慢性阻塞性肺疾病患者血清LCN1和LCN2的表达水平及临床意义

Expression Levels of Serum LCN1 and LCN2 in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Its Clinical Significance

目的探讨慢性阻塞性肺疾病(COPD)患者血清脂质运载蛋白1(LCN1)、脂质运载蛋白2(LCN2)的表达水平及临床意义。方法选取2015年5月~2017年4月上海同济大学附属杨浦医院收治的COPD患者93例,其中急性加重期53例设为加重期组,稳定期40例设为稳定期组。另选取在该院同期行健康体检者40例作为对照组。分别采用酶联免疫试剂盒检测LCN1,LCN2和高敏C反应蛋白(hs-CRP),分析LCN1,LCN2与临床资料的相关性。结果加重期组、稳定期组及正常对照组年龄、性别、BMI相比差异无统计学意义(F/χ~2=1.599~2.028,均P>0.05),加重期组hs-CRP,中性粒细胞,白细胞计数均显著升高,FEV1/FVC,FEV1%pred及PaO2均显著降低(F=64.942~481.808,均P<0.05)。加重期组血清中LCN1,LCN2表达水平明显高于稳定期组(t=19.088,18.904,均P<0.05)。COPD患者血清中LCN1,LCN2水平与年龄、性别、BMI无显著相关性(r=0.010~0.161,P>0.05),与hs-CRP,中性粒细胞百分比、白细胞计数呈显著的正相关性(r=0.418~0.712,均P<0.05),与FEV1/FVC,FEV1%pred及PaO2呈明显负相关性(r=-0.482~0.782,均P<0.05)。多元线性回归分析,hs-CRP,中性粒细胞、白细胞计数、FEV1/FVC,FEV1%pred均为LCN1和LCN2的独立影响因素(OR=0.329~4.035,P<0.05)。结论 LCN1和LCN2在COPD急性加重患者血清中均呈显著高表达,与COPD急性加重密切相关,推测LCN1和LCN2可能为诊断COPD潜在分子标志物。

Objective To investigate the expression level of serum LCN1 and LCN2 in patients with acute exacerbation of chronic obstructive pulmonary disease（COPD）and its clinical significance.Methods From May 2015 to April 2017 in Shanghai Yangpu Hospital Affiliated to Tongji University 93 cases with chronic obstructive pulmonary disease were collect-ed as the research object,the acute exacerbation of chronic obstructive pulmonary disease（COPD）in 53 patients,was as the exacerbation group,and chronic obstructive pulmonary disease（COPD）in 40 patients,was as stable group.Another 40 cases were selected to hospital for physical examination,volunteers were set as normal control group.Venous blood was collected, patients sera by ELISA kit for detection of LCN1,LCN2 and high sensitive C reactive protein（hs-CRP）,correlation analysis between LCN1,LCN2 and clinical parameters of patients respectively.Results The exacerbation group,stable group and normal control group with age,gender,BMI had no significant difference（F/χ2=1.599~2.028,all P＆gt;0.05）.In the exac-erbation group,the expression of hs-CRP,neutrophil percentage,and white blood cell count were significantly increased,but FEV1/FVC,FEV1% pred and PaO2were significantly decreased（F=64.942~481.808,all P〈0.05）.The serum levels of LCN1 and LCN2 in the exacerbation group were significantly higher than those in the stable group（t=19.088,18.904,all P＆lt;0.05）.The expression of LCN1,LCN2 in serum of COPD patients with age,sex,BMI had no significant correlation（r=0.010~0.161,all P〉0.05）,it showed a significant positive correlation with hs-CRP,neutrophil percentage,white blood cell count（r=0.418~0.712,all P〈0.05）,and there was a negative correlation with FEV1/FVC,FEV1% pred and PaO2（r=-0.482^-0.782,P〈0.05）.Multiple linear regression analysis showed that the percentage of hs-CRP,the percentage of neutrophils,WBC count,and FEV1/FVC,FEV1% pred were independent factors of LCN1,LCN2（OR=0.329~4.035,P〈0.05）.Conclusion Both LCN1 and LCN2 are highly expressed in serum of patients with COPD,and the expression of LCN1 and LCN2 was closely related to the acute attack of COPD.It would be speculated that LCN1 and LCN2 may be po-tential molecular marker for the diagnosis of acute exacerbation of COPD.