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[1]沈琪乐,赵勤华,宫素岗,等.COPD稳定期患者血清CC16蛋白表达与肺功能、肺气肿表型的关系分析[J].中华肺部疾病杂志,2024,(05):690-695.[doi:10.3877/cma.j.issn.1674-6902.2024.05.004]
　Shen Qile,Zhao Qinhua,Gong Sugang,et al.Relationship between serum CC16 protein expression, lung function and emphysema phenotype in stable COPD patients[J].,2024,(05):690-695.[doi:10.3877/cma.j.issn.1674-6902.2024.05.004]
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COPD稳定期患者血清CC16蛋白表达与肺功能、肺气肿表型的关系分析(PDF)

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

卷:
期数:
2024年05期
页码:
690-695
栏目:
论著
出版日期:
2024-10-25

文章信息/Info

Title:
Relationship between serum CC16 protein expression, lung function and emphysema phenotype in stable COPD patients
作者:
沈琪乐; 赵勤华; 宫素岗; 刘锦铭; 王 岚; 邱宏玲
200433 上海,同济大学附属上海市肺科医院肺循环科
Author(s):
Shen Qile;  Zhao Qinhua;  Gong Sugang;  Liu Jinming;  Wang Lan;  Qiu Hongling.
Pulmonary Circulation Department, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai 200433, ChinA
关键词:
肺疾病; 慢性阻塞性;  肺功能;  肺气肿表型;  克拉拉细胞分泌蛋白
Keywords:
Chronic obstructive pulmonary disease;  Lung function;  Emphysema phenotype;  Clara cell secretory protein 16
分类号:
R563
DOI:
10.3877/cma.j.issn.1674-6902.2024.05.004
摘要:
目的 分析慢性阻塞性肺疾病(chronic obstructive pulmonary diseases, COPD)稳定期患者血清克拉拉细胞分泌蛋白(Clara cell secretory protein 16, CC16)表达与肺功能和肺气肿表型的关系。方法 收集100例COPD稳定期的患者为对象,根据一氧化碳的单次呼吸弥散量(TLCO)的Z评分将患者分为47例非肺气肿COPD(non-emphysematous COPD, NE-COPD)和53例肺气肿COPD(emphysematous COPD, E-COPD)。通过酶联免疫吸附法(enzyme linked immunosorbent assay, ELISA)测量血清CC16浓度。Spearman相关性和线性回归被用来检测CC16水平与COPD 肺功能之间的关系。 结果 E-COPD患者肺气肿指数(emphysema index, EI)[1.40%(0.95%,1.86%)vs. 5.00%(3.13%,8.64%)]较NE-COPD患者增加(P<0.05),而第1秒用力呼气容/用力肺活量的Z评分(FEV1/FVCz-score)[-2.51(-3.06,-1.97)vs. -2.96(-3.85,-2.25)]、TLCOz-score[-0.89(-1.32,-0.05)vs. -2.79(-4.02,-2.18)]、肺泡容积(alveolar volume, VA )z-score[0.01(-0.92,0.84)vs. -1.03(-1.69,-0.36)]、一氧化碳转移系数(KCO)z-score[-0.78(-1.30,0.06)vs. -2.33(-3.14,-1.41)〗以及血清CC16[14.63(8.87,26.74)ng/ml vs. 8.90(2.90,14.89)ng/ml]降低(P<0.001)。经Sperman相关性分析,血清CC16水平与EI呈负相关(Rho=-0.344); 而与TLCO z-score(Rho=0.384)、KCO z-score(Rho=0.266)、VAz-score(Rho=0.214)、FEV1/FVCz-score(Rho=0.383)呈正相关性,P<0.05。在E-COPD(Rho=0.408)、NE-COPD(Rho=0.379)亚组中血清CC16水平与FEV1/FVCz-score呈正相关(P<0.001)。校正人口统计学、心肺运动试验参数、用药等临床因素后,COPD患者、E-COPD、NE-COPD中血清CC16水平与FEV1/FVCz-score仍然显著相关(P<0.05)。 结论 血清CC16水平与COPD患者肺功能和肺气肿表型有关的重要因子,低血清CC16寓意着COPD患者病情可能较严重,可能合并复杂的病理表型,同时伴有肺功能不佳。
Abstract:
Objective To investigate the relationship between serum Clara cell secretory protein(CC16)expression and lung function and emphysema phenotype in patients with chronic obstructive pulmonary disease(COPD)in the stable stage. Methods A cross-sectional study was conducted in 100 patients with stable COPD in which serum CC16 concentrations were measured by enzyme-linked immunosorbent assay(ELISA). Spearman's correlation and linear regression were used to test the relationship between CC16 levels and lung function in COPD. Results Patients were categorized into 47 cases of non-emphysematous COPD(NE-COPD)and 53 cases of emphysematous COPD(E-COPD)using the Z-score of single breath diffusion of carbon monoxide(TLCO). Compared with NE-COPD, the emphysema index(EI)[1.40%(0.95%,1.86%)vs. 5.00%(3.13%,8.64%)]was significantly increased in patients with E-COPD(P<0.05), whereas, z-score of forceful expiratory volume in the first second(FEV1)/forceful lung capacity(FEV1/FVCz-score)[-2.51(-3.06,-1.97)vs. -2.96(-3.85,-2.25)], TLCO z-score[-0.89(-1.32,-0.05)vs. -2.79(-4.02, -2.18)], alveolar volume(VA)z-score[0.01(-0.92,0.84)vs. -1.03(-1.69,-0.36)], diffusion constant for carbon monoxide(KCO)z-score[-0.78(-1.30,0.06)vs. -2.33(-3.14,-1.41)], and serum CC16[14.63(8.87, 26.74)ng/ml vs. 8.90(2.90,14.89)ng/ml] were significantly reduced(P<0.05). After Sperman correlation analysis, serum CC16 level was negatively correlated with EI(Rho=-0.344); while it was negatively correlated with TLCO z-score(Rho=0.384), KCO z-score(Rho=0.266), VAz-score(Rho=0.214), FEV1/FVCz-score(Rho=0.383)were positively correlated; all P<0.05. In the subgroups of E-COPD(Rho=0.408), NE-COPD(Rho=0.379), the levels of serum CC16 were positively correlated with FEV1/FVCz-score were all positively correlated(P<0.001). After correcting for demographics, cardiopulmonary exercise test parameters, medication, and other clinical factors, serum CC16 levels remained significantly correlated with FEV1/FVCz-score in all COPD patients, E-COPD, and NE-COPD subgroups(P<0.05). Conclusion Serum CC16 level is an important factor associated with lung function and emphysema phenotype in patients with COPD, and low serum CC16 signifies that patients with COPD may have more severe disease and may combine more complex pathological phenotypes with poorer lung function.

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备注/Memo

备注/Memo:
基金项目: 上海市中西医结核综合专项建设项目(ZHYY-ZXYJHZX-2-25)
通信作者: 刘锦铭, Email: jinmingliu@tongji.deu.cn
更新日期/Last Update: 2024-10-25