COPD纤维支气管镜肺泡灌洗液中可溶性晚期糖基化终末产物受体水平的临床意义

The Clinical Significances of Soluble Receptor for Advanced Glycation Endproducts in Bronchoscopy Alveolus Lavage Fluid among Patients with COPD

目的探讨纤维支气管镜肺泡灌洗液中可溶性晚期糖基化终末产物受体(sRAGE)水平在COPD中的临床意义。方法选取2012年10月—2013年5月入住辽宁医学院附属第一医院重症监护病房COPD患者40例为COPD组,另选取同时期非COPD组患者40例为非COPD组;将COPD患者分为轻度COPD组(12例)、中度COPD组(10例)、重度COPD组(10例)、极重度COPD组(8例)。采用酶联免疫吸附试验(ELISA)方法检测纤维支气管镜肺泡灌洗液中sRAGE水平。结果 COPD组患者纤维支气管镜肺泡灌洗液sRAGE水平为(191±71)ng/L,高于非COPD组的(55±56)ng/L(t=9.44,P<0.001)。轻度COPD组纤维支气管镜肺泡灌洗液sRAGE水平为(111±44)ng/L、中度COPD组为(184±45)ng/L、重度COPD组为(226±34)ng/L、极重度COPD组为(273±30)ng/L,差异有统计学意义(F=30.48,P<0.001),且极重度COPD组高于重度COPD组,重度COPD组高于中度COPD组,中度COPD组高于轻度COPD组(P<0.05)。直线相关分析结果显示,COPD患者纤维支气管镜肺泡灌洗液sRAGE水平与一秒用力呼气容积占预计值百分比(FEV1%)呈负相关(r=-0.738,P<0.05)。结论 COPD患者纤维支气管镜肺泡灌洗液中sRAGE水平较非COPD患者增高,纤维支气管镜肺泡灌洗液中sRAGE水平与COPD病情严重程度有关,可作为评价COPD预后的一个指标。

Objective To discuss the clinical significances of soluble receptor for advanced glycation end-products （ sRAGE）in bronchoscopy alveolus lavage fluid（ BALF）in patients with COPD. Methods A total of 40 patients with COPD who were admitted to the department of intensive care unit of the First Hospital Affiliated to Liaoning Medical University from Oc-tober 2012 to May 2013,were selected as the COPD group,meanwhile 40 patients with non-COPD were selected as the non-COPD group,and these COPD patients were divided into mild group（12 cases）,moderate group（10 cases）,severe group （10 cases）,very severe group（8 cases）. The sRAGE concentrations in BALF were detected by enzyme-linked immunosor-bent assay（ELISA）. Results The concentration of sRAGE in BALF of patients in the COPD group（191 ±71）ng/L was sig-nificantly higher than that in the non-COPD group（55 ±56）ng/L（t=9. 44,P〈0. 001）. The concentration of sRAGE in BALF of COPD patients in the mild group,moderate group,severe group and very severe group was（111 ± 44） ng/L,（184 ±45）ng/L,（226 ±34）ng/L,and（273 ±30）ng/L,respectively,there were significant differences in concentration of sRAGE among these groups（F=30. 48,P〈0. 001）,and the concentration of sRAGE in very severe COPD group was signifi-cantly higher than that in severe COPD group,the concentration of sRAGE in severe COPD group was significantly higher than that in moderate group,the concentration of sRAGE in moderate group was significantly higher than that in mild group（ P 〈0. 05 ） . Linear correlation analysis results showed that the concentration of sRAGE in BALF of COPD patients were negatively cor-related with FEV1%（r= -0. 738,P 〈0. 05）. Conclusion The concentration of sRAGE in BALF of COPD patients was higher than that of non-COPD patients;The concentration of sRAGE in BALF is related to severity of COPD,it could be used as an index of the prognosis evaluation of COPD.