稳定期COPD患者外周血肺表面活性蛋白-A和肿瘤坏死因子-α及生长分化因子-15的表达及意义

Expression levels and clinical significance of lung surfactant protein A,tumor necrosis factor-α,and growth differentiation factor-15 in peripheral blood of patients with stable COPD

目的探讨稳定期慢性阻塞性肺疾病(COPD)患者外周血肺泡表面活性蛋白-A(SP-A)、肿瘤坏死因子-α(TNF-α)及生长分化因子-15(GDF-15)的表达水平及意义。方法将99例稳定期COPD患者作为观察组,同期54例体检健康者作为对照组,比较2组受试者外周血SP-A、TNF-α、GDF-15水平及一秒用力呼气容积占预计值百分比(FEV1%pred)、一秒用力呼气容积与用力肺活量比值(FEV1/FVC),比较不同慢性阻塞性肺疾病全球倡议(GOLD)分级COPD患者外周血SP-A、TNF-α及GDF-15水平;采用Spearman分析COPD患者外周血SPA、TNF-α、GDF-15水平与FEV1%pred、FEV1/FVC的相关性,Pearson分析COPD患者外周血SP-A、TNF-α、GDF-15水平与各级GOLD的相关性。结果观察组SP-A、TNF-α、GDF-15水平高于对照组,FEV1%pred、FEV1/FVC低于对照组,差异有统计学意义(P<0.05);Ⅲ~Ⅳ级COPD患者外周血SP-A、TNF-α、GDF-15水平高于Ⅰ~Ⅱ级患者,差异有统计学意义(P<0.05);COPD患者外周血SP-A、TNF-α及GDF-15水平均与FEV1%pred、FEV1/FVC呈负相关关系(P<0.01),GOLD分级与患者外周血SP-A、TNF-α、GDF-15水平呈正相关关系(r=0.391、0.412、0.354,P<0.01)。结论稳定期COPD患者外周血SP-A、TNF-α、GDF-15水平升高,与FEV1%pred、FEV1/FVC呈负相关、与病情严重程度呈正相关。

Objective To explore the expression levels of lung surfactant protein A(SP-A), tumor necrosis factor α( TNF-α), and growth differentiation factor-15( GDF-15) in patients with stable chronic obstructive pulmonary disease(COPD) and their clinical significance.Methods A total of99 patients with stable COPD were selected as observation group, Meanwhile, 54 healthy individuals who underwent physical examination were recruited as control group. The levels of SP-A, TNF-α,GDF-15, forced expiratory volume in one second as a percentage of predicted(FEV1% pred) and the ratio of FEV1to forced vital capacity(FEV1/FVC) were compared between two groups. The levels of SP-A, TNF-α, and GDF-15 in peripheral blood were compared among COPD patients at different Global Initiative for Chronic Obstructive Lung Disease( GOLD) grade. Spearman correlation was applied to analyze the association of the levels of SP-A, TNF-α, and GDF-15 in peripheral blood of COPD patients with FEV1% pred and FEV1/FVC. Pearson correlation was conducted to analyze the association of levels of SP-A, TNF-α, and GDF-15 in peripheral blood of the COPD patients at different GOLD grade.Results The levels of SP-A, TNF-α, and GDF-15 were higher in observation group than those in control group, while FEV1% pred and FEV1/FVC in observation group were lower than those in control group(P< 0. 05). The levels of SP-A, TNF-α, and GDF-15 in peripheral blood of the COPD patients at GOLD grades Ⅲ-Ⅳ were greater than those of the COPD patients at GOLD grades Ⅰ-Ⅱ (P< 0. 05). The levels of SP-A, TNF-α and GDF-15 in peripheral blood of the COPD patients were negatively correlated with FEV1% pred and FEV1/FVC(P< 0. 01), but positively correlated with GOLD grades(r= 0. 391, 0. 412, 0. 354;P< 0. 01).Conclusion In peripheral blood of the patients with stable COPD, the levels of SP-A, TNF-α, and GDF-15 are significantly elevated and negatively correlated with FEV1% pred and FEV1/FVC but positively correlated with the severity of the disease.