2021 年第 5 期 第 16 卷

血清颗粒蛋白前体水平与慢性阻塞性肺疾病急性加重期患者肺功能及病情严重程度的关系

Relationship between serum progranulin level and pulmonary function and severity in patients with acute exacerbation of chronic obstructive pulmonary disease

作者：李文英曾瑜汪得喜洪泽鑫

英文作者：Li Wenying Zeng Yu Wang Dexi Hong Zexin

单位：暨南大学附属广州红十字会医院广州市红十字会医院呼吸内科510000

英文单位：Department of Respiratory Guangzhou Red Cross Hospital the Affiliated Hospital Jinan University Guangzhou 510000 China

关键词：慢性阻塞性肺疾病；颗粒蛋白前体；肺功能

英文关键词：Chronicobstructivepulmonarydisease;Progranulin;Pulmonaryfunction

• 摘要：

• 目的 探讨血清颗粒蛋白前体（PGRN）水平与慢性阻塞性肺疾病（COPD）急性加重期（AECOPD）患者肺功能及病情严重程度的关系。方法 选取2019年1月至2020年5月于暨南大学附属广州红十字会医院随诊的AECOPD患者167例（AECOPD组），稳定期COPD患者100例（SCOPD组），另选取体检健康者93例（健康对照组）。比较3组研究对象的基本临床资料、血清PGRN水平和肺功能，以及不同病情严重程度AECOPD患者血清PGRN水平和肺功能，分析AECOPD患者血清PGRN水平与肺功能指标及病情严重程度的相关性。结果 3组性别、年龄、体重指数及吸烟指数比较差异均无统计学意义（均P>0.05）。AECOPD组和SCOPD组血清PGRN水平均高于健康对照组［（237±26）、（171±21）μg/L比（126±21）μg/L］，且AECOPD组高于SCOPD组，第1秒用力呼气容积（FEV1）、FEV1占预计值百分比（FEV1%）、用力肺活量（FVC）及FEV1/FVC均低于健康对照组，且AECOPD组均低于SCOPD组（均P<0.05）。随着AECOPD患者病情严重程度的加重，血清PGRN水平逐渐升高，FEV1、FEV1%、FVC、FEV1/FVC水平逐渐降低（均P<0.05）。AECOPD患者血清PGRN水平与FEV1（r=-0.621，P<0.001）、FVC（r=-0.676，P<0.001）和FEV1/FVC（r=-0.769，P<0.001）均呈负相关，与病情严重程度（r=0.745，P<0.001）呈正相关。结论 AECOPD患者血清PGRN水平与肺功能呈负相关，与病情严重程度呈正相关，可作为患者病情评估的指标。

• Objective To investigate the relationship between serum progranulin(PGRN) level and pulmonary function and severity in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods From January 2019 to May 2020, 167 patients with AECOPD followed-up in Guangzhou Red Cross Hospital, Jinan University (AECOPD group), 100 patients with stable chronic obstructive pulmonary disease (SCOPD group)and 93 healthy people(healthy control group)were selected. The basic clinical data, serum PGRN level and lung function of the three groups were compared. The serum PGRN level and pulmonary function index, lung function of AECOPD patients with different severity were compared. The correlations between serum PGRN level and pulmonary function indexes and severity of patients with AECOPD were analyzed. Results There was no significant differences in gender, age, body mass index and smoking index among the three groups (all P>0.05). The serum PGRN levels of AECOPD group and SCOPD group were higher than those of healthy control group ［(237±26), (171±21)μg/L vs (126±21)μg/L］, and that of AECOPD group was higher than that of SCOPD group(all P<0.05). Forced expiratory volume in the first second(FEV1), FEV1 as a percentage of predicted (FEV1%), forced vital capacity(FVC) and FEV1/FVC of AECOPD group and SCOPD group were lower than those of healthy control group, and those of AECOPD group were lower than those of SCOPD group (all P<0.05). With the aggravation of AECOPD patients′ severity, serum PGRN level showed a gradually increasing trend, while FEV1, FVC, FEV1/FVC and FEV1% levels showed  gradually decreasing trends(all P<0.05). PGRN level in AECOPD patients was significantly negatively correlated with FEV1(r=-0.621, P<0.001), FVC(r=-0.676, P<0.001) and FEV1/FVC(r=-0.769, P<0.001), and positively correlated with disease severity(r=0.745, P<0.001). Conclusion The level of serum PGRN in AECOPD patients is negatively correlated with pulmonary function, and positively correlated with the severity, which can be used as an index for the evaluation of the disease.