慢性阻塞性肺疾病患者血清可溶性程序性死亡受体1及其配体的变化及其临床意义

Changes and significance of serum soluble programmed death receptor 1 and its ligands in patients with chronic obstructive pulmonary disease

目的:探讨慢性阻塞性肺疾病(COPD)患者血清可溶性程序性死亡受体-1(sPD-1)及其配体sPD-L1的变化及其临床意义。方法:选取2017年1月至2018年7月广西中医药大学第一附属医院仁爱分院收治的100例COPD患者为研究对象,以其中50例COPD急性加重期(AECOPD)患者为AECOPD组,50例COPD稳定期患者为COPD稳定组,另选择同期在本院体检的健康志愿者50例作为对照组。采用酶联免疫吸附试验法(ELISA)检测3组血清sPD-1及sPD-L1水平,并分析sPD-1及sPD-L1与COPD患者第1秒用力呼气容积(FEV1)占用力肺活量(FVC)百分比(FEV1/FVC)、FEV1占预计值的百分比(FEV1%pred)的相关性。结果:AECOPD组和COPD稳定组FEV1%pred和FEV1/FVC比较无明显差异(P>0.05)。3组血清sPD-1水平比较,差异无统计学意义(P>0.05);AECOPD组患者血清sPD-L1水平明显高于COPD稳定组和对照组(P<0.05),COPD稳定组患者血清sPD-L1水平明显高于对照组(P<0.05)。AECOPD组和COPD稳定组患者血清sPD-L1水平均与FEV1%pred及FEV1/FVC呈负相关关系(P<0.05)。结论:sPD-L1在COPD患者血清中呈高表达,且其表达水平与患者肺功能下降有关,有可能成为COPD的一项临床检测指标。

Objective:To investigate the changes and significance of serum soluble programmed death-1(sPD-1)and its ligands sPD-L1 in patients with chronic obstructive pulmonary disease(COPD).Methods:From January 2017 to July 2018,100 patients with COPD treated in our hospital were selected,and divided into acute exacerbation of COPD(AECOPD)group and stable COPD group,with 50 cases in each group.A total of 50 healthy subjects were defined as a control group.The levels of sPD-1 and sPD-L1 were detected by enzyme-linked immunosorbent assay.The correlation between the sPD-1 or sPD-L1 level and the ratio of forced expiratory volume in the first second(FEV1)to forced vital capacity(FVC),and the percentage of FEV1 in the predicted value(FEV1%pred)was analyzed.Results:There was no significant difference in FEV1%pred and FEV1/FVC between the AECOPD group and stable COPD group(P>0.05).The sPD-1 level was similar in the three groups(P>0.05).The sPD-L1 level was higher in AECOPD group than that in stable COPD group and control group,and it was higher in stable COPD group compared with control group(P<0.05).The sPD-L1 level was negatively correlated with FEV1%pred and FEV1/FVC inAECOPD group and stable COPD group(P<0.05).Conclusion:sPD-L1 was highly expressed in patients with COPD,and its expression level was related to the reduction of lung function in patients,which may be a clinical indicator for COPD.