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中华肺部疾病杂志(电子版)

中华肺部疾病杂志(电子版) ›› 2019, Vol. 12 ›› Issue (06) : 722 -726. doi: 10.3877/cma.j.issn.1674-6902.2019.06.011

论著

血清铜蓝蛋白、血红素结合蛋白和α2-巨球蛋白诊断哮喘与COPD的价值分析
康敏1, 吴轶1   
  1. 1. 202150　上海，上海交通大学医学院附属新华医院崇明分院呼吸内科
  • 收稿日期:2019-05-18 出版日期:2019-12-20
  • 基金资助:
    上海市崇明区"可持续发展创新行动计划"项目(CKY2019-4)

Values of serum ceruloplasmin, hemopexin and α2-macroglobulin in diagnosis of asthma and chronic obstructive pulmonary disease

Min Kang1, Yi Wu1   

  1. 1. Department of Respiratory Medicine, Chongming Branch, Xinhua Hospital Affiliated to Medical School of Shanghai Jiaotong University, Shanghai 202150, China
  • Received:2019-05-18 Published:2019-12-20
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康敏, 吴轶. 血清铜蓝蛋白、血红素结合蛋白和α2-巨球蛋白诊断哮喘与COPD的价值分析[J]. 中华肺部疾病杂志(电子版), 2019, 12(06): 722-726.

Min Kang, Yi Wu. Values of serum ceruloplasmin, hemopexin and α2-macroglobulin in diagnosis of asthma and chronic obstructive pulmonary disease[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2019, 12(06): 722-726.

目的

探讨血清铜蓝蛋白(CP)、血红素结合蛋白(HPx)及α-巨球蛋白(AMG)在诊断哮喘与慢性阻塞性肺疾病(COPD)中的临床价值。

方法

选择2015年1月至2018年1月我院收治的44例COPD患者作为COPD组，选择同期收治的36例哮喘患者作为哮喘组，选取同期来医院体检的健康志愿者30例作为对照组，均留取各组患者空腹外周血，测定血清CP、Hpx、AMG、MPO水平，并留取痰标本，测定各组受检者痰液嗜酸性粒细胞阳离子蛋白(ECP)、白介素-8(IL-8)水平的差异。

结果

哮喘组、COPD组血清CP分别为(484.22±42.33)μg/ml、(550.45±51.75)μg/ml，MPO水平分别为(62.45±5.71)ng/ml、(81.02±4.33)ng/ml均高于对照组(322.65±52.63)μg/ml、(7.62±2.74)ng/ml(P<0.05)，COPD组血清CP、MPO又高于哮喘组(P<0.05)；哮喘组、COPD组血清Hpx分别为(89.25±10.14)%、(82.31±9.54)%，AMG分别为(136.41±30.78)μg/ml、(98.45±25.54)μg/ml低于对照组(102.32±19.56)%、(355.31±150.65)μg/ml，COPD组Hpx、AMG又低于哮喘组(P<0.05)；哮喘组、COPD组痰液ECP分别为(184.25±62.52)μg/L、(41.33±10.65)μg/L、IL-8分别为(405.31±228.41)ng/ml、(740.26±168.57)ng/ml高于对照组(17.05±9.77)μg/L、(19.23±10.66)ng/ml，哮喘组ECP高于COPD组，IL-8低于COPD组(P<0.05)。

结论

COPD系以中性粒细胞浸润为主的气道炎症，而哮喘以嗜酸性粒细胞浸润为主，前者CP、MPO、IL-8均高于后者，Hpx、AMG及ECP均低于后者，可作为两者鉴别依据。

关键词: 肺疾病, 慢性阻塞性, 支气管哮喘, 铜蓝蛋白, 血红素结合蛋白, α-巨球蛋白, 诊断
Objective

To analyze the clinical value of serum ceruloplasmin (CP), hemopexin (HPx) and α2-macroglobulin (AMG) in the diagnosis of asthma and chronic obstructive pulmonary disease (COPD).

Methods

A total of 44 patients with COPD admitted to our hospital from January 2015 to January 2018 were enrolled as the COPD group, 36 patients with asthma in the same period were selected as the asthma group, and 30 healthy volunteers who underwent physical examination during the same period were selected as the control group. The fasting peripheral blood of each group was collected. The levels of serum CP, Hpx and AMG were measured. The sputum samples were collected. The differences in the levels of eosinophil cationic protein (ECP) and interleukin-8 (IL-8) in each group were measured.

Results

The serum levels of CP were (484.22±42.33) μg /ml and (550.45±51.75) μg /ml, respectively, and the serum levels of MPO were (62.45±5.71) ng/ml and (81.02±4.33) ng/ml, respectively, in the asthma group and the COPD group, which were higher than those of the control group [ (322.65±52.63) μg /ml and (7.62±2.74) ng/ml, respectively, P<0.05]. And the serum levels of CP and MPO in the COPD group were also higher than those of the asthma group (P<0.05). The serum levels of Hpx were (89.25±10.14)% and (82.31±9.54)%, respectively, and the serum levels of AMG were (136.41±30.78) μg /ml and (98.45±25.54) μg /ml, respectively, in the asthma group and the COPD group, which were lower than those of the control group [(102.32±19.56) % and (355.31±150.65) μg /ml, respectively, P<0.05]. The ECP levels of the sputum were (184.25±62.52) μg /L and (41.33±10.65) μg /L, respectively, and the IL-8 levels were (405.31±228.41) ng/ml, (740.26±168.57) ng/ml and (19.23±10.66) ng/ml, respectively, in the asthma group and the COPD group, which were significantly higher than those of the control group [(17.05±9.77) μg/L and (19.23±10.66) ng/ml, respectively, P<0.05]. And the ECP levels in the asthma group were higher than those of the COPD group (P<0.05), however, the IL-8 levels in the asthma group were lower than those of the COPD group (P<0.05).

Conclusion

COPD is an airway inflammation mainly by neutrophil infiltration and asthma is mainly by eosinophil infiltration. The CP, MPO and IL-8 levels of the former are higher than those of the latter, while Hpx, AMG and ECP levels are lower than those of the latter, which can be used as a basis for their identification.

Key words: Chronic obstructive pulmonary disease, Asthma, Ceruloplasmin, Hemopexin, α-macroglobulin, Diagnosis
表1 各组血清CP、MPO水平比较(±s)
组　别 例数 CP(μg/ml) MPO(ng/ml)
对照组 30 322.65±52.63 7.62±2.74
哮喘组 36 484.22±42.33 62.45±5.71
COPD组 44 550.45±51.75 81.02±4.33
F值   36.828 82.205
P值   0.000 0.000
表2 各组痰液ECP、IL-8水平比较(±s)
组　别 例数 ECP(μg/L) IL-8(ng/ml)
对照组 30 17.05±9.77 19.23±10.66
哮喘组 36 184.25±62.52 405.31±228.41
COPD组 44 41.33±10.65 740.26±168.57
F值   33.845 48.682
P值   0.000 0.000
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