慢性阻塞性肺疾病患者血清Clara细胞分泌蛋白16、人中性粒细胞多肽表达及临床意义

Expressions and Clinical Significance of Serum Clara Cell Secretory Protein 16 and Human Neutrophil Peptide in Patients with ChronicObstructive Pulmonary Disease

目的 探讨慢性阻塞性肺疾病(COPD)患者血清Clara细胞分泌蛋白16(CC16)、人中性粒细胞多肽1-3(HNP1-3)表达及临床意义。方法 选取2018年6月—2022年6月收治的COPD 154例作为COPD组,同期健康体检者90例作为对照组。另根据气流受限程度将COPD 154例分为轻中度组(57例)、重度组(73例)和极重度组(24例)3组;根据病情分期将COPD 154例分为急性加重期组(52例)和稳定期组(102例)。比较COPD组和对照组血清CC16、HNP1-3水平及肺功能指标[第1秒用力呼气容积占预计值百分比(FEV1%)、第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)],不同气流受限程度及病情分期组血清CC16、HNP1-3水平。采用Pearson相关性分析探讨COPD患者血清CC16和HNP1-3水平与肺功能指标相关性,绘制受试者工作特征(ROC)曲线分析血清CC16和HNP1-3对COPD急性加重的预测价值。结果 COPD组血清CC16水平及FEV1%、FEV1/FVC低于对照组,血清HNP1-3水平高于对照组(P<0.01)。不同气流受限程度COPD 3组随着气流受限程度加重,血清CC16水平逐渐降低,血清HNP1-3水平逐渐升高(P<0.05)。急性加重期组血清CC16水平低于稳定期组,血清HNP1-3水平高于稳定期组(P<0.01)。Pearson相关性分析结果显示,COPD患者血清CC16水平与FEV1%、FEV1/FVC呈正相关,血清HNP1-3水平与FEV1%、FEV1/FVC呈负相关(P<0.05)。ROC曲线分析结果显示,血清CC16、HNP1-3及二者联合预测COPD急性加重的曲线下面积分别为0.738、0.867和0.893。结论 COPD患者血清CC16水平降低、HNP1-3水平升高,且与肺功能指标具有相关性。血清CC16和HNP1-3水平对COPD急性加重有一定预测价值。

Objective To investigate the expression and clinical significance of serum Clara cell secretory protein 16(CC16)and human neutrophil peptide-3(HNP1-3)in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 154 patients with COPD who were admitted from June 2018 to June 2022 were selected as COPD group,and 90 healthy subjects who underwent physical examination during the same period were selected as control group.According to the degree of airflow restriction,154 patients with COPD were divided into three groups:mild to moderate group(n=57),severe group(n=73)and extremely severe group(n=24).According to the disease stage,154 patients with COPD were divided into acute exacerbation group(n=52)and stable group(n=102).The serum levels of CC16 and HNP1-3 and pulmonary function indexes[percentage of forced expiratory volume in the first second to the expected value(FEV1%),ratio of forced expiratory volume in the first second to forced vital capacity(FEV1/FVC)]were compared between COPD group and control group,and the serum levels of CC16 and HNP1-3 were compared between groups with different degrees of airflow restriction and disease stages.Pearson correlation analysis was used to investigate the correlation between serum CC16 and HNP1-3 levels and lung function indexes in COPD patients,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum CC16 and HNP1-3 in acute exacerbation of COPD.Results The serum CC16 level,FEV1%and FEV1/FVC in COPD group were lower than those in control group,while the serum HNP1-3 level was higher than that in control group(P<0.01).With the aggravation of airflow restriction,the serum CC16 level was gradually decreased and the serum HNP1-3 level was gradually increased in COPD 3 groups(P<0.05).The serum CC16 level in the acute exacerbation group was lower than that in the stable stage,while the serum HNP1-3 level was higher than that in the stable stage(P<0.01).Pearson correlation analysis showed that serum CC16 level in COPD patients was positively correlated with FEV1%and FEV1/FVC,while serum HNP1-3 level was negatively correlated with FEV1%and FEV1/FVC(P<0.05).ROC curve analysis showed that the areas under the ROC curve of serum CC16,HNP1-3 alone and in combination in prediction of acute exacerbation of COPD were 0.738,0.867 and 0.893,respectively.Conclusion The serum CC16 level is decreased and HNP1-3 level is increased in COPD patients,which is correlated with lung function indexes.Serum CC16 and HNP1-3 levels have certain predictive value for acute exacerbation of COPD.