Ⅳ型胶原蛋白、Ⅲ型前胶原氨基端肽与老年特发性肺纤维化病人肺功能和急性加重的相关性

doi:10.3969/j.issn.1003-9198.2023.09.016

摘要/Abstract

摘要： 目的探讨Ⅳ型胶原蛋白(ⅣC)、Ⅲ型前胶原氨基端肽(PⅢNP)与老年特发性肺纤维化(IPF)病人肺功能和IPF急性加重(AE-IPF)的相关性。方法选择2018年1月至2022年1月我院收治的89例IPF病人(IPF组)和42例门诊体检健康者(对照组)。检测血清ⅣC、PⅢNP水平以及肺功能,随访出院1个月内AE-IPF的发生情况。采用Pearson相关系数描述ⅣC、PⅢNP与肺功能的相关性,采用多因素Logistic回归分析AE-IPF的危险因素,绘制ROC曲线分析ⅣC、PⅢNP预测AE-IPF的价值。结果 IPF组血清ⅣC、PⅢNP水平高于对照组(P＜0.01),FEV1、FVC、FEV1/FVC、最大自主通气(MVV)均低于对照组(P＜0.01)。ⅣC、PⅢNP与FEV1、FVC、FEV1/FVC、MVV均呈负相关(P＜0.01)。随访期间49例发生AE-IPF,高水平ⅣC、高水平PⅢNP、感染是AE-IPF的危险因素(P＜0.05)。ⅣC、PⅢNP预测AE-IPF的曲线下面积为0.718、0.768,联合ⅣC和PⅢNP诊断AE-IPF的曲线下面积为0.940,大于单独ⅣC、PⅢNP的诊断效率(Z=3.941、2.991,P均＜0.05)。结论老年IPF病人血清ⅣC、PⅢNP 水平显著增高,且与肺通气功能下降以及AE-IPF的发生有关,可作为预测AE-IPF的标志物。

关键词: 特发性肺纤维化, Ⅳ型胶原蛋白, Ⅲ型前胶原, 氨基端肽, 肺功能, 急性加重

Abstract: Objective To investigate the correlation of type Ⅳ collagen (ⅣC) and amino terminal peptide of type Ⅲ procollagen (PⅢNP) with pulmonary function and acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) in the elderly patients with IPF. Methods From January 2018 to January 2022, 89 elderly patients with IPF (IPF group) and 42 elderly receiving health examination (control group) in our hospital were enrolled in this study. The levels of serum ⅣC, PⅢNP and pulmonary function were detected, and the incidence of AE-IPF was recorded within 1 month follow-up after discharge. Pearson correlation coefficient was used to describe the correlation between ⅣC, PⅢNP and pulmonary function. Multivariate Logistic regression analysis was used to analyze the risk factors of AE-IPF. Receiver operating characteristic curve (ROC) was used to analyze the value of ⅣC and PⅢNP in predicting AE-IPF. Results The serum levels of ⅣC and PⅢNP in IPF group were higher than those in control group (P<0.01), and the levels of FEV1, FVC, FEV1/FVC and MVV in IPF group were lower than those in control group (P < 0.01). ⅣC and PⅢNP were both negatively correlated with FEV1, FVC, FEV1/FVC and MVV (P < 0.01). During the follow-up period, 49 cases of AE-IPF occurred. High levels of ⅣC, PⅢNP and infection were the risk factors for AEI-IPF (P<0.05). The areas under the curve of ⅣC and PⅢNP in predicting AE-IPF were 0.718 and 0.768, and the area under the curve of the combination of ⅣC and PⅢNP in diagnosing AE-IPF was 0.940, which was greater than that of ⅣC and PⅢNP alone (Z=3.941,2.991, all P<0.05). Conclusions The serum levels of ⅣC and PⅢNP are significantly increased in the patients with IPF, which are related to the decline of pulmonary ventilation function and the occurrence of AE-IPF, and can be used as predictive markers of AE-IPF.

Key words: idiopathic pulmonary fibrosis, type Ⅳ collagen, type Ⅲ procollagen, N-terminal propeptide, lung function, acute exacerbation

中图分类号:

R 563

孙晖, 任莉, 胡静星, 李秀娥, 郝旭. Ⅳ型胶原蛋白、Ⅲ型前胶原氨基端肽与老年特发性肺纤维化病人肺功能和急性加重的相关性[J]. 实用老年医学, 2023, 37(9): 929-933.

SUN Hui, REN Li, HU Jing-xing, LI Xiu-e, HAO Xu. Correlation of type Ⅳ collagen and amino terminal peptide of typeⅢ procollagen with pulmonary function and acute exacerbation in elderly patients with idiopathic pulmonary fibrosis[J]. Practical Geriatrics, 2023, 37(9): 929-933.

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