血清趋化因子CCL19和CCL21水平变化在慢性阻塞性肺疾病中的意义及对肺动脉高压的预测价值

Significance of changes in serum chemokine CCL19 and CCL21 levels in chronic obstructive pulmonary disease and their predictive value for pulmonary hypertension

目的探讨血清趋化因子CCL19和CCL21水平变化在慢性阻塞性肺疾病中的意义及对肺动脉高压的预测价值。方法选择于我院住院治疗的慢性阻塞性肺疾病患者150例,根据肺动脉压是否正常分为肺动脉压增高组(68例)和肺动脉压正常组(82例),并选取健康体检者60例作为对照组。比较各组血清趋化因子CCL19和CCL21水平的差异。应用logistics回归模型分析影响慢性阻塞性肺疾病患者发生肺动脉高压的危险因素。应用受试者工作(ROC)曲线评价CCL19和CCL21水平对肺动脉高压的诊断价值。结果 CCL19和CCL21水平在对照组、肺动脉压正常组、肺动脉压增高组间逐渐升高,差异均有统计学意义(P<0.05)。单因素和多因素回归分析显示:CCL19和CCL21为影响慢性阻塞性肺疾病患者发生肺动脉高压的危险因素(P<0.05); ROC曲线分析显示,CCL19的曲线下面积为0.905,CCL21的曲线下面积为0.937。结论 CCL19和CCL21水平是影响慢阻肺患者发生肺动脉高压的危险因素,并与肺动脉压力呈正相关,可作为预测发生肺动脉高压的参考指标。

Objective To investigate the levels of CCL19 and CCL21 in serum in patients with chronic obstructive pulmonary disease,and to explore their predictive value for pulmonary hypertension.Methods 150 patients with chronic obstructive pulmonary disease hospitalized in our hospital were selected.According to whether the pulmonary artery pressure was normal,all patients were divided into pulmonary artery pressure increasing group(68cases)and pulmonary artery pressure normal group(82cases).60 healthy people were selected as the control group.The differences of the levels of CCL19and CCL21levels in serum were compared in each group.Application of logistic regression model was used to analyze risk factors affecting pulmonary hypertension in patients with chronic obstructive pulmonary disease.The use of receiver operating(ROC)curves was performed to evaluate the diagnostic value of CCL19and CCL21levels in pulmonary arterial hypertension.Results The levels of CCL19and CCL21gradually increased in the control group,the normal pulmonary artery pressure group,and the pulmonary arterial pressure increase group,and the differences were statistically significant(P<0.05).Univariate and multivariate regression analysis showed that CCL19and CCL21were risk factors for pulmonary hypertension in patients with chronic obstructive pulmonary disease(P<0.05).ROC curve analysis shows that the area under the curve of CCL19 was 0.905,and the area under the curve of CCL21was 0.937.Conclusion CCL19and CCL21levels were risk factors for pulmonary hypertension in COPD patients.Both were positively related to pulmonary artery pressure and can be used as references for predicting pulmonary hypertension.