肺间质纤维化并发肺气肿病人血清TGF-β，VEGF和IGF-I作用、意义及与吸烟相关性研究

Research on the Significance and Role of the Serum TGF-β,VEGF, IGF-I and Its Correlation with Smoking of the Patients with Combined Pulmonary Fibrosis and Emphysema

目的观察和分析肺问质纤维化并发肺气肿（CPFE）患者血清转化生长因子-β1（TGF-β1）、血管内皮生长因子（VEGF）、胰岛素样生长因子I（IGF—I）的表达水平及与患者吸烟情况的相关性。方法选取40例CPFE患者作为A组，选取40例特发性肺间质纤维化（IPF）患者作为B组，选取40例肺气肿作为C组。对三组患者的病程、吸烟情况及动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）血气指标进行检测和比较；对三组患者的血清TGF-β1，VEGF和IGF-I水平进行检测和比较。结果B组患者的病程和吸烟比例均显著低于A组和C组，C组患者的吸烟年限、平均每日吸烟量和PaCO2均显著高于A组和B组，A组患者的PaO2显著高于B组和C组，以上差异均有统计学意义（q=4．056-7．638，χ^2=6．084，15．221，P〈0．05）；C组患者的血清TGF-β1，VEGF和IGF-I水平均显著低于A组和B组，差异均有统计学意义（q=3．548-6．392，P〈0．05）；A组吸烟患者的血清VEGF水平显著低于不吸烟患者（t=6．138，P〈0．05），A组患者的血清VEGF水平与吸烟年限（r=0．615）、平均每日吸烟量（r=0．536）呈负相关关系（P〈0．05），B组患者的血清TGF-N水平与平均每日吸烟量（r=6．375，P〈O．05）呈正相关关系，C组患者的血清VEGF水平与吸烟年限（r=0．592）、平均每日吸烟量（r=0．556）呈负相关关系（P〈0.05）。结论CPFE患者的肺间质纤维化病变与血清TGF-β1，VEGF和IGF-I水平的上升有关，而血清VEGF水平的降低则与患者的吸烟年限和吸烟量具有相关性，可能参与了肺气肿的发病过程。

Objective To observe and analyze the expression levels of the serum transforming growth factors-β1 （TGF-β1）, vascular endothelial growth factor （VEGF）,insulin like growth factor I （IGF-I ） and its correlation with smoking of the patients with combined pulmonary fibrosis and emphysema （CPFE）. Methods 40 cases of patients with CPFE were selected as group A,40 cases of patients with idiopathic pulmonary fibrosis （IPF） were selected as group B,and 40 cases of patients with emphysema were selected as group C. The smoking status,the course of disease and the blood gas indexes of arterial partial pressure of oxygen （PaO2）,partial pressure of carbon dioxide （PaCO2） of the patients in the three groups were detected and compared. The serum TGF-β1, VEGF and IGF I levels of the patients in the three groups were detected and compared. Results The course of disease,the smoking ratio of the patients in group B were significantly lower than those in group A or group C. The smoking duration,the daily average amount of smoking,PaCO2 of the patients in group C were sig- nificantly higher than those in group A or group B. PaO2 of the patients in group A was significantly higher than that of group B or group C. The above differences were statistically significant （q = 4. 056±7. 638, χ^2 = 6. 084,15. 221, P〈0.05）. The serum TGF-β1,VEGF and IGF-I levels of the patiep-ts in group C were significantly lower than those in group A or group B. The difference was statistically significant （q= 3. 548- 6. 392, P〈0.05）. The serum VEGF level of the smoking patients in group A was significantly lower than that of no-smoking patients （t= 6. 138,P〈0.05）. The serum VEGF level of patients in group A was negatively correlated with the smoking duration （r=- 0. 615）,the daily average amount of smoking （r= -0. 536, P〈0.05）. The serum TGF-β1 level of the patients in group B was correlated positively with the daily average amount of smoking （r=6. 375 ,P〈0. 05）. The serum VEGF level of of patients in group C was negatively correlated with the smoking duration （r=-0. 592）,the daily average amount of smoking （r= -0. 556, P〈0.05）. Conclusion The pulmonary interstitial fibrosis of the patients CPFE was related with the rises of the serum TGF-β1, VEGF and IGF-I levels.The decreased serum VEGF level was correlated with the smoking duration and the smoking amount of the patients, may be involved in the pathogenesis of emphysema.