支气管肺发育不良儿童支气管肺泡灌洗液中KL-6、G-CSF及IGF-1表达意义  

Expression significance of KL-6,G-CSF and IGF-1 in bronchoalveolar lavage fluid in children with bronchopulmonary dysplasia

作　　者：叶楠 杜泽敏 高龙飞 YE Nan;DU Zemin;GAO Longfei(Pediatric Emergency Department,Mayo Cardiovascular Hospital of Hebei,Shijiazhuang,Hebei 050000,China;Department of Respiratory,Hebei Children′s Hospital,Shijiazhuang,Hebei 050000,China)

机构地区：[1]河北梅奥心血管病医院小儿急诊科,河北石家庄050000 [2]河北省儿童医院呼吸三科,河北石家庄050000

出　　处：《临床肺科杂志》2025年第3期359-365,共7页Journal of Clinical Pulmonary Medicine

基　　金：河北省医学科学研究课题(20211381)

摘　　要：目的探讨支气管肺发育不良(Bronchopulmonary dysplasia,BPD)儿童支气管肺泡灌洗液(Bronchoalveolar lavage fluid,BALF)中Ⅱ型肺泡细胞表面抗原(Kerbs von Lungren 6 antigen,KL-6)、粒细胞集落刺激因子(Granulocyte-colony stimulating factor,G-CSF)及胰岛素样生长因子(Insulin-like growth factor-1,IGF-1)表达意义,为临床诊疗提供参考。方法选取2020年2月-2023年10月河北梅奥心血管病医院收治的192例BPD患儿,根据吸入氧浓度(Inhalation of oxygen concentration,FiO_(2))分为轻度BPD组(n=103,未用氧)、中度BPD组(n=60,21%<FiO_(2)<30%),重度BPD组(n=29,FiO_(2)≥30%或机械通气)。比较不同吸氧程度BPD患儿出生后不同时间BALF中KL-6、G-CSF、IGF-1表达水平及FeNO、潮气呼吸肺功能。分析BALF中KL-6、G-CSF、IGF-1与吸氧程度、呼出气一氧化氮(Fractional exhaled nitric oxide,FeNO)及潮气呼吸肺功能[达峰容积比(Volume to peak expiratory flow as a proportion of exhaled volume,VPEF/VE)、达峰时间比(Time to peak tidal expiratory flow as a proportion of expiratory time,TPTEF/TE)]的相关性。结果轻度BPD组KL-6表达水平低于中度BPD组、重度BPD组,且中度BPD组低于重度BPD组(P<0.05);轻度BPD组G-CSF表达水平低于中度BPD组、重度BPD组,且中度BPD组低于重度BPD组(P<0.05);轻度BPD组IGF-1表达水平高于中度BPD组、重度BPD组,且中度BPD组高于重度BPD组(P<0.05);轻度BPD组FeNO小于中度BPD组、重度BPD组,VPEF/VE、TPTEF/TE大于中度BPD组、重度BPD组,且中度BPD组FeNO小于重度BPD组,VPEF/VE、TPTEF/TE大于重度BPD组(P<0.05);BPD患儿出生后1 d、7 d、14 d、28 d BALF中KL-6、G-CSF与吸氧程度呈正相关,IGF-1与吸氧程度呈负相关(P<0.05);BPD患儿出生后1 d BALF中KL-6、G-CSF与矫正胎龄40周时FeNO呈正相关,与矫正胎龄40周时VPEF/VE、TPTEF/TE呈负相关(P<0.05);BPD患儿出生后1 d BALF中IGF-1与矫正胎龄40周时FeNO呈负相关,与矫正胎龄40周时VPEF/VE、TPTEF/TE呈正相关(P<0.05)。结论BObjective To investigate the expression significance of type II alveolar cell Kerbs von Lungren 6 antigen(KL-6),granulocyte colony-stimulating factor(G-CSF),and insulin-like growth factor(IGF-1)in bronchoalveolar lavage fluid(BALF)in children with bronchopulmonary dysplasia(BPD),and to provide reference for clinical diagnosis and treatment.Methods A total of 192 children with BPD admitted to Hebei Mayo Cardiovascular Hospital from February 2020 to October 2023 were selected and divided into mild BPD group(103 cases without oxygen),moderate BPD group(60 cases,21%<FiO_(2)<30%)and severe BPD group(29 cases,FiO_(2)≥30%or mechanically ventilated)according to inhaled oxygen concentration.Compare the expression levels of KL-6,G-CSF,and IGF-1 in BALF and the pulmonary function of FeNO and damp respiration in BPD children with different oxygen absorption levels at different times after birth.The correlations of KL-6,G-CSF,and IGF-1 in BALF with the degree of oxygen absorption,exhaled nitric oxide(FeNO),and tidal respiratory lung function(VPEF/VE,TPTEF/TE)were analyzed.Results The expression level of KL-6 in mild BPD group was lower than that in the moderate BPD group and severe BPD group,and moderate BPD group was lower than that in the severe BPD group(P<0.05).The expression level of G-CSF in the mild BPD group was lower than that in the moderate BPD group and severe BPD group,and the moderate BPD group was lower than that in the severe BPD group(P<0.05).The expression level of IGF-1 in mild BPD group was higher than that in the moderate BPD group and severe BPD group,and the moderate BPD group was higher than that in the severe BPD group(P<0.05).FeNO in the mild BPD group was lower than that in the moderate BPD group and severe BPD group,VPEF/VE and TPTEF/TE were higher than that in the moderate BPD group and severe BPD group,and FeNO in the moderate BPD group was lower than that in the severe BPD group,VPEF/VE and TPTEF/TE were higher than that in severe BPD group(P<0.05).The levels of KL-6 and G-CSF in BALF at 1,7,1

关 键 词：支气管肺发育不良 Ⅱ型肺泡细胞表面抗原 粒细胞集落刺激因子 胰岛素样生长因子 支气管肺泡灌洗液 

分 类 号：R722.6[医药卫生—儿科]