外周血RABL6基因甲基化水平与慢性阻塞性肺疾病合并肺动脉高压的关系  

The correlation between peripheral blood RABL6 gene methylation level and pulmonary hypertension in patients with chronic obstructive pulmonary disease

作　　者：徐丽娜 纪王斐 李丽丽 Xu Lina;Ji Wangfei;Li Lili(Department of Respiratory Medicine,Nantong Third Affiliated Hospital of Nantong University,Nantong Third People′s Hospital,Nantong 226000,China)

机构地区：[1]南通大学附属南通第三医院,南通市第三人民医院呼吸内科,南通226000 [2]南京中医药大学附属医院,江苏省中医院老年医学科,南京210029

出　　处：《国际呼吸杂志》2025年第1期49-55,共7页International Journal of Respiration

基　　金：南通市市级科技计划项目(JCZ20080)。

摘　　要：目的分析外周血RABL6基因甲基化水平与慢性阻塞性肺疾病(慢阻肺病)合并肺动脉高压(PH)的关系。方法本研究为病例对照研究,采用目的抽样法选取2022年2月至2024年5月期间于南通大学附属南通第三医院接受治疗的215例慢阻肺病患者为研究对象。根据患者是否合并PH将其分为慢阻肺病合并PH组(56例)和慢阻肺病组(159例)。收集患者的临床资料包括性别、年龄、身体质量指数、吸烟史、基础疾病史(糖尿病、高血压)、慢阻肺病病程、入院时的实验室检查指标[动脉血氧分压、动脉血二氧化碳分压、动脉血pH值、血肌酐、乳酸、白蛋白、C反应蛋白(CRP)、白细胞计数、淋巴细胞计数、中性粒细胞计数、嗜酸性粒细胞百分比、血小板计数、血红蛋白、D-二聚体]和肺动脉收缩压(PASP)。检测外周血RABL6基因CpG 2、CpG 3、CpG 4、CpG 5、CpG 10、CpG 17位点甲基化水平。采用Pearson相关分析探讨慢阻肺病合并PH患者PASP与各临床指标的相关性。多因素logistic回归分析筛选慢阻肺病合并PH的影响因素。受试者操作特征(ROC)曲线分析RABL6基因CpG 17位点甲基化水平、CRP、嗜酸性粒细胞百分比,以及三者联合诊断慢阻肺病合并PH的价值。结果慢阻肺病组男108例,女51例,年龄(69.73±10.16)岁;慢阻肺病合并PH组男35例,女21例,年龄(70.29±10.35)岁。慢阻肺病合并PH组CRP、嗜酸性粒细胞百分比、D-二聚体均高于慢阻肺病组,白蛋白低于慢阻肺病组[(17.38±4.32)mg/L比(12.76±3.15)mg/L,(3.86±1.07)%比(2.87±0.65)%,(0.53±0.14)mg/L比(0.38±0.10)mg/L,(34.82±5.18)g/L比(40.24±6.75)g/L,均P<0.001],其余临床资料比较差异均无统计学意义(均P>0.05)。慢阻肺病合并PH组CpG 17位点甲基化水平高于慢阻肺病组[(36.91±8.12)%比(26.84±6.80)%,P<0.001],其余位点甲基化水平比较差异均无统计学意义(均P>0.05)。Pearson相关分析结果显示,在慢阻肺病合并PH患者中,PASP�ObjectiveTo analyze the relationship between peripheral blood RABL6 gene methylation level and pulmonary hypertension(PH)in patients with chronic obstructive pulmonary disease(COPD).MethodsThis was a case-control study involving 215 COPD patients who received treatment at Nantong Third Affiliated Hospital of Nantong University from February 2022 to May 2024 as the research subjects by the purposive sampling.They were grouped into COPD combined with PH group(56 cases)and COPD group(159 cases)based on whether they had PH.The clinical data were collected,including gender,age,body mass index,smoking history,basic disease history(diabetes,hypertension),course of COPD,laboratory examination indicators on admission(arterial partial pressure of oxygen,arterial partial pressure of carbon dioxide,arterial blood pH,creatinine,lactate,albumin[ALB],C-reactive protein[CRP],white blood cell count,lymphocyte count,neutrophil count,eosinophil percentage[EOS%],platelet count,hemoglobin,D-dimer[D-D])and pulmonary artery systolic pressure(PASP).The methylation levels of the RABL6 gene at CpG 2,CpG 3,CpG 4,CpG 5,CpG 10,and CpG 17 sites in peripheral blood were detected.Pearson method was applied to explore the correlation between PASP and various clinical indicators in patients with COPD combined with PH.Multivariate logistic regression analysis was applied to screen factors influencing COPD combined with PH.Receiver operator characteristic(ROC)curve was applied to analyze the value of the RABL6 gene methylation at CpG 17 site,CRP,EOS%and their combination in diagnosing COPD combined with PH.ResultsThere were 108 males and 51 females in the COPD group,with an average age of 69.73±10.16 years.There were 35 males and 21 females in the COPD combined with PH group,with an average age of 70.29±10.35 years.CRP(17.38±4.32 mg/L vs 12.76±3.15 mg/L),EOS%(3.86%±1.07%vs 2.87%±0.65%),and D-D(0.53±0.14 mg/L vs 0.38±0.10 mg/L)in the COPD combined with PH group were significantly higher than those in the COPD group,while ALB(34.82±5.18 g/L

关 键 词：肺疾病 慢性阻塞性 高血压 肺性 RABL6 DNA甲基化 

分 类 号：R563.9[医药卫生—呼吸系统] R544.1[医药卫生—内科学]