肝素结合蛋白与1,25-(OH)_2D_3在慢性阻塞性肺疾病急性加重期患者血清中的表达水平及临床意义

Serum expression levels and clinical significance of heparin binding protein and 1,25-(OH)_2D_3 in patients with acute exacerbation of chronic obstructive pulmonary disease

目的:探讨肝素结合蛋白(HBP)与1,25-(OH)_2D_3在慢性阻塞性肺疾病急性加重期(AECOPD)患者血清中的表达水平及临床意义。方法:选择2012年7月至2015年7月广州医科大学附属第五医院收治的82例慢性阻塞性肺疾病患者作为研究对象,其中AECOPD组48例、COPD稳定期组34例。酶联免疫吸附试验测定1,25-(OH)_2D_3、HBP水平,同时检测血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)及WBC水平,同步行肺功能及相关检查。结果:AECOPD患者HBP水平为(74.15±13.24)ng/m L,明显高于COPD稳定期患者的(51.57±10.22)ng/m L(P<0.05);AECOPD患者1,25-(OH)_2D_3水平为(14.85±5.32)ng/m L,明显低于COPD稳定期患者的(19.46±6.52)ng/m L(P<0.05)。AECOPD患者PCT、hs-CRP及WBC水平均高于COPD稳定期患者(P<0.05),肺功能各项指标均明显低于COPD稳定患者(P<0.05)。血清1,25-(OH)_2D_3与肺功能指标呈正相关,HBP水平与肺功能指标呈负相关(P<0.05)。结论:血清1,25-(OH)_2D_3、HBP可作为AECOPD的辅助诊断指标,二者在COPD气道炎症及重塑中可能具有重要作用。

Objective：To investigate serum expression levels and clinical significance of heparin binding protein （HBP） and 1,25-（OH）2D3 in patients with acute exacerbation of chronic obstructive pulmonary disease （ AECOPD） . Methods：Included in this study were 82 COPD patients treated in the Fifth Affiliated Hospital of Guangzhou Medical University between July 2012 and July 2015. These subjects comprised AECOPD group （ n=48） and stable COPD group （n=34）. Enzyme-linked immunosorbent assay （ELISA） was used to measure the serum levels of 1,25-（OH）2D3 and HBP. Meanwhile,the patients were examined for serum procalcitonin （PCT）,high-sensitivity C-reactive protein （hs-CRP）,WBC and pulmonary function. Results：The HBP level in AECOPD patients was（74.15±13.24） ng/mL,significantly higher than （51.57±10.22） ng/mL in the stable COPD patients （P〈0.05）. The 1,25-（OH）2D3 level was （14.85±5.32） ng/mL in AECOPD patients,significantly lower than （19. 46±6.52） ng/mL in the stable COPD patients （P〈0.05）. AECOPD patients had higher PCT,hs-CRP and WBC,and significantly lowered pulmonary function indexes,compared with stable COPD patients. Serum 1,25-（ OH） 2 D3 level was positively correlated,while the HBP level was negatively correlated,with lung function indexes （P〈0.05）. Conclusion：The serum 1,25-（OH）2D3 and HBP levels can be used as diagnostic markers for AECOPD. The both may be playing an important role in airway inflammation and remodeling in patients with COPD.