痰HNP-1、HNP-2、人抗菌肽LL-37水平对支气管扩张症急性加重的预测效能分析  

Analysis on predictive efficacy of HNP-1,HNP-2 and human cathelicidin LL-37 levels in sputum for acute exacerbation of bronchiectasis

作　　者：倪为波 郭立娟 邓晔 鲍洁[1] 商焕霞 NI Weibo;GUO Lijuan;DENG Ye;BAO Jie;SHANG Huanxia(Department of Respiratory and Critical Care Medicine(Hebei Provincial Key Laboratory of Pulmonary Diseases),Hebei Chest Hospital,Shijiazhuang 050000,China)

机构地区：[1]河北省胸科医院呼吸与危重症医学科(河北省肺病重点实验室),石家庄050000

出　　处：《中国临床新医学》2025年第3期308-312,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：河北省2024年度医学科学研究课题(编号:20241356)。

摘　　要：目的分析痰人中性粒细胞肽(HNP)-1、HNP-2、人抗菌肽LL-37水平对支气管扩张症急性加重的预测效能。方法招募2021年9月至2023年6月河北省胸科医院收治的129例支气管扩张症稳定期患者。采用自然咳嗽法收集患者治疗前的痰液标本,以酶联免疫吸附试验检测HNP-1、HNP-2、人抗菌肽LL-37水平。根据随访6个月内急性加重发生情况分为急性加重组(48例)和非急性加重组(81例)。采用Pearson相关分析HNP-1、HNP-2、人抗菌肽LL-37水平与改良的FACED(E-FACED)评分、肺功能的相关性。采用多因素logistic回归分析支气管扩张症急性加重的影响因素。通过受试者工作特征(ROC)曲线分析HNP-1、HNP-2、人抗菌肽LL-37水平预测支气管扩张症急性加重的效能。结果急性加重组吸烟比例、糖尿病比例、E-FACED评分以及HNP-1、HNP-2、人抗菌肽LL-37水平高于非急性加重组,第1秒用力呼气容积(FEV 1)占预计值百分比(FEV 1%pred)低于非急性加重组,差异有统计学意义(P<0.05)。HNP-1、HNP-2、人抗菌肽LL-37水平与E-FACED评分呈正相关(P<0.05),与FEV 1%pred呈负相关(P<0.05)。多因素logistic回归分析结果显示,吸烟史、糖尿病以及较高的HNP-1、HNP-2、人抗菌肽LL-37水平是支气管扩张症急性加重的独立危险因素(P<0.05)。ROC曲线分析结果显示,HNP-1、HNP-2、人抗菌肽LL-37水平均有助于预测支气管扩张症急性加重(P<0.05),且三者联合的预测效能[AUC(95%CI)=0.908(0.845~0.952)]较单一指标更高(P<0.001),灵敏度为75.00%,特异度为93.83%。结论痰HNP-1、HNP-2、人抗菌肽LL-37水平均与支气管扩张症急性加重有关,三者联合能提高对支气管扩张症急性加重的预测效能。Objective To analyze the predictive efficacy of human neutrophil peptide-1(HNP-1),human neutrophil peptide-2(HNP-2)and human cathelicidin LL-37 levels in sputum for acute exacerbation of bronchiectasis.Methods A total of 129 patients with stable bronchiectasis who were admitted to Hebei Chest Hospital from September 2021 to June 2023 were recruited.Before treatment,sputum samples of the patients were collected by natural cough method,and the levels of HNP-1,HNP-2 and human cathelicidin LL-37 were detected by using enzyme-linked immunosorbent assay(ELISA).According to the occurrence of acute exacerbation within 6 months of follow-up,the patients were divided into acute exacerbation group(48 cases)and non-exacerbation group(81 cases).The correlations of HNP-1,HNP-2 and human cathelicidin LL-37 levels with enhanced FACED(E-FACED)scores and lung function were analyzed by using Pearson correlation analysis.Multivariate logistic regression was used to analyze the influencing factors for acute exacerbation of bronchiectasis.The efficacy of HNP-1,HNP-2 and human cathelicidin LL-37 levels in predicting acute exacerbation of bronchiectasis was analyzed by using receiver operating characteristic(ROC)curve.Results The proportion of patients smoking,the proportion of patients with diabetes,the E-FACED scores,and the levels of HNP-1,HNP-2 and human cathelicidin LL-37 in the acute exacerbation group were higher than those in the non-exacerbation group,and the forced expiratory volume in 1 second(FEV 1)as percentage of predicted value(FEV 1%pred)in the acute exacerbation group were lower than those in the non-exacerbation group,with statistically significant differences between the two groups(P<0.05).Levels of HNP-1,HNP-2 and human cathelicidin LL-37 were positively correlated with E-FACED scores(P<0.05)and were negatively correlated with FEV 1%pred(P<0.05).The results of multivariate logistic regression analysis showed that smoking history,diabetes and higher HNP-1,HNP-2 and human cathelicidin LL-37 levels were independent risk

关 键 词：人中性粒细胞肽-1 人中性粒细胞肽-2 人抗菌肽LL-37 支气管扩张症 急性加重 预测效能 

分 类 号：R563.1[医药卫生—呼吸系统]