血管细胞黏附分子-1、肝素结合蛋白蛋白及调节性T细胞水平检测对支气管哮喘并发肺部感染患者的预测意义

doi:10.3877/cma.j.issn.1674-6902.2025.06.010

中华肺部疾病杂志(电子版) ›› 2025, Vol. 18 ›› Issue (06) : 911 -916. doi: 10.3877/cma.j.issn.1674-6902.2025.06.010

论著

血管细胞黏附分子-1、肝素结合蛋白蛋白及调节性T细胞水平检测对支气管哮喘并发肺部感染患者的预测意义

李晓颜¹^,^†(

), 邢爱花², 董瑞生³, 王瑞玲⁴, 贾子江¹, 郑丽琴⁵

¹032200　汾阳，山西省汾阳医院医学检验科
²032200　汾阳，山西省汾阳医院心血管内科
³032200　汾阳，山西省汾阳医院医学影像科
⁴032200　汾阳，山西省汾阳医院内窥镜室
⁵032200　汾阳，山西省汾阳医院呼吸与危重症科

收稿日期:2025-02-13 出版日期:2025-12-25
通信作者: 李晓颜
基金资助:
山西省卫生健康委科研课题计划(2024225)

Predictive significance of the detection of VCAM-1, HBP protein and Treg cell levels for patients with bronchial asthma complicated with pulmonary infection

Xiaoyan Li¹^,^†(), Aihua Xing², Ruisheng Dong³, Ruiling Wang⁴, Zijiang Jia¹, Liqin Zhen⁵

¹Medical Laboratory Department, Shanxi Fenyang Hospital, Fenyang 032200, China
²Cardiovascular Department, Shanxi Fenyang Hospital, Fenyang 032200, China
³Medical Imaging Department, Shanxi Fenyang Hospital, Fenyang 032200, China
⁴Endoscope Room, Shanxi Fenyang Hospital, Fenyang 032200, China
⁵Respiratory and critical care medicine Department, Shanxi Fenyang Hospital, Fenyang 032200, China

Received:2025-02-13 Published:2025-12-25
Corresponding author: Xiaoyan Li

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引用本文：

李晓颜, 邢爱花, 董瑞生, 王瑞玲, 贾子江, 郑丽琴. 血管细胞黏附分子-1、肝素结合蛋白蛋白及调节性T细胞水平检测对支气管哮喘并发肺部感染患者的预测意义[J/OL]. 中华肺部疾病杂志(电子版), 2025, 18(06): 911-916.

Xiaoyan Li, Aihua Xing, Ruisheng Dong, Ruiling Wang, Zijiang Jia, Liqin Zhen. Predictive significance of the detection of VCAM-1, HBP protein and Treg cell levels for patients with bronchial asthma complicated with pulmonary infection[J/OL]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(06): 911-916.

目的

分析血管细胞黏附分子-1(vascular cell adhesion molecule-1, VCAM-1)、肝素结合蛋白(heparin-binding protein, HBP)及调节性T细胞(regulatory T cell, Treg)水平检测对支气管哮喘(bronchial asthma, BA)并发肺部感染患者的预测意义。

方法

回顾性分析2020年6月至2024年12月于我院收治的67例哮喘患者的病例资料，根据肺部影像学有无感染分为感染者32例为观察组，无肺部感染者35例为对照组。比较患者临床资料、肺功能参数、血VCAM-1、HBP蛋白及Treg细胞水平变化。采用Pearson或Spearman秩相关分析血VCAM-1、HBP蛋白及Treg细胞水平与肺功能参数的相关性，应用受试者工作特征(receiver operating characteristic, ROC)曲线判断VCAM-1、HBP蛋白及Treg细胞水平对哮喘患者肺部感染预测。

结果

观察组白细胞计数(white blood cell, WBC)(7.53±2.82)×10⁹/L、降钙素原(procalcitonin, PCT)(0.24±0.12)ng/ml、C反应蛋白(C-reactive protein, CRP)(34.04±12.82)mg/L、血沉(erythrocyte sedimentation rate, ESR)(19.57±2.36)mm/1 h、动脉血二氧化碳分压(partial pressure of carbon dioxide in arterial blood, PaCO₂)(51.36±7.25)mmHg、VCAM-1(532.22±68.87)ng/ml及HBP(54.68±14.88)ng/ml高于对照组[(5.84±1.61)×10⁹/L、(0.17±0.05)ng/ml、(28.63±7.49)mg/L、(18.41±2.17)mm/1 h、(46.29±7.63)mmHg、(421.71±68.35)ng/ml、(35.84±8.92)ng/ml]，动脉血氧分压(partial pressure of oxygen in arterial blood, PaO₂)(69.38±9.85)mmHg、第一秒用力肺活量(forced expiratory volume in one second, FEV₁)(1.53±0.27)L、第一秒用力肺活量与用力肺活量比值(ratio of forced expiratory volume in one second to forced vital capacity, FEV₁/FVC)(55.18±7.10)%、最大呼气峰流速(peak expiratory flow, PEF)(316.69±31.24)L/min、Treg(3.88±0.56)%低于对照组[(72.85±8.43)mmHg、(1.71±0.29)L、(62.82±9.20)%、(343.05±41.77)L/min、(4.75±0.61)%]，差异有统计学意义(P<0.05)。哮喘患者VCAM-1与肺功能FEV₁、FEV₁/FVC、PEF参数负相关(r＝－0.433、－0.532、－0.489，P<0.05)，哮喘患者HBP蛋白与肺功能FEV₁、FEV₁/FVC、PEF参数负相关(r＝－0.340、－0.465、－0.517，P<0.05)，Treg细胞水平与肺功能FEV₁、FEV₁/FVC、PEF参数正相关(r＝0.367、0.461、0.468，P<0.05)。ROC曲线显示，VCAM-1、HBP蛋白、Treg细胞水平分别及联合预测哮喘并发肺部感染的AUC分别为0.887、0.861、0.870、0.900，分别及联合预测的AUC值比较无差异(P>0.05)。哮喘并发肺部感染患者双肺感染24例，胸腔沉积发生3例。

结论

VCAM-1、HBP蛋白及Treg细胞水平与肺部感染密切相关，对哮喘并发肺部感染具有预测意义，为临床诊治和病情监测提供参考。

关键词: 支气管哮喘, 肺部感染, 血管细胞黏附分子-1, 肝素结合蛋白, 调节性T细胞, 肺功能

Objective

Analysis of vascular cell adhesion molecule-1 (VCAM-1), heparin-binding protein (HBP), and regulatory T cells The predictive significance of Treg level detection for patients with bronchial asthma (BA) complicated with pulmonary infection.

Methods

A retrospective analysis was conducted on the case data of 67 asthma patients admitted to our hospital from June 2020 to December 2024. According to whether there was lung infection or not, they were divided into 32 infected cases as the observation group and 35 cases without lung infection as the control group. The clinical data, pulmonary function parameters, changes in blood VCAM-1, HBP protein and Treg cell levels of the two groups of patients were compared. Pearson or Spearman rank correlation analysis was used to analyze the correlations between the levels of blood VCAM-1, HBP protein and Treg cells and pulmonary function parameters, and the receiver operating characteristic was applied. The ROC curve was used to predict the levels of VCAM-1, HBP protein and Treg cells for pulmonary infection in patients with bronchial asthma.

Results

The white blood cell count (WBC) of patients in the observation group was (7.53±2.82) ×10⁹/L, procalcitonin (PCT) was (0.24±0.12) ng/ml, and C-reactive protein (CRP) was (34.04±12.82) mg/L, erythrocyte sedimentation rate (ESR) was (19.57±2.36) mm/1 h, partial pressure of carbon dioxide in arterial blood (PaCO₂) (51.36±7.25) mmHg, VCAM-1 (532.22±68.87) ng/ml and HBP (54.68±14.88) ng/ml were higher than those in the control group [(5.84±1.61) ×10⁹/L, (0.17±0.05) ng/ml, (28.63±7.49) mg/L, (18.41±2.17) mm/1 h, (46.29±7.63) mmHg, (421.71±68.35) ng/ml, (35.84±8.92) ng/ml], partial pressure of oxygen in arterial blood (PaO₂) was (69.38±9.85) mmHg, forced expiratory volume in one second (1.53±0.27) L, ratio of forced expiratory volume in one second to forced vital capacity (FEV₁/FVC) was (55.18±7.10)%, peak expiratory flow (PEF) (316.69±31.24)L/min and Treg (3.88±0.56)% were lower than those in the control group [(72.85±8.43)mmHg, (1.71±0.29)L, (62.82±9.20)%, (343.05±41.77)L/min, (4.75±0.61)%], the difference was statistically significant (P<0.05). In patients with bronchial asthma, VCAM-1 was negatively correlated with the parameters of pulmonary function FEV₁, FEV₁/FVC, and PEF (r=-0.433, -0.532, -0.489, P<0.05). The HBP protein in patients with bronchial asthma was negatively correlated with the parameters of pulmonary function FEV₁, FEV₁/FVC, and PEF (r=-0.340, -0.465, -0.517, P<0.05). The level of Treg cells was positively correlated with the parameters of FEV₁, FEV₁/FVC and PEF in lung function (r=0.367, 0.461, 0.468, P<0.05). The ROC curve showed that the AUCs of VCAM-1, HBP protein, and Treg cell levels for predicting pulmonary infection in patients with bronchial asthma, respectively and in combination, were 0.887, 0.861, 0.870, and 0.900, respectively. There was no difference in the AUC values predicted respectively and in combination (P>0.05). There were 24 cases of bilateral lung infection and 3 cases of thoracic deposition in patients with bronchial asthma complicated with pulmonary infection.

Conclusion

The levels of VCAM-1, HBP protein and Treg cells are closely related to pulmonary infection and have predictive significance for BA complicated with pulmonary infection, providing a reference for clinical diagnosis, treatment and disease monitoring.

Key words: Bronchial asthma, Pulmonary infection, Vascular cell adhesion molecule-1, Heparin-binding protein, Regulatory T cells, Lung function

表1 两组哮喘患者临床资料比较(

±s)

临床资料	观察组(n＝32)	对照组(n＝35)	t/χ²值	P值
男/女(n)	17/15	19/16	0.009	0.924
WBC(×10⁹/L)	7.53±2.82	5.84±1.61	3.045	0.003
PCT(ng/ml)	0.24±0.12	0.17±0.05	3.165	0.002
CRP(mg/L)	34.04±12.82	28.63±7.49	2.131	0.037
FPG(mmol/L)	5.05±1.09	5.18±1.14	0.476	0.636
HbA1c(%)	5.15±1.23	5.24±1.11	0.315	0.754
ALT(U/L)	29.64±3.35	30.42±3.59	0.917	0.363
AST(U/L)	25.83±3.86	26.56±4.17	0.742	0.461
Scr(μmol/L)	82.58±13.14	86.89±12.64	1.368	0.176
BUN(mmol/L)	4.64±1.35	4.47±1.19	0.548	0.586
ESR(mm/1 h)	19.57±2.36	18.41±2.17	2.096	0.040
16KD	1.03±0.07	1.02±0.06	0.629	0.531
38KD	1.15±0.13	1.18±0.12	0.982	0.330
CFP10	1.14±0.12	1.12±0.11	0.712	0.479

表1 两组哮喘患者临床资料比较(

±s)

临床资料	观察组(n＝32)	对照组(n＝35)	t/χ²值	P值
男/女(n)	17/15	19/16	0.009	0.924
WBC(×10⁹/L)	7.53±2.82	5.84±1.61	3.045	0.003
PCT(ng/ml)	0.24±0.12	0.17±0.05	3.165	0.002
CRP(mg/L)	34.04±12.82	28.63±7.49	2.131	0.037
FPG(mmol/L)	5.05±1.09	5.18±1.14	0.476	0.636
HbA1c(%)	5.15±1.23	5.24±1.11	0.315	0.754
ALT(U/L)	29.64±3.35	30.42±3.59	0.917	0.363
AST(U/L)	25.83±3.86	26.56±4.17	0.742	0.461
Scr(μmol/L)	82.58±13.14	86.89±12.64	1.368	0.176
BUN(mmol/L)	4.64±1.35	4.47±1.19	0.548	0.586
ESR(mm/1 h)	19.57±2.36	18.41±2.17	2.096	0.040
16KD	1.03±0.07	1.02±0.06	0.629	0.531
38KD	1.15±0.13	1.18±0.12	0.982	0.330
CFP10	1.14±0.12	1.12±0.11	0.712	0.479

表2 哮喘患者VCAM-1、HBP蛋白及Treg细胞水平与肺功能的相关性

项　目	FEV₁(L)		FEV₁/FVC(%)		PEF(L/min)
项　目	r值	P值	r值	P值	r值	P值
VCAM-1(ng/ml)	－0.433	0.000	－0.532	0.000	－0.489	0.000
HBP(ng/ml)	－0.340	0.005	－0.465	0.000	－0.517	0.000
Treg(%)	0.367	0.002	0.461	0.000	0.468	0.000

表2 哮喘患者VCAM-1、HBP蛋白及Treg细胞水平与肺功能的相关性

项　目	FEV₁(L)		FEV₁/FVC(%)		PEF(L/min)
项　目	r值	P值	r值	P值	r值	P值
VCAM-1(ng/ml)	－0.433	0.000	－0.532	0.000	－0.489	0.000
HBP(ng/ml)	－0.340	0.005	－0.465	0.000	－0.517	0.000
Treg(%)	0.367	0.002	0.461	0.000	0.468	0.000

表3 VCAM-1、HBP蛋白及Treg细胞水平预测哮喘ROC结果

因　素	AUC	SE	灵敏度(%)	特异度(%)	约登指数	95%CI
VCAM-1(ng/ml)	0.887	0.039	100.00	68.57	0.686	0.810~0.964
HBP(ng/ml)	0.861	0.052	84.37	85.71	0.701	0.759~0.962
Treg(%)	0.870	0.045	81.25	82.86	0.641	0.782~0.958
联合	0.900	0.037	87.50	80.00	0.675	0.828~0.972

表3 VCAM-1、HBP蛋白及Treg细胞水平预测哮喘ROC结果

因　素	AUC	SE	灵敏度(%)	特异度(%)	约登指数	95%CI
VCAM-1(ng/ml)	0.887	0.039	100.00	68.57	0.686	0.810~0.964
HBP(ng/ml)	0.861	0.052	84.37	85.71	0.701	0.759~0.962
Treg(%)	0.870	0.045	81.25	82.86	0.641	0.782~0.958
联合	0.900	0.037	87.50	80.00	0.675	0.828~0.972

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Predictive significance of the detection of VCAM-1, HBP protein and Treg cell levels for patients with bronchial asthma complicated with pulmonary infection

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Predictive significance of the detection of VCAM-1, HBP protein and Treg cell levels for patients with bronchial asthma complicated with pulmonary infection