摘要【目的】探讨核心蛋白聚糖(DCN)在特发性肺纤维化(IPF)患者血清中的表达及其意义。【方法】选取2016年3月至2018年3月在陕西省第四人民医院诊治的87例IPF患者(IPF组)、82例特发性间质性肺炎(idiopathic interstitial pneumonia,IIP)患者(非IPF组)和100例健康体检者(对照组)作为研究对象。采用ELISA法检测三组受试者血清DCN水平。分析IPF患者血清DCN水平与病情及预后的关系。【结果】IPF组血清DCN水平显著低于非IPF组和对照组(均 P <0.05);IPF患者血清DCN水平与高分辨率CT(HRCT)评分呈负相关( r =-0.524, P <0.001)。IPF急性加重(AE-IPF)患者血清DCN水平低于IPF疾病稳定(SD-IPF)患者,其差异有统计学意义( t =7.806, P <0.001)。87例IPF患者,随访1~12个月,18例(20.68%)死亡。DCN高水平组(DCN≥7.51 mg/L)平均生存时间长于DCN低水平组(DCN<7.51 mg/L),其差异有统计学意义( χ2 =11.423, P <0.001)。Cox单因素及多因素分析结果显示:HRCT评分、DCN水平与IPF患者预后密切相关。【结论】血清DCN水平能反映IPF患者疾病严重程度,且与IPF患者预后密切相关。
Abstract：【Objective】To investigate the relationship between serum decorin (DCN) level and prognosis in patients with idiopathic pulmonary fibrosis (IPF). 【Methods】A prospective selection of 87 IPF patients (the IPF group), 82 IIP patients (idiopathic interstitial pneumonia or non-IPF group) and 100 healthy subjects (the control group), who were treated in Guangdong Women and Children Hospital and the Fifth Affiliated Hospital of Guangzhou Medical University from March 2016 to March 2018, were selected as subjects. Serum DCN levels were measured in all three groups by ELISA and the relationship between serum DCN levels and prognosis in patients with IPF was analyzed. 【Results】Serum DCN level in the IPF group was lower than that in the non-IPF group and the control group ( q =6.975, 18.962, both P <0.05). There was a negative correlation between serum DCN level and high resolution CT (HRCT) scores in patients with IPF ( r =-0.524, P <0.001). Serum DCN level in patients with acute exacerbation of IPF (AE-IFP) was lower than that in stable disease of IPF (SD-IPF) patients ( t =7.806, P <0.001). Eighty-seven patients with IPF were followed up for 1 to 12 months. The result showed that 18 patients (20.68%) died. The mean survival time of the DCN high-level group (DCN≥7.51 mg/L) was higher than that of the DCN low-level group (DCN<7.51 mg/L), the difference was statistically significant ( χ2 =11.423, P <0.001). Cox univariate and multivariate analysis showed that HRCT scores and DCN levels were closely related to the prognosis of patients with IPF. 【Conclusion】Serum DCN levels can reflect the severity of disease in IPF patients and are closely related to the prognosis of patients with IPF.
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2021, Vol. 38 
