-αlevels are high in patients with COPD and PF,suggesting that these indicators can be used to predict COPD complicated with PF.

关 键 词：慢性阻塞性肺疾病 肺间质纤维化 临床特点 血清转化生长因子-Β1 结缔组织生长因子 肿瘤坏死因子-α 

分 类 号：R563[医药卫生—呼吸系统] R392.32[医药卫生—内科学]