慢性阻塞性肺疾病患者血清HIF-1α、OPN水平与继发肺动脉高压的关系

Relationship between serum hypoxia inducible factor-1 alpha and osteopontin levels in chronic obstructive pulmonary disease patients with secondary pulmonary hypertension

目的探讨慢性阻塞性肺疾病(COPD)患者血清低氧诱导因子1α(HIF-1α)、骨桥素(OPN)水平与继发肺动脉高压(PH)的关系。方法回顾性选取2016年6月至2018年6月北京市海淀医院收治的COPD继发PH患者100例,依据肺动脉收缩压(PASP)分为轻度组(PASP为31~40 mmHg,n=48)、中度组(PASP为41~70 mmHg,n=32)、重度组(PASP>70 mmHg,n=20),同期选取单纯COPD(无继发PH)患者50例。检测所有患者的血清HIF-1α、OPN水平和肺通气功能[动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)]。结果COPD继发PH患者PASP [(56.24±6.82)mmHg]、PaCO2 [(54.18±6.72) mmHg]和血清HIF-1α[(265.42±30.21) pg/ml]、OPN [(160.95±19.71)μg/L]水平明显高于单纯COPD患者[(20.46±2.49) mmHg、(45.04±4.88) mmHg、(182.12±25.12) pg/ml、OPN(102.12±15.42)μg/L]但PaO2 [(62.45±7.82) mmHg]明显低于单纯COPD患者[(75.04±7.86)mmHg],差异均具有统计学意义(P<0.05);重度组患者PASP[(81.42±8.59) mmHg]、PaCO2 [(64.01±6.82) mmHg]和血清HIF-1α[(319.41±33.42)pg/ml]、OPN [(200.52±23.04)μg/L]水平明显高于中度组[(55.79±5.62) mmHg、(54.99±5.72) mmHg、(264.27±27.62) pg/ml、OPN(159.72±17.97)μg/L]但PaO2 [(51.04±5.67) mmHg]明显低于中度组[(61.05±6.32) mmHg];中度组患者PASP、PaCO2和血清HIF-1α、OPN水平明显高于轻度组[(36.24±3.81) mmHg、(50.02±5.12) mmHg、(230.11±25.72) pg/ml、OPN(135.42±15.27)μg/L],但PaO2明显低于轻度组[(67.52±6.91) mmHg],差异均具有统计学意义(P<0.05);Pearson相关性分析结果显示血清HIF-1α、OPN水平与PASP呈明显正相关(r=0.812 <0.001;r=0.803,P<0.001)。结论COPD患者血清HIF-1α、OPN水平与继发PH有关血清HIF-1α、OPN水平可作为评估COPD继发PH及其病情的重要指标。

Objective To discuss the relationship between serum hypoxia inducible factor-1 alpha(HIF-1α) and osteopontin(OPN)levels in chronic obstructive pulmonary disease(COPD) patients with secondary pulmonary hypertension(PH).Methods One hundred COPD patients with secondary PH were retrospectively selected from June 2016 to June 2018 in Beijing Haidian Hospital,according to the pulmonary artery systolic pressure(PASP),they were divided into mild group(PASP 31~40 mmHg,n=48),moderate group(PASP 41~70 mmHg,n=32),severe group(PASP> 70 mmHg,n=20).At the same time,50 patients with simple COPD(without secondary PH) were selected.Serum HIF-la,OPN levels and pulmonary ventilation function [PaO2,PaCO2] were measured in all patients.Results The PASP [(56.24±6.82)mmHg],PaCO2 [(54.18±6.72) mmHg] and serum HIF-1α[(265.42±30.21) pg/ml],OPN [(160.95±19.71)μg/L] levels in COPD patients with secondary PH were significantly higher than those in COPD patients [(20.46±2.49) mmHg,(45.04±4.88) mmHg,(182.12±25.12) pg/ml,OPN(102.12±15.42)μg/L],but the PaO2 [(62.45±7.82) mmHg] was significantly lower than those in COPD patients[(75.04±7.86) mmHg],the difference was statistically significant(P <0.05).The PASP [(81.42±8.59) mmHg],PaCO2[(64.01±6.82) mmHg] and serum HIF-1α[(319.41±33.42) pg/ml],OPN [(200.52±23.04)μg/L] levels in severe group were significantly higher than those in moderate group [(55.79±5.62) mmHg,(54.99±5.72) mmHg,(264.27±27.62) pg/ml,OPN(159.72±17.97)μg/L],but the PaO2 [(51·04±5.67) mmHg] was significantly lower than those in moderate group [(61.05±6.32) mmHg],and the PASP,PaCO2 and serum HIF-1α,OPN levels in moderate group were significantly higher than those in mild group [(36.24±3.81) mmHg,(50.02±5.12) mmHg,(230.11±25.72) pg/ml,OPN(135.42±15.27)μg/L],but the PaO2 was significantly lower than those in mild group [(67.52±6.91) mmHg],the difference was statistically significant(P <0.05).The Pearson correlation analysis showed that,serum HIF-1α and OPN levels were positively correlated with PASP(r=0.812,P <0.001;r=0.803,P <0.001).Conclusion Serum HIF-1α and OPN levels in COPD patients are related to secondary PH,which can be used as the important indexes to evaluate secondary PH and its condition.