先天性心脏病相关肺动脉高压成年患者血浆LCN2和IL-16水平的变化及意义  

Changes and significance of plasma LCN2 and IL-16 levels in adult patients with congenital heart disease associated pulmonary arterial hypertension

作　　者：陈倩倩 花颖[1] 郑冬冬[1] 张伟[1] 王巍 黄荣[1] 李晓飞[1] CHEN Qianqian;HUA Ying;ZHENG Dongdong;ZHANG Wei;WANG Wei;HUANG Rong;LI Xiaofei(Department of Cardiovascular Diseases,Affiliated Hospital,NantongUniversity,Nantong 226006,CHINA)

机构地区：[1]南通大学附属医院心血管内科,江苏226006 [2]南通大学附属南通第三医院重症医学科

出　　处：《江苏医药》2024年第7期662-668,共7页Jiangsu Medical Journal

基　　金：南通市科技计划项目(JCZ19107)。

摘　　要：目的 研究血浆中性粒细胞明胶酶相关脂质运载蛋白2(LCN2)和IL-16水平在先天性心脏病相关肺动脉高压(CHD-PAH)成年患者的变化及其意义。方法 根据右心导管术测定的平均肺动脉压(mPAP)水平将122例CHD成年患者分为无PAH组(mPAP<25 mmHg, 50例)、轻度PAH组(25 mmHg≤mPAP<35 mmHg, 43例)和中重度PAH组(mPAP≥35 mmHg, 29例),另设28例健康成年人作对照(对照组)。采用ELISA法检测血浆LCN2和IL-16水平,化学发光法检测血浆氨基末端B型尿钠肽前体(NT-proBNP)水平。结果 中重度PAH组血浆LCN2水平高于其他各组,轻度PAH组血浆LCN2水平高于无PAH组和对照组(P<0.05);中重度PAH组血浆IL-16水平高于无PAH组和对照组,轻度PAH组血浆IL-16水平高于无PAH组(P<0.05)。LCN2与IL-16呈正相关(P<0.01),且两者均与mPAP、肺动脉收缩压、肺血管阻力和NT-proBNP呈正相关(P<0.01)。ROC曲线结果显示,当LCN2取诊断界值为84.8 ng/mL时,其诊断CHD合并PAH的灵敏度为73.6%,特异度为88.0%;当IL-16取诊断界值为121.2 pg/mL时,其诊断CHD合并PAH的灵敏度为84.7%,特异度为62.0%;两者联合诊断PAH的AUC为0.862。多因素logistic回归分析结果显示,血浆LCN2和IL-16水平升高是CHD患者合并PAH的独立危险因素(P<0.05)。结论 CHD-PAH成年患者血浆LCN2和IL-16水平升高,可用于评估CHD-PAH严重程度和预后。Objective To study the changes and significance of plasma of lipocalin 2(LCN2)and IL-16 levels in the adult patients with congenital heart disease-associated pulmonary arterial hypertension(CHD-PAH).Methods On the basis of the mean pulmonary arterial pressure(mPAP)measured by right cardiac catheter,122 adult CHD patients were divided into three groups of A(mPAP≥35 mmHg,29 cases),B(25 mmHg≤mPAP<35 mmHg,43 cases),and C(mPAP<25 mmHg,50 cases).Another 28 healthy adults were taken as the controls(group D).Plasma levels of LCN2 and IL-16 were detected by ELISA,and plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP)level was detected by chemiluminescence.Results The plasma LCN2 level in group A was higher than that in the other three groups,which in group B was higher than that in groups of C and D(P<0.05).The plasma IL-16 level in group A was higher than that in groups of C and D,which in group B was higher than that in group C(P<0.05).LCN2 was positively correlated with IL-16(P<0.01),and both LCN2 and IL-16 were positively correlated with mPAP,pulmonary artery systolic pressure,pulmonary vascular resistance and NT-proBNP(P<0.01).ROC curve analysis results showed that when the cut-off value of LCN2 was 84.8 ng/mL,the sensitivity and specificity in the diagnosis of CHD-PAH were 73.6%and 88.0%.When the cut-off value of IL-16 was 121.2 pg/mL,the sensitivity and specificity in the diagnosis of CHD-PAH were 84.7%and 62.0%.When the two indicators were combined use,the AUC for diagnosing PAH was 0.862.The results of multivariate logistic regression analysis showed that the increased plasma levels of LCN2 and IL-16 were the independent risk factors for PAH in CHD patients(P<0.05).Conclusion The increased plasma levels of LCN2 and IL-16 in adult patients with CHDPAH can be used to assess the severity and prognosis of CHD-PAH.

关 键 词：先天性心脏病 肺动脉高压 白细胞介素-16 中性粒细胞明胶酶相关脂质运载蛋白2 

分 类 号：R541[医药卫生—心血管疾病]