血清EGFR、Lrg1水平是肺结核患者发生支气管狭窄的独立危险因素

黄秀芳.血清EGFR、Lrg1水平是肺结核患者发生支气管狭窄的独立危险因素[J].内科急危重症杂志,2022,28(5):383-386

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DOI：10.11768/nkjwzzzz20220507

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作者	单位	E-mail
黄秀芳	成都市新都区人民医院	435079253@qq.com

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中文摘要:

目的：检测肺结核患者血清表皮生长因子受体（EGFR）、富亮氨酸α2糖蛋白1（Lrg1）表达水平，探讨其与患者支气管狭窄的关系。方法：收集180例肺结核患者的临床资料，根据患者是否发生支气管狭窄将其分为单纯肺结核组（97例）和支气管狭窄组（83例）。采用酶联免疫吸附（ELISA）法检测患者血清EGFR、Lrg1水平；一氧化氮（FeNO）测定仪检测受试者呼出气FeNO水平；肺功能仪检测第1秒用力呼气量（FEV-1）、用力肺活量（FVC）、最大呼气峰流速（PEF）水平；Pearson法分析支气管狭窄肺结核患者血清EGFR、Lrg1水平与肺功能指标相关性；受试者工作特征（ROC）曲线分析血清EGFR、Lrg1水平对肺结核患者支气管狭窄的诊断价值。结果：支气管狭窄组血清EGFR、Lrg1、FeNO水平高于单纯肺结核组，FEV-1、FVC、PEF水平低于单纯肺结核组（P均＜0.05）；支气管狭窄肺结核患者血清EGFR与Lrg1、FeNO水平呈正相关（r=0.661、r=0.521，P均＜0.05），与FEV-1、FVC、PEF呈负相关（r=-0.492、-0.483、-0.457, P均＜0.05）；Lrg1与FeNO呈正相关（r=0.536, P＜0.05），与FEV-1、FVC、PEF呈负相关（r=-0.487、-0.454、-0.479, P均＜0.05）；血清EGFR、Lrg1水平诊断肺结核患者支气管狭窄的曲线下面积（AUC）分别为0.794、0.842，特异性分别为85.6%、83.5%，敏感度分别为66.3%、73.5%；两者联合诊断的AUC为0.896，特异性为94.8%，敏感度为74.7%；血清EGFR、Lrg1水平是肺结核患者发生支气管狭窄的独立危险因素（P均＜0.05）。结论：血清EGFR、Lrg1水平与肺结核患者发生支气管狭窄有一定的相关性，在肺结核并支气管狭窄的筛查中可能具有一定评估价值。

英文摘要:

Objective: To detect the expression of epidermal growth factor receptor (EGFR) and leucine-rich-alpha-2-glycoprotein 1 (Lrg1) in the serum of patients with pulmonary tuberculosis, and to explore their relationships with bronchial stenosis. Methods: The clinical data of 180 patients with pulmonary tuberculosis were collected. According to whether the patients had bronchial stenosis, they were divided into simple tuberculosis group (97 cases) and bronchial stenosis group (83 cases). The levels of EGFR and Lrg1 were detected by enzyme-linked immunosorbent assay (ELISA). The level of exhaled nitric oxide (FeNO) was measured by nitric oxide analyzer. The first second forced expiratory volume (FEV1), forced vital capacity (FVC) and peak expiratory flow rate (PEF) were measured by pulmonary function instrument. Pearson's method was used to analyze the correlations between the levels of EGFR, Lrg1 and pulmonary function indexes. The diagnostic values of EGFR and Lrg1were analyzed by receiver operating characteristic (ROC) curve for bronchial stenosis in patients with pulmonary tuberculosis. Results: The levels of serum EGFR, Lrg1 and FeNO in the bronchial stenosis group were higher, and the levels of FEV1, FVC and PEF were lower than those in the simple tuberculosis group (all P<0.05). Serum EGFR was positively correlated with Lrg1 and FeNO levels in patients with bronchial stenosis and pulmonary tuberculosis (r=0.661, r=0.521, all P<0.05), while EGFR was negatively correlated with FEV1, FVC and PEF (r=-0.492, -0.483, -0.457, all P<0.05). Lrg1 was positively correlated with FeNO (r=0.536, all P<0.05), while Lrg1 was negatively correlated with FEV1, FVC and PEF (r=-0.487, -0.454, -0.479, all P<0.05). The area under AUC curve of serum EGFR and Lrg1 levels in the diagnosis of bronchial stenosis in patients with pulmonary tuberculosis was 0.794 and 0.842, respectively. The specificity was 85.6% and 83.5% respectively, and the sensitivity was 66.3% and 73.5% respectively. The AUC of the combined diagnosis was 0.896, the specificity was 94.8%, and the sensitivity was 74.7%; and serum EGFR and Lrg1 were independent risk factors for bronchial stenosis in patients with pulmonary tuberculosis (all P<0.05). Conclusions: The levels of EGFR and Lrg1 in serum are related to the occurrence of bronchial stenosis in patients with pulmonary tuberculosis, which may have a certain evaluation value in the screening of pulmonary tuberculosis with bronchial stenosis.