中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2016, Vol. 45 ›› Issue (3): 255–259.doi: 10.12007/j.issn.0258-4646.2016.03.016

• 论著 • 上一篇    下一篇

IGF-1、IGFBP-4和IGFBP-5支气管肺泡灌洗液和血清中的表达及意义

吴倩,孔灵菲,李振华,康健   

  1. 中国医科大学附属第一医院呼吸疾病研究所,沈阳110001
  • 收稿日期:2015-09-15 出版日期:2016-02-29 发布日期:2016-02-24
  • 通讯作者: 孔灵菲 E-mail:E-mail:konglingf@sina.com
  • 作者简介:吴倩(1988 -),女,医师,硕士研究生.

The Expressions and Roles of IGF-Ⅰ,IGFBP-4 and IGFBP-5 in BALF and Serum of Patients with Idiopathic Pulmonary Fibrosis

WU Qian,KONG Ling-fei,LI Zhen-hua,KANG Jian   

  1. Institute of Respiratory Diseases,The First Hospital,China Medical University,Shenyang 110001,China
  • Received:2015-09-15 Online:2016-02-29 Published:2016-02-24

摘要: 目的 检测特发性肺纤维化(IPF)患者支气管肺泡灌洗液(BALF)和血清中胰岛素样生长因子 1(IGF-Ⅰ)、胰岛素样生长因子结合蛋白 4(IGFBP-4)、胰岛素样生长因子结合蛋白 5(IGFBP-5)的表达水平,探讨其在 IPF 患者的诊治及病情评估方面的临床意义。方法 选择 2012 年 2 月至 2013 年 3 月就诊于中国医科大学附属第一医院的 IPF 患者 22 例作为 IPF 组,另选择Ⅰ期肺结节病患者 16 例作为对照非纤维化组,检测并比较 2 组 BALF 和血清中 IGF-Ⅰ、IGFBP-4、IGFBP-5 表达水平的差异,分析三者的浓度与细胞学计数、肺功能、血气分析、肺 HRCT 评分的相关性。结果 IPF 组患者 BALF 中 IGF-Ⅰ、IGFBP-4 水平高于对照组,血清中 IGFBP-5 水平高于对照组。IPF 组 BALF 和血清中的 IGFBP-5 水平均与巨噬细胞百分比呈正相关。IPF 组血清中 IGF-Ⅰ水平与用力肺活量(FVC%)、一氧化碳弥散量(DLCO%)呈正相关,BALF 中 IGFBP-4 水平与第一秒用力呼气容积(FEV1%)、FVC%呈负相关,血清中 IGFBP-4 水平与 FEV1%呈正相关。IPF 组 BALF 和血清中 IGF-Ⅰ、IGFBP-4、IGFBP-5 水平与氧分压(PaO2)无相关性。IPF 组 BALF 中 IGF-Ⅰ、IGFBP-4 水平与肺高分辨率 CT(HRCT)评分呈正相关。结论 IPF 患者体内 IGF-Ⅰ、IGFBP-4、IGFBP-5 表达水平升高,这 3 项指标可作为 IPF 患者病情监测、疗效判断乃至靶向治疗的客观指标。

关键词: 特发性肺纤维化, 支气管肺泡灌洗液, 胰岛素样生长因子1, 胰岛素样生长因子结合蛋白4, 胰岛素样生长因子结合蛋白5

Abstract: Objective To detect the change and significance of the level of insulin-like growth factor(IGF-I),insulin-like growth factorbinding protein-4(IGFBP-4)and insulin-like growth factor-binding protein-5(IGFBP-4)in bronchoalveolar lavage fluid(BALF)and serum of patients with IPF,and to study their roles in the diagnosis,treatment and clinical significance of patients with IPF. Methods Twenty two patients with IPF and 16 patients with pulmonary sarcoidosis as control group were enrolled from Department of Respiratory Disease in the First Hospital of China Medical University. The level of IGF-I,IGFBP-4 and IGFBP-5 in BALF and serum were detected and compared between these groups. Correlation analysis were made between the concentration of IGFBP-4 and IGFBP-5 and the data of cytology count,blood gas analysis and pulmonary HRCT score in IPF group. Results The level of IGF-I,IGFBP-4 in BALF increased in IPF group compared with control group and the level of IGFBP-5 in serum also increased in IPF group. The level of IGFBP-5 in BALF and serum was positively correlated with M% in IPF group. In IPF group,the level of IGF-I in serum was positively correlated with FVC% and DLCO% level. The level of IGFBP-4 in BALF were negatively correlated with FEV1%,FVC% and IGFBP-4 level in serum was positively correlated with FEV1%. The level of IGF-I,IGFBP-4 and IGFBP-5 in BALF and serum of IPF group were not correlated with PaO2. The levels of IGF-I and IGFBP-4 in BALF of IPF group were positively correlated with pulmonary HRCT score. Conclusion The expression of IGF-Ⅰ,IGFBP-4 and IGFBP-5 is elevated in the patients with IPF and may become objective indicators to determine the efficacy even targeted therapy.

Key words: idiopathic pulmonary fibrosis, bronchoalveolar lavage fluid, insulin-like growth factor-I, insulin-like growth factorbinding protein-4, insulin-like growth factor-binding protein-5

中图分类号: 

  • R563.1+3
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