COPD急性加重期患者外周血单核细胞Toll样受体及MCP-1、激活素A表达与预后的关系  

Relationship between Expression of Toll-like Receptor,MCP-1 and Activin A in Peripheral Blood Mononuclear Cells and Prognosis in Patients with Acute Exacerbation of COPD

作　　者：云俊杰[1] 徐影[1] YUN Junjie;XU Ying(Shanghai Ninth People’s Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200021,China)

机构地区：[1]上海交通大学医学院附属第九人民医院,上海200021

出　　处：《北华大学学报（自然科学版）》2023年第4期461-465,共5页Journal of Beihua University（Natural Science）

基　　金：上海市卫生健康委员会医药科研项目(2020LP053).

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)急性加重期患者外周血单核细胞Toll样受体2、Toll样受体4、单核细胞趋化蛋白-1(MCP-1)、激活素A表达与预后的关系.方法选取COPD急性加重期患者65例为COPD急性加重期组,COPD稳定期患者48例为COPD稳定期组,同期健康体检者35名为对照组.采集空腹肘静脉血,肝素抗凝,应用Ficoll淋巴细胞分离液抽提外周血中单个核细胞,流式细胞仪检测Toll样受体2、Toll样受体4表达水平;采集空腹肘静脉血,离心收集血清,酶联免疫吸附法检测血清MCP-1、激活素A浓度;出院后对COPD急性加重期患者随访3 a,记录生存情况.结果COPD急性加重期组Toll样受体2、Toll样受体4表达水平明显高于COPD稳定期组和对照组,COPD稳定期组明显高于对照组(P<0.05);COPD急性加重期组血清MCP-1、激活素A浓度明显高于COPD稳定期组和对照组,COPD稳定期组明显高于对照组(P<0.05);COPD急性加重期组FEV1、FEV1%、(FEV1/FVC)%明显低于COPD稳定期组和对照组,COPD稳定期组明显低于对照组(P<0.05);COPD急性加重期患者FEV1/FVC%与Toll样受体2、Toll样受体4、MCP-1、激活素A呈负相关关系(P<0.01).65例COPD急性加重期患者随访3 a,生存41例(63.08%),死亡24例(36.92%).ROC曲线分析显示,Toll样受体2、Toll样受体4、MCP-1、激活素A单独和联合检测对COPD急性加重期患者预后均具有较高的评估价值(P<0.05),其中联合检测的评估价值最高(AUC=0.951),灵敏度、阳性预测值明显高于各指标单独检测.结论COPD急性加重期患者外周血单核细胞中Toll样受体2、Toll样受体4高表达,血清MCP-1、激活素A高表达,且与肺功能损伤程度密切相关,联合检测可用于患者预后评估.Objective To investigate the relationship between the expression of Toll-like receptor 2,Toll-like receptor 4,monocyte chemoattractant protein-1(MCP-1),activin A and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Method 65 patients with acute exacerbation of COPD were selected as the acute exacerbation of COPD group,48 patients with stable COPD were selected as the stable COPD group,and 35 patients with physical examination in the same period were selected as the control group.Collect fasting elbow vein blood,anticoagulate with heparin,extract mononuclear cells from peripheral blood with Ficoll lymphocyte separation solution,and detect the expression level of Toll-like receptor 2 and Toll-like receptor 4 by flow cytometry.The fasting elbow vein blood was collected,and the serum was collected by centrifugation.The concentration of serum MCP-1 and activin A were detected by enzyme-linked immunosorbent assay.The patients with acute exacerbation of COPD were followed up for 3 years after discharge,and the survival condition was recorded.Results The expression levels of Toll-like receptor 2 and Toll-like receptor 4 in patients with acute exacerbation of COPD group were significantly higher than those in patients with stable COPD group and control group,and those in patients with stable COPD were significantly higher than those in control group(P<0.05).The concentration of serum MCP-1 and activin A in the acute exacerbation of COPD group was significantly higher than those in the stable phase of COPD group and the control group,and those in the stable phase of COPD group was significantly higher than those of the control group(P<0.05).FEV1,FEV1%,(FEV1/FVC)%in the acute exacerbation of COPD group were significantly lower than those in the stable phase of COPD group and the control group,and the stable phase of COPD group was significantly lower than that in the control group(P<0.05).FEV1/FVC%in patients with acute exacerbation of COPD was negatively correlated with Toll-like

关 键 词：慢性阻塞性肺疾病 急性加重期 TOLL样受体2 Toll样受体4 单核细胞趋化蛋白-1 激活素A 预后 

分 类 号：R563[医药卫生—呼吸系统]