COPD稳定期患者不同临床表型血清中性粒细胞胞外诱捕网水平与维生素D水平的相关性分析  

Correlation analysis of serum neutrophil extracellular trapping net level and vitamin D level in stable COPD patients with different clinical phenotypes

作　　者：陈瑜婷 黄玲 夏俊杰[2] 邱宇[2] 弋可[3] 王金诚 陈润娇 薛海诗 CHEN Yuting;HUANG Ling;XIA Junjie;QIU Yu;YI Ke;WANG Jincheng;CHEN Runjiao;XUE Haishi(Clinical Medical College of Southwest Medical University,Luzhou,Sichuan 646000,China;Department of Respiratory and Critical Care,The Third People′s Hospital of Mianyang(Sichuan Mental Health Center)Mianyang,Sichuan 621054,China;Department of Respiratory and Critical Care Medicine,Sichuan Science City Hospital,Mianyang,Sichuan 621054,China;Department of Respiratory and Critical Care Medicine,Zhongjiang County People′s Hospital,Deyang,Sichuan 618199,China)

机构地区：[1]西南医科大学临床医学院,四川泸州646000 [2]绵阳市第三人民医院(四川省精神卫生中心)呼吸与危重症学科,四川绵阳621054 [3]四川省科学城医院呼吸与危重症学科,四川绵阳621054 [4]中江县人民医院呼吸与危重症学科,四川德阳618199

出　　处：《临床肺科杂志》2023年第9期1357-1362,共6页Journal of Clinical Pulmonary Medicine

基　　金：四川省卫生健康科研课题基金(No.19PJ218)。

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)稳定期患者不同临床表型血清中性粒细胞胞外诱捕网(NETs)、维生素D(VD)水平及二者之间的相关性,分析血清NETs、VD水平与疾病严重程度的关系以及对COPD的诊断价值。方法选取2021年6月至2022年10月于我院就诊的COPD稳定期患者72例作为实验组,同时选取健康对照组15例。根据外周血嗜酸性粒细胞(EOS)计数及过去1年患者频繁发病次数,将患者分为非EOS频繁加重表型(41例),EOS频繁加重表型(14例),非频繁加重表型(17例)。检测所有研究对象的血清25羟维生素D(25-OH-VD)、瓜氨酸组蛋白3(CitH3)、髓过氧化物酶-DNA(MPO-DNA)水平。结果(1)实验组血清25-OH-VD水平低于对照组(P<0.05),其中非EOS频繁加重表型、非频繁加重表型血清CitH3、MPO-DNA水平高于对照组(P<0.05),实验组组间比较血清25-OH-VD、CitH3、MPO-DNA水平差异有统计学意义(P<0.05)。(2)入组患者血清25-OH-VD水平随GOLD分级增加呈下降趋势(P<0.05),血清CitH3、MPO-DNA水平随GOLD分级增加呈上升趋势(P<0.05)。(3)Pearson相关性分析显示,CitH3、MPO-DNA水平与25-OH-VD水平成负相关。其中,非EOS频繁加重表型、非频繁加重表型血清CitH3、MPO-DNA与25-OH-VD成负相关(P<0.05),而在EOS频繁加重表型上无明显相关性(P>0.05)。(4)ROC曲线分析,25-OH-VD、CitH3、MPO-DNA预测COPD发病的AUC分别为0.8005、0.7556、0.7088,截断值分别为21.58ng/mL、16.35ng/mL、23.33ng/mL。结论COPD稳定期各表型间血清NETs水平与VD水平存在差异,且二者成负相关。NETs、VD在评估COPD严重程度上具有一定价值,NETs可成为潜在的评估患者病情及严重程度的血清学指标。Objective To investigate the serum neutrophil extracellular trapping NETs(NETs)and vitamin D(VD)levels in patients with chronic obstructive pulmonary disease(COPD)with different clinical phenotypes and their correlation,and to analyze the relationship between serum NETs and VD levels and the severity of the disease,as well as the diagnostic value of COPD.Methods A total of 72 patients with stable COPD treated in our hospital from June 2021 to October 2022 were selected as the experimental group,while 15 healthy control groups were selected.According to peripheral blood eosinophilia(EOS)count and frequency of occurrence in the past year,the patients were classified into non-EOS frequent aggravation phenotype(41 cases),EOS frequent aggravation phenotype(14 cases),and non-EOS frequent aggravation phenotype(17 cases).Serum levels of 25-hydroxyvitamin D(25-OH-VD),citrulline histone 3(CitH3),and myeloperoxidase DNA(MPO-DNA)were detected in all subjects.Results(1)The level of serum 25-OH-VD in the experimental group was lower than that in the control group(P<0.05),the serum CitH3 and MPO-DNA levels in non-EOS frequently aggravated phenotype and non-frequently aggravated phenotype were higher than those in the control group(P<0.05).There were significant differences in serum 25-OH-VD,CitH3,and MPO-DNA levels among experimental groups(P<0.05).(2)The level of serum 25-OH-VD was negatively correlated with GOLD grade(P<0.05),while the levels of serum CitH3 and MPO-DNA were positively correlated with GOLD grade(P<0.05).(3)Pearson correlation analysis showed that the levels of serum CitH3 and MPO-DNA were negatively correlated with the level of serum 25-OH-VD.Among them,the serum CitH3 and MPO-DNA of non-EOS frequently aggravated phenotype and non-frequently aggravated phenotype were negatively correlated with the levels of serum 25-OH-VD(P<0.05),but there was no significant correlation in EOS frequently aggravated phenotype(P>0.05).(4)ROC curve analysis showed that AUC of 25-OH-VD,CitH3,and MPO-DNA were 0.8005,0.7556,and 0.70

关 键 词：慢性阻塞性肺疾病 临床表型 中性粒细胞胞外诱捕网 维生素D 相关性分析 

分 类 号：R563.9[医药卫生—呼吸系统]