血清Cav-1、LTB4和Corin检测对慢性阻塞性肺疾病患者肺动脉高压的诊断价值

The value of serum Cav-1,LTB4 and Corin for the diagnosis of pulmonary hypertension in patients with chronic obstructive pulmonary disease

目的探讨血清窖蛋白-1(Cav-1)、白三烯B4(LTB4)和利钠肽活化酶(Corin)检测对慢性阻塞性肺疾病(COPD)患者肺动脉高压(PAH)的诊断价值。方法将2017年1月至2019年12月在该院就诊的COPD患者共135例纳入研究,将其分为COPD稳定期组(60例)和COPD急性发作期(AECOPD)组(75例)。另外,选取同期该院体检健康者45例作为对照组。观察并比较各组血清Cav-1、LTB4和Corin水平,分析血清Cav-1、LTB4和Corin水平与缺氧严重程度和PAH严重程度的关系,计算上述3项指标单独和联合检测用于COPD患者PAH诊断的灵敏度和特异度。结果AECOPD组血清Cav-1和Corin水平低于COPD稳定期组和对照组(P<0.05),COPD稳定期组血清Cav-1和Corin水平低于对照组(P<0.05)。血清Cav-1和Corin水平随COPD患者缺氧程度或PAH严重程度增加而降低(P<0.05)。AECOPD组血清LTB4水平高于COPD稳定期组和对照组(P<0.05),COPD稳定期组血清LTB4水平高于对照组(P<0.05),血清LTB4水平随COPD患者缺氧程度和PAH严重程度的增加而升高(P<0.05)。Cav-1、LTB4和Corin联合检测用于COPD患者PAH诊断的灵敏度为90.8%,特异度为94.4%,曲线下面积(AUC)为0.972。3项指标联合检测用于COPD患者PAH诊断的AUC大于各项指标单独检测(P<0.05),而Cav-1、LTB4和Corin各项指标单独检测的AUC比较差异无统计学意义(P>0.05)。结论Cav-1、LTB4和Corin参与了COPD并发PAH的发生、发展过程,这3项指标联合检测用于COPD患者PAH的诊断具有较高的灵敏度和特异度。

Objective To observe the clinical value of serum caveolin-1(Cav-1),leukotriene B4(LTB4)and natriuretic peptide activating enzyme(Corin)in patients with chronic obstructive pulmonary disease(COPD)in the diagnosis of pulmonary hypertension(PAH).Methods A total of 135 patients with COPD treated in our hospital from January 2017 to December 2019 were enrolled in the study,who were divided into the stable COPD group(60 cases)and the acute exacerbation of COPD(AECOPD)group(75 cases).In addition to that,45 healthy people who underwent health examinations in the hospital during the same period were enrolled as the control group.Observe the serum levels of Cav-1,LTB4 and Corin and compare those indicators among the 3 groups,analyze the relationship between serum Cav-1,LTB4 and Corin levels and the severity of hypoxia or PAH.The sensitivities and specificities of the combined and single detection of the above three indicators for the diagnosis of PAH in COPD patients were calculated.Results The serum Cav-1 and Corin levels in AECOPD group were lower than those in stable COPD group and control group(P<0.05),while the levels in stable COPD group were lower than those in control group(P<0.05).The serum Cav-1 and Corin levels decreased as the hypoxia or PAH severity increased(P<0.05).The serum LTB4 levels were significantly higher than those in stable COPD group and control group(P<0.05),while those in stable COPD group were significantly higher compared with the control group(P<0.05),and increased as the hypoxia or PAH severity increased(P<0.05).The sensitivity of the combined detection of Cav-1,LTB4 and Corin for the diagnosis of PAH in COPD patients was 90.8%,the specificity was 94.4%,and the AUC was 0.972.The combined detection of 3 indicators for the diagnosis of PAH in COPD patients has greater AUC than the individual indicators(P<0.05),while the AUC of Cav-1,LTB4 and Corin indicators were not statistically different(P>0.05).Conclusion Cav-1,LTB4 and Corin are involved in the occurrence and development of COPD complicated with PAH,the combined detection of the three indicators for the diagnosis of PAH in COPD patients has high sensitivity and specificity.