特发性间质性肺炎急性加重期患者血清核心蛋白多糖、血管生成素-2的表达及临床意义

Expression and clinical significance of serum core protein polysaccharide and angiopoietin-2 in patients with idiopathic interstitial pneumonia in acute exacerbation

目的探讨特发性间质性肺炎(IIP)急性加重期患者血清核心蛋白多糖(DCN)、血管生成素-2(Ang-2)的表达及临床意义。方法选取2017年1月至2018年1月该院诊治的86例IIP患者的临床资料,根据病情分为稳定期组(38例)和急性加重期组(48例),根据生存预后情况将急性加重期组分为生存组(28例)和死亡组(20例)。以40例体检健康者作为对照组。统计学分析各组血清DCN、Ang-2、实验室指标的表达差异及不同预后的急性加重期IIP患者血清DCN、Ang-2水平的表达差异。采用Pearson相关分析IIP急性加重期患者血清DCN、Ang-2水平与实验室指标的相关性。多因素Cox回归分析影响IIP急性加重期患者生存预后的因素。结果与对照组及稳定期组相比,急性加重期组患者血清DCN水平明显较低,而Ang-2水平明显较高(P<0.05)。Pearson相关分析显示,IIP急性加重期患者血清DCN水平与肺泡表面活性蛋白A(SP-A)、肺泡表面活性蛋白D(SP-D)、C反应蛋白(CRP)、红细胞沉降率(ESR)水平呈负相关(P<0.05);血清Ang-2水平与SP-A、SP-D、CRP、ESR水平呈正相关(P<0.05)。与生存组相比,死亡组患者血清DCN水平较低,而Ang-2水平较高(P<0.05)。Cox回归分析结果显示,急性加重期IIP患者血清DCN、Ang-2水平是影响患者生存预后的因素(P<0.05)。结论IIP急性加重期患者血清DCN水平降低,而Ang-2水平升高,两者是影响患者的生存预后的因素,可作为判断IIP急性加重期患者预后的标志物。

Objective To study the expression and clinical significance of serum core protein polysaccharide(DCN)and angiopoietin-2(Ang-2)in patients with idiopathic interstitial pneumonia(IIP)in acute exacerbation.Methods The clinical data of 86 patients with IIP diagnosed and treated in the hospital from January 2017 to January 2018 were analyzed,and the patients were divided into stable stage group(n=38)and acute exacerbation stage group(n=48)according to the condition.The patients of the acute exacerbation were divided into survival group(n=28)and death group(n=20)according to survival prognosis.A total of 40 healthy people who were examined in the same period were selected as the control group.The differences in the expression of serum DCN,Ang-2 and laboratory indicators of each group and the difference in the expression of serum DCN and Ang-2 in IIP patients with different prognosis were analyzed statistically.Pearson correlation analysis was used to analyze the correlation between serum DCN and Ang-2 expression and laboratory indexes in patients with IIP in acute exacerbation.Multivariate Cox regression analysis of the factors affecting the survival and prognosis of patients with IIP in acute exacerbation.Results Compared with the control group and the stable stage group,the level of serum DCN of patients with IIP in acute exacerbation stage group was significantly lower,while the level of Ang-2 was significantly higher(P<0.05).Pearson correlation analysis showed that the level of serum DCN of patients with IIP in acute exacerbation was significantly negatively correlated with surfactant protein A(SP-A),surfactant protein D(SP-D),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)(P<0.05).The levels of serum Ang-2 were significantly positively correlated with SP-A,SP-D,CRP and ESR(P<0.05).Compared with the survival group,the level of serum DCN in the death group was significantly lower,while the level of Ang-2 was significantly higher(P<0.05).Cox regression analysis showed that the levels of serum DCN and Ang-2 in patients with IIP in acute exacerbation were the factors affecting the survival prognosis of patients(P<0.05).Conclusion The level of serum DCN of patients with IIP in acute exacerbation is decreased,while the level of Ang-2 is increased.Both the indicators affect the survival prognosis of patients,which are expected to become the new markers for judging the prognosis of patients with IIP in acute exacerbation.