慢性阻塞性肺疾病患者血清SDC-1、ANGPTL4、PGRN与肺功能及炎性反应的相关性分析

Correlation analysis of serum SDC-1,ANGPTL4 and PGRN with lung function and inflammatory response in patients with chronic obstructive pulmonary disease.

目的分析慢性阻塞性肺疾病(COPD)患者血清多配体蛋白聚糖-1(SDC-1)、血管生成素样蛋白4(ANGPTL4)及颗粒蛋白前体(PGRN)与肺功能及炎性反应的相关性。方法选取2017年2月—2019年12月南京医科大学附属逸夫医院呼吸内科收治COPD患者150例作为研究对象,按病情分为急性加重期组88例及稳定期组62例,另选取同期于医院进行体检的健康志愿者60例作为健康对照组。检测并比较3组血清SDC-1、ANGPTL4、PGRN、炎性因子水平及肺功能指标,分析COPD患者血清SDC-1、ANGPTL4、PGRN与血清炎性因子及肺功能指标的相关性。结果急性加重期组及稳定期组的血清SDC-1、ANGPTL4及PGRN水平均高于健康对照组,且急性加重期组上述指标水平均高于稳定期组(F=10.485、13.275、7.195,P均<0.01)。急性加重期组及稳定期组的第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC均低于健康对照组,且急性加重期组上述指标水平低于稳定期组(F/P=8.274/0.000、6.274/0.010、8.975/0.000)。急性加重期组及稳定期组的血清肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)及IL-17水平均高于健康对照组,且急性加重期组上述指标水平均高于稳定期组(F=20.853、33.285、16.823,P<0.000)。COPD患者血清SDC-1、ANGPTL4及PGRN水平与FEV_(1)、FVC、FEV_(1)/FVC均呈负相关,与血清TNF-α、IL-8、IL-17均呈正相关(P均<0.01)。结论COPD患者血清SDC-1、ANGPTL4及PGRN存在明显高表达,在急性加重期患者中升高更加明显,且随着上述血清指标水平的升高,肺功能越差,炎性反应越严重。

Objective To study the correlation between serum syndecan-1(SDC-1),angiogenin-like protein 4(ANGPTL4)and granuloprotein precursor(PGRN)and lung function and inflammatory response in patients with chronic obstructive pulmonary disease(COPD).Methods 150 patients with COPD were admitted to the Department of Respiratory Medicine of Yifu Hospital Affiliated to Nanjing Medical University from February 2017 to December 2019 were selected as the study group.they were divided into 88 patients in the acute exacerbation group and 62 patients in the stable period group according to their conditions.In addition,60 healthy volunteers who underwent physical examination in Yifu Hospital Affiliated to Nanjing Medical University during the same period were selected as the control group.The serum levels of SDC-1,ANGPTL4,PGRN,inflammatory factors and lung function indexes of the three groups were tested and compared,and the correlation between serum SDC-1,ANGPTL4,PGRN and serum inflammatory factors and lung function indexes in COPD patients was analyzed.Results serum levels of SDC-1,ANGPTL4 and PGRN in the acute exacerbation group and the stabilized group were higher than those in the control group,and the levels of these indicators in the acute exacerbation group were higher than those in the stabilized group(F/P=10.485/0.000,13.275/0.000,7.195/0.001).The forced expiratory volume(FEV_(1)),FEV_(1)/FVC and forced vital capacity(FVC)at the first second in the acute exacerbation group and the stabilized group were all lower than those in the control group.In addition,the level of the above indicators in the acute exacerbation group was significantly lower than that in the stable period group(F=8.274/0.000,6.274/0.010,8.975/0.000).Serum levels of tumor necrosis factor-leukin-leukin-8(IL-8)and interleukin-17(IL-17)in the acute exacerbation group and the stabilized group were all higher than those in the control group,and those in the acute exacerbation group were all higher than those in the stabilized group(F/P=20.853/0.000,33.285/0.000,16.823/0.000).Through Pearson correlation analysis,the following can be obtained:Serum levels of SDC-1,ANGPTL4 and PGRN in COPD patients were negatively correlated with FEV_(1),FVC,FEV_(1)/FVC(r/P=-0.416/0.024,-0.474/0.012,-0.513/0.006,r/P=-0.468/0.011,-0.419/0.021,-0.505/0.010,r/P=-0.531/0.002,-0.559/0.001,-0.604/0.000).Positive correlation was found between serum TNF-αand serum IL-8 and IL-17(r=0.638,0.671,0.619,r=0.654,0.637,0.609,r=0.675,0.682,0.690;all P=0.000).Conclusion Serum SDC-1,ANGPTL4 and PGRN are significantly overexpressed in patients with COPD,and increased more significantly in patients with acute exacerbation,and the higher the level of the above blood indicators,the worse the lung function,the more serious the inflammatory response.