慢性阻塞性肺疾病合并肺动脉高压患者血清Myostatin、Smad3、MuRF-1的表达及诊断价值

Expression and diagnostic value of Myostatin,Smad3 and MuRF-1 in serum of patients with chronic obstructive pulmonary disease combined with pulmonary hypertension

目的检测慢性阻塞性肺疾病(COPD)合并肺动脉高压(PH)患者外周血清Myostatin、Smad3、MuRF-1的表达水平,并探讨其对COPD合并肺动脉高压的诊断价值。方法将62例确诊为COPD稳定期患者,根据超声心动图检查结果分为COPD组31例[肺动脉收缩压(PASP)值<40 mmHg]和COPD合并PH组31例PASP值≥40 mmHg。用ELISA法检测2组外周血清Myostatin、Smad3和MuRF-1的浓度,绘制受试者工作特征曲线(ROC),并计算敏感度及特异度。结果COPD合并PH组血清Myostatin、Smad3、MuRF-1表达水平显著高于COPD组(P<0.05);Myostatin、Smad3及MuRF-1其ROC曲线下面积分别为0.918、0.836、0.864,最佳截断值分别为254.53 pg/mL、4.09 ng/mL、381.26 pg/mL,敏感度分别为93.5%、64.5%、74.2%,特异度分别为80.6%、77.4%、77.4%。结论COPD合并PH患者外周血清中Myostatin、Smad3、MuRF-1表达水平较COPD患者显著升高,Myostatin的敏感度高于Smad3和MuRF-1,有望成为协助鉴别诊断COPD合并PH的重要指标。

Objective To detect the expression levels of myostatin,Smad3 and MuRF-1 in peripheral serum of patients with chronic obstructive pulmonary disease(COPD)combined with pulmonary hypertension(PH)and to explore the diagnostic value.Methods 62 patients with COPD were divided into COPD group(31 cases,PASP value<40 mmHg)and COPD combined with PH group(31 cases,PASP value≥40 mmHg)according to echocardiographic results.The concentration of myostatin,Smad3 and MuRF-1 in peripheral serum of two groups was detected by ELISA.The receiver operating characteristic curve(ROC)was drawn and the sensitivity and specificity were calculated.Results The levels of serum myostatin,Smad3 and MuRF-1 in COPD combined with PH group were significantly higher than those in COPD group(P<0.05).The areas under ROC curve of myostatin,Smad3 and Murf-1 were 0.918,0.836 and 0.864,respectively,and the best cutoff values were 254.53pg/mL,4.09ng/mL and 381.26pg/mL,respectively.The sensitivity of myostatin,Smad3 and MuRF-1 were 93.5%,64.5% and 74.2%,respectively and the specificities were 80.6%,77.4% and 77.4%,respectively.Conclusion The expression levels of myostatin,Smad3 and MuRF-1 in peripheral serum of patients with COPD combined with PH were significantly higher than those of patients with COPD.Myostatin is more sensitive than Smad3 and MuRF-1,which is expected to be a new indicator to help the differential diagnosis of COPD combined with PH.