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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2025年01期

页码:

23-28

栏目:

论著

出版日期:

2025-02-25

文章信息/Info

Title:

Serum CCN1, ECP, and GSH-Px levels in AECOPD patients and correlation with pulmonary and immune function

作者:

陈 晨; 裴永坚; 黄永康; 周 童

215004 江苏,苏州大学附属第二医院呼吸与危重症医学科

Author(s):

Chen Chen;  Pei Yongjian;  Huang Yongkang;  Zhou Tong.

Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China

关键词:

急性加重期; 肺疾病; 慢性阻塞性;  嗜酸性粒细胞阳离子蛋白;  谷胱甘肽过氧化物酶;  肺功能;  免疫功能

Keywords:

Chronic obstructive pulmonary disease;  acute exacerbation;  Eosinophil cationic protein;  Glutathione peroxidase;  Pulmonary function;  Immune function

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2025.01.004

摘要:

目的 分析慢性阻塞性肺疾病急性加重期(acute exacerbation phase of chronic obstructive pulmonary, AECOPD)患者血清富半胱氨酸蛋白 61(cysteine-rich 61, CCN1)、嗜酸性粒细胞阳离子蛋白(eosinophil cationic protein, ECP)和谷胱甘肽过氧化物酶(glutathione peroxidase, GSH-Px)的表达水平,及与肺功能、免疫功能的相关性和在AECOPD诊断中的意义。方法 选择2019年1月到2024年6月在我院收治的AECOPD患者55例为观察组,同时选取同期稳定期COPD患者43例作为对照组。采用酶联免疫吸附法测定血清CCN1、ECP、GSH-Px表达水平,通过肺功能测试仪测定一秒钟用力呼气量百分比预测值(predicted forced expiratory volume in one second,FEV1%pred)、用力呼气量与用力肺活量比值(FEV₁/forced vital capacity, FEV₁/FVC)和中段呼气流速百分比预测值(predicted maximal mid-expiratory flow, MMEF%pred),分析免疫功能指标,包括CD4⁺ T细胞、CD8⁺ T细胞、免疫球蛋白A(immunoglobulin A, IgA)、免疫球蛋白M(immunoglobulin M, IgM)。采用Pearson相关分析血清CCN1、ECP、GSH-Px水平与肺功能及免疫功能的相关性。采用受试者工作特征曲线(receiver operating characteristic, ROC)判断血清CCN1、ECP、GSH-Px水平对AECOPD的诊断。结果 观察组CCN1(173.15±35.63)ng/ml、ECP(30.16±4.25)ng/ml高于对照组(153.27±27.86)ng/ml、(19.23±2.84)ng/ml(P<0.05)。GSH-Px(29.14±3.16)U/L低于对照组(46.36±3.77)U/L(P<0.05)。观察组FEV₁%pred(58.43±5.13)%、FEV₁/FVC(58.28±7.35)%、MMEF%pred(26.27±5.13)%低于对照组FEV₁%pred(74.18±10.04)%、FEV₁/FVC(67.41±7.90)%、MMEF%pred(40.07±5.79)%(P<0.05)。观察组CD4⁺(29.93±3.12)%低于对照组(38.24±2.76)%(P<0.05)。CD8⁺(35.16±4.07)%、IgA(264.72±17.49)mg/dl、IgM(126.94±14.37)mg/dl高于对照组CD8⁺(27.29±2.25)%、IgA(195.83±15.21)mg/dl、IgM(95.57±10.94)mg/dl(P<0.05)。Pearson相关分析显示,血清CCN1、ECP水平与FEV₁%pred、FEV₁/FVC、MMEF%pred呈负相关(r<0,P<0.05),与CD8⁺、IgA、IgM呈正相关(r>0,P<0.05); GSH-Px水平与FEV₁%pred、FEV₁/FVC、MMEF%pred呈正相关(r>0,P<0.05),与CD8⁺、IgA、IgM呈负相关(r<0,P<0.05)。ROC分析显示,血清CCN1、ECP、GSH-Px联合检测时,AUC为0.973(95%CI:0.944～0.999),敏感度为97.1%、特异度为97.8%,约登指数为0.949,有诊断价值高。 结论 AECOPD患者血清CCN1、ECP和GSH-Px水平与肺功能及免疫功能相关,显示其作为AECOPD生物标志物的诊断意义,可作为临床中预测AECOPD病情。

Abstract:

Objective This study aimed to analyze the serum levels of cysteine-rich 61(CCN1), eosinophil cationic protein(ECP), and glutathione peroxidase(GSH-Px)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD), exploring their correlation with pulmonary and immune function, as well as their potential diagnostic value in AECOPD. Methods A retrospective analysis was conducted on 55 AECOPD patients admitted to the Second Affiliated Hospital of Soochow University from January 2019 to June 2024(observation group). Forty-three stable COPD patients during the same period were selected as the control group. Serum CCN1, ECP, and GSH-Px levels were measured using enzyme-linked immunosorbent assay(ELISA). Pulmonary function was assessed by measuring the percentage of predicted forced expiratory volume in one second(FEV₁%pred), FEV₁/forced vital capacity(FEV₁/FVC)ratio, and the percentage of predicted maximal mid-expiratory flow(MMEF%pred). Immune function was evaluated by assessing CD4⁺ and CD8⁺ T-cell counts, as well as immunoglobulin A(IgA)and immunoglobulin M(IgM)levels. Pearson correlation analysis was used to evaluate the relationship between serum CCN1, ECP, and GSH-Px levels and pulmonary and immune function. The diagnostic value of these biomarkers for AECOPD was assessed using receiver operating characteristic(ROC)curve analysis. Results The observation group had higher CCN1(173.15±35.63 ng/ml)and ECP(30.16±4.25 ng/ml)levels compared to the control group(CCN1: 153.27±27.86 ng/ml; ECP: 19.23±2.84 ng/ml, P<0.05), while GSH-Px levels(29.14±3.16)U/L were significantly lower than in the control group(46.36±3.77 U/L, P<0.05). Pulmonary function parameters in the observation group, including FEV₁%pred(58.43±5.13%), FEV₁/FVC(58.28±7.35%), and MMEF%pred(26.27±5.13%), were significantly lower than those in the control group(FEV₁%pred: 74.18±10.04%; FEV₁/FVC: 67.41±7.90%; MMEF%pred: 40.07±5.79%, P<0.05). Additionally, CD4⁺ T-cell levels(29.93±3.12%)in the observation group were lower than in the control group(38.24±2.76%, P<0.05), whereas CD8⁺ T-cell levels(35.16±4.07%), IgA(264.72±17.49 mg/dl), and IgM(126.94±14.37 mg/dl)were higher than those in the control group(CD8⁺: 27.29±2.25%; IgA: 195.83±15.21 mg/dl; IgM: 95.57±10.94 mg/dl, P<0.05). Pearson correlation analysis revealed that serum CCN1 and ECP levels were negatively correlated with FEV₁%pred, FEV₁/FVC, and MMEF%pred(r<0, P<0.05)but positively correlated with CD8⁺, IgA, and IgM(r>0, P<0.05). Conversely, GSH-Px levels were positively correlated with FEV₁%pred, FEV₁/FVC, and MMEF%pred(r>0, P<0.05)and negatively correlated with CD8+, IgA, and IgM(r<0, P<0.05). ROC analysis demonstrated that combined detection of serum CCN1, ECP, and GSH-Px achieved the highest diagnostic efficacy for AECOPD, with an area under the curve(AUC)of 0.973(95%CI: 0.944-0.999), a sensitivity of 97.1%, a specificity of 97.8%, and a Youden index of 0.949. Conclusion Changes in serum CCN1, ECP, and GSH-Px levels in AECOPD patients are closely related to pulmonary and immune function, highlighting their diagnostic value as biomarkers for AECOPD. These findings support their potential application as predictive and monitoring tools in clinical practice.

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备注/Memo

备注/Memo:

基金项目: 江苏省卫生健康委医学科研立项项目(M2022033)
通信作者: 周 童, Email: z510498281@163.com

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更新日期/Last Update: 2025-02-20