血清胱抑素C与稳定期慢性阻塞性肺疾病患者疾病严重程度相关性分析

Correlative analysis of the level of serum cystatin-C in different severity of patients with stable chronic obstructive pulmonary disease

目的探讨稳定期慢性阻塞性肺疾病(COPD)患者不同气流受限及疾病严重程度时血清胱抑素C(Cys-C)水平的变化及其相关性,寻找评估稳定期COPD患者疾病严重程度的生物标志物。方法选取山西大医院2016年1月至12月门诊随访的94例COPD患者作为COPD组;选取同期本院体检中心的31例健康体检者作为健康对照组,分别行肺功能检查,同时检测血清胱抑素C和肌酐(Cr)水平,计算肾小球滤过率(GFR)。根据肺功能FEV1%预计值将COPD组患者分为GOLD1、2、3、4级;根据过去1年的加重次数、生活质量评分(CAT)又将COPD组患者分为A、B、C、D四个亚组。结果 COPD组患者血清Cys-C水平高于健康对照组,差异有统计学意义(P<0.05);COPD患者全球慢性阻塞性肺疾病防治倡议(GOLD)1、2、3、4级血清Cys-C水平差异有统计学意义(P<0.01),GOLD 4级患者血清Cys-C水平高于GOLD1、2和3级;COPDA、B、C、D组患者血清Cys-C水平差异有统计学意义(P<0.01),D组血清Cys-C水平高于A、B组,C组血清Cys-C水平高于A组;相关性分析显示血清Cys-C与CRP呈正相关,与GFR、FEV1%预计值呈负相关。结论稳定期COPD患者血清胱抑素C水平增高,并且随着气流受限及综合评估严重程度的加重而升高,提示胱抑素C可作为评估COPD严重程度的生物标志物。

Objective To observe change and the correlation of serum Cystatin C( Cys-C) levels of the stability of stable chronic obstructive pulmonary disease( COPD) patients with different limited airflow and the severity of disease. Methods A total of 94 COPD patients of Shanxi Dayi hospital from January 2016 to December were followed up as COPD group; 31 healthy subjects in the hospital physical examination center were selected as healthy control group. Pulmonary function tests,serum cystatin C and creatinine( Cr) levels were measured respectively,meanwhile,Calculated glomerular filtration rate. According to the estimated percentage of pulmonary function FEV1,the patients with COPD were divided into four different subgroups:GOLD1,2,3 and 4 stage; According to the history of acute exacerbation number and COPD assessment test,the patients with COPD were divided into four different subgroups: A,B,C and D. Results The serum CysC level in patients with stable COPD was higher than those in healthy controls( P < 0. 05). There were significant differences in the serum Cys-C among stable COPD patients of GOLD1,2,3 and 4 stage( P<0.01),the serum Cys-C levels in GOLD4 stage were higher than GOLD1,2,3 stage.There were significant differences in the serum Cys-C among stable COPD patients of A,B,C and D subgroup( P < 0. 01),the serum Cys-C levels in D subgroup were higher than A,B subgroup,the serum Cys-C levels in C subgroup were higher than A subgroup. The serum Cys-C levels were positive correlated with CRP( P < 0. 01) and significantly negativecorrelated with FEV1( P < 0. 01) and GFR( P < 0. 01). Conclusions COPD patients serum Cys-C level is higher,and increased with COPD disease severity. The serum Cys-C level may become biomarkers of the assessment of severity in patients with COPD.