慢性阻塞性肺疾病患者血清IL-34质量浓度变化及临床意义

Changes of serum IL-34 levels in patients with chronic obstructive pulmonary disease and its clinical significance

目的探讨慢性阻塞性肺疾病(慢阻肺)患者血清白细胞介素-34(IL-34)质量浓度变化及临床意义。方法选取2017年1月—2019年6月中南大学湘雅医学院附属海口医院收治的120例慢阻肺患者作为研究对象,其中,慢阻肺急性加重期患者64例(急性加重组),慢阻肺稳定期患者56例(稳定组),另选取同期体检健康者50例作为对照组,分别采集3组血液标本,应用酶联免疫吸附试验法检测3组血清IL-34质量浓度,采用肺功能仪测定肺功能相关指标,分析血清IL-34质量浓度与肺功能指标的关系,绘制受试者工作特征曲线,分析血清IL-34在慢阻肺临床诊断中的应用价值。结果3组患者血清IL-34质量浓度比较差异有统计学意义(P<0.05);与对照组比较,急性加重组和稳定组患者血清IL-34质量浓度明显升高;与稳定组比较,急性加重组患者血清IL-34质量浓度明显升高;3组患者第1秒用力呼气容积(FEV_(1))、呼气流量峰值(PEF)、第1秒用力呼气容积占预计值百分比(FEV_(1)%pred)、第1秒用力呼气容积与用力肺活量比值(FEV_(1)/FVC)比较差异均有统计学意义(P<0.05);与对照组比较,急性加重组和稳定组患者FEV_(1)、PEF、FEV_(1)%pred、FEV_(1)/FVC明显下降(P<0.05);与稳定组比较,急性加重组患者FEV_(1)、PEF、FEV_(1)%pred、FEV_(1)/FVC明显下降(P<0.05);Sperman相关性结果提示,急性加重组和稳定组患者血清IL-34质量浓度均与FEV_(1)%pred、FEV_(1)/FVC呈负相关关系(P<0.05);受试者工作特征曲线分析结果显示,血清IL-34诊断慢阻肺急性加重期的曲线下面积为0.834(95%CI:[0.597,0.985]),诊断敏感性为93.06%,特异性为81.67%;血清IL-34诊断慢阻肺稳定期的曲线下面积为0.811(95%CI:[0.558,0.916]),诊断敏感性为91.26%,特异性为79.93%。结论IL-34在慢阻肺患者血清中表达上调,或将成为慢阻肺潜在的生物学标志物。

Objective To explore the changes of serum IL-34 levels in patients with chronic obstructive pulmonary disease(COPD)and their clinical significance.Methods 120 patients with chronic obstructive pulmonary disease admitted into Central South University Xiangya School of Medicine Affiliated Haikou Hospital from January,2017 to June,2019 were included in the study.Of them,64 patients classified into the acute exacerbation of COPD(acute plus recombination)group,56 patients into the stable COPD group,and another 50 patients who were healthy in Central South University Xiangya School of Medicine Affiliated Haikou Hospital during the same period were selected as the control group.Three groups of blood samples were collected,and the levels of serum interleukin-34(IL-34)were detected by enzyme-linked immunosorbent assay(ELISA).Pulmonary function was used to measure lung function related indicators.The relationship between serum IL-34 level and lung function index was analyzed,and the ROC curve was drawn,in order to analyze the value of serum IL-34 in the clinical diagnosis of chronic obstructive pulmonary disease.Results Serum IL-34 levels were significantly different between the 3 groups(P<0.05).Compared with the control group,serum IL-34 levels were significantly elevated in the COPD acute plus recombinant and COPD stable groups.Compared with the COPD stable group,serum IL-34 level was significantly increased in patients with acute COPD plus recombination.The forced expiratory volume in 1 second(FEV_(1)),peak expiratory flow rate(PEF),forced expiratory volume in 1 second as a percentage of predicted value(FEV_(1)%pred),ratio of forced expiratory volume to forced vital capacity in 1 second(FEV_(1)/FVC)comparison,and the differences were all statistically significant(P<0.05).Compared with the control group,the FEV_(1),PEF,FEV_(1)%pred and FEV_(1)/FVC were significantly decreased in the COPD acute plus recombination and COPD stable group(P<0.05).Compared with the COPD stable group FEV_(1),PEF,FEV_(1)%pred and FEV_(1)/FVC were significantly decreased in patients with acute COPD plus recombination(P<0.05).Sperman correlation results suggested that serum IL-34 levels and FEV_(1)%pred in patients with acute COPD plus recombination and COPD stabilization and FEV_(1)/FVC was negatively correlated(P<0.05).The ROC curve analysis showed that the area under the curve of serum IL-34 in the diagnosis of acute exacerbation of COPD was 0.834(95%CI:[0.597,0.985]),the diagnostic sensitivity was 93.06%,the specificity was 81.67%.Serum IL-34 was diagnosed with COPD.The area under the curve of the stationary phase was 0.811(95%CI:[0.558,0.916]),the diagnostic sensitivity was 91.26%and the specificity was 79.93%.Conclusion IL-34 is up-regulated in the serum of patients with chronic obstructive pulmonary disease or can be a potential biomarker for chronic obstructive pulmonary disease.