外周血IGF-1、PAI-1和TGF-β1在肺间质纤维化合并肺气肿患者中的表达及意义分析

Expression and Significance of Peripheral Blood IGF-1, PAI-1 and TGF-β1 in Patients with Pulmonary Interstitial Fibrosis and Emphysema

目的探讨肺间质纤维化合并肺气肿(CPFE)患者血清胰岛素样生长因子-1(IGF-1)、纤溶酶原激活物抑制物-1(PAI-1)及转化生长因子-β1(TGF-β1)表达水平,探讨其在疾病诊治及病情评估等方面的临床意义。方法选取2018年6月—2019年6月四川省绵阳市中心医院呼吸科收治的CPFE患者40例(CPFE组),并选取同期特发性肺间质纤维化(IPF)患者40例(IPF组)和肺气肿患者40例(肺气肿组)作为对照,检测并比较三组血清IGF-1、PAI-1、TGF-β1表达水平的差异,并分析三种细胞因子浓度与吸烟指数、血气分析及肺功能指标的相关性。结果CPFE组、IPF组血清IGF-1、PAI-1、TGF-β1水平均明显高于肺气肿组(P<0.05),CPFE组与IPF组之间比较差异无统计学意义(P>0.05)。CPFE组与肺气肿组血清IGF-1、PAI-1、TGF-β1均与吸烟指数呈正相关(P<0.05)。CPFE组血清IGF-1与第一秒用力呼气容积(FEV1%)、用力肺活量(FVC%)、一氧化碳弥散量(DLCO%)水平均呈负相关(P<0.05),PAI-1与FEV1%、DLCO%呈负相关(P<0.05),TGF-β1与DLCO%呈负相关(P<0.05);IPF组血清IGF-1与FVC%、DLCO%呈负相关(P<0.05),PAI-1与DLCO%呈负相关(P<0.05);肺气肿组血清IGF-1、PAI-1、TGF-β1与肺功能指标均无明显相关性(P均>0.05)。三组血清IGF-1、PAI-1、TGF-β1与PaO2均无明显相关性(P均>0.05)。结论CPFE患者血清IGF-1、PAI-1、TGF-β1表达水平升高,这三项指标有望成为疾病病情监测、疗效评估甚至是靶向治疗的客观指标。

Objective To investigate the expression of serum insulin-like growth factor-1(IGF-1),plasminogen activating inhibitor-1(PAI-1)and transforming growth factor-β1(TGF-β1)in patients with pulmonary fibrosis complicated with emphysema(CPFE),and to explore their clinical significance in the diagnosis,treatment and evaluation of the disease.Methods From June 2018 to June 2019,40 patients with CPFE(CPFE group),40 patients with(IPF)(IPF group)and 40 patients with emphysema(emphysema group)were selected as controls.The expression of IGF-1,PAI-1,TGF-β1 in serum of the three groups was detected and compared,and the concentrations of three cytokines and smoking index were analyzed.Correlation between blood gas analysis and pulmonary function indexes.Results The average water content of serum IGF-1,PAI-1,TGF-β1 in CPFE group and IPF group was significantly higher than that in emphysema group(P<0.05).There was no significant difference between CPFE group and IPF group(P>0.05).Serum IGF-1,PAI-1,TGF-β1 was positively correlated with smoking index between).CPFE group and emphysema group(P<0.05).Serum IGF-1 and forced vital capacity(FVC%)in).CPFE group were significantly higher than those in emphysema group(P<0.05).The levels of carbon monoxide dispersion(DLCO%)were negatively correlated,PAI-1 was negatively correlated with FEV1%,DLCO%,and TGF-β1 was negatively correlated with DLCO%(P<0.05).Serum IGF-1 was negatively correlated with FVC%,DLCO%and PAI-1 was negatively correlated with DLCO%in IPF group,but there was no significant correlation between serum IGF-1,PAI-1,TGF-β1 and pulmonary function in emphysema group(P>0.05).There was no significant correlation between serum IGF-1,PAI-1,TGF-β1 and PaO2 in the three groups.Conclusion The expression level of serum IGF-1,PAI-1,TGF-β1 in patients with CPFE is increased.These three indexes are expected to be objective indexes for disease monitoring,curative effect evaluation and even targeted therapy.