摘要
目的检测慢性阻塞性肺疾病(COPD)并发肺动脉高压(PAH)患者血清半乳糖凝集素-3(galectin-3)、微小RNA-128-3p(miR-128-3p)水平,分析二者与COPD患者发生PAH的相关性。方法选取2018年4月-2021年4月昆山市中医医院收治的120例COPD患者,根据是否合并PAH分为单纯COPD组(n=64)和COPD合并PAH组(n=56),另选择健康体检(肺功能正常)者60人为对照组。收集所有研究对象的临床资料,包括性别、年龄、体质量指数(BMI)、静息状态下肺动脉收缩压(PASP)水平、用力肺活量(FVC)、第1秒用力呼气容积占预计百分比(FEV_(1)%pred),并计算FEV_(1)/FVC。采用q RT-PCR法检测血清miR-128-3p、galectin-3水平,ELISA法检测血清galectin-3水平,并分析血清galectin-3、miR-128-3p与PASP的相关性,ROC曲线分析galectin-3、miR-128-3p水平对COPD患者发生PAH的预测价值,Logistics回归分析COPD患者并发PAH的影响因素。结果与对照组比较,单纯COPD组、COPD合并PAH组FEV_(1)%pred、FEV_(1)/FVC及miR-128-3p水平均降低,PASP、血清galectin-3蛋白及mRNA水平均升高,差异均有统计学意义(P均<0.05)。与单纯COPD组比较,COPD合并PAH组FEV_(1)%pred、FEV_(1)/FVC及miR-128-3p水平均降低,PASP、血清galectin-3蛋白及mRNA水平均升高,差异均有统计学意义(P均<0.05)。COPD合并PAH患者血清galectin-3与PASP成正相关(r=0.453,P<0.001),与miR-128-3p成负相关(r=-0.547,P<0.001);血清miR-128-3p与PASP成负相关(r=-0.573,P<0.001)。血清galectin-3预测COPD患者发生PAH的曲线下面积为0.809,敏感度、特异度分别为66.1%、87.5%;血清miR-128-3p预测COPD患者发生PAH的曲线下面积为0.871,敏感度、特异度分别为83.9%、76.6%;二者联合预测的曲线下面积为0.878,敏感度、特异度分别为80.4%、89.1%。Galectin-3、miR-128-3p及FEV_(1)/FVC是影响COPD患者并发PAH的独立危险因素(P<0.05)。结论COPD合并PAH患者血清中galectin-3表达升高,miR-128-3p表达降低,二者均与PASP有关,且对COPD患者发生PAH有一定的预测价值。
Objective To detect the levels of serum galectin-3 and microRNA-128-3p(miR-128-3p)in patients with chronic obstructive pulmonary(COPD)complicated pulmonary arterial hypertension(PAH),and analyze the correlation between them and the occurrence of PAH in COPD patients.Methods A total of 120 COPD patients admitted to Traditional Chinese medicine Hospital of Kunshan were selected and divided into a simple COPD group(64 cases)and a COPD complicated PAH group(56 cases)according to whether they were complicated with PAH.Another 60 cases of healthy physical examination(normal lung function)were selected as the control group.The clinical data of all study subjects were collected,including gender,age,body mass index(BMI),resting pulmonary artery systolic pressure(PASP)level,forced vital capacity(FVC),forced expiratory volume at one second as a percentage of expected value(FEV_(1)%pred),and FEV_(1)/FVC was calculated.The q RT-PCR method was used to detect the serum miR-128-3p and galectin-3 level;ELISA method was used to detect the serum galectin-3 level,and analyze the correlation between serum galectin-3,miR-128-3p and PASP;ROC curve was used to analyze the predictive value of galectin-3 and miR-128-3p levels for PAH in COPD patients.The influencing factors of PAH in patients with PCOD were analyzed by multivariate logistics regression analysis.Results The levels of FEV_(1)%pred,FEV_(1)/FVC and miR-128-3p in the simple COPD group and COPD complicated PAH group were lower than those in the control group,and the levels of PASP and serum galectin-3 were higher than those in the control group(P<0.05);the levels of FEV_(1)%pred,FEV_(1)/FVC and miR-128-3p in the COPD complicated PAH group were lower than those in the simple COPD group,and the levels of PASP and serum galectin-3 were higher than those in the simple COPD group(P<0.05).The serum galectin-3 of patients with COPD complicated PAH was positively correlated with PASP(r=0.453,P<0.001),and was negatively correlated with miR-128-3p(r=-0.547,P<0.001),and serum miR-128-3p was negatively correlated with PASP(r=-0.573,P<0.001).The area under the curve of serum galectin-3 in predicting PAH in COPD patients was 0.809,and the sensitivity and specificity were 66.1%and 87.5%,respectively;the area under the curve of serum miR-128-3p in predicting PAH in COPD patients was 0.871,and the sensitivity and specificity were 83.9%and 76.6%,respectively;the area under the curve of the two joint predictions was 0.878,and the sensitivity and specificity were 80.4%and 89.1%,respectively.Galectin-3 level,miR-128-3p level and FEV_(1)/FVC were independent influencing factors of PAH in patients with PCOD(P<0.05).Conclusion The expression of galectin-3 in the serum of patients with COPD complicated PAH was increased,and the expression of miR-128-3p was decreased,both of which were related to PASP,and had a certain predictive value for the occurrence of PAH in COPD patients.
作者
王晓磊
陈昕芳
赵晓艳
黄辉
WANG Xiao-lei;CHEN Xin-fang;ZHAO Xiao-yan;HUANG Hui(Department of Pulmonary Disease,Traditional Chinese Medicine Hospital of Kunshan,Kunshan,Jiangsu 215300,China)
出处
《热带医学杂志》
CAS
2023年第1期30-35,共6页
Journal of Tropical Medicine
基金
国家自然科学基金(82004271)
江苏省基础研究计划(自然科学基金)(BK20200260)
