Page 77 - 南京医科大学学报自然科学版

第42卷第9期 南京医科大学学报（自然科学版）
2022年9月 Journal of Nanjing Medical University（Natural Sciences） ·1271 ·

·临床研究·

支气管肺泡灌洗液中CCL2水平对特发性肺纤维化患者预后的

判断价值

王 学，伊 晴，刘小琴，张英为 ，周玉皆
*
南京中医药大学鼓楼临床医学院呼吸与危重症医学科，江苏 南京 210008

［摘 要］ 目的：探究在临床实践中支气管肺泡灌洗液（bronchoalveolar lavage fluid，BALF）中趋化因子CCL2［chemokine（C⁃C
motif）ligand 2］和性别⁃年龄⁃生理学指标（gender⁃age⁃physiological index，GAP）评分对特发性肺纤维化（idiopathic pulmonary
fibrosis，IPF）预后的判断价值以及两者之间的相关性。方法：回顾性分析了2017年1月—2019年12月在南京鼓楼医院住院确
诊为IPF的患者35例，同期收集了因慢性咳嗽（chronic cough，CC）就诊、但无其他肺部疾病或其他器官疾病的门诊患者10例。
比较两组患者的性别、年龄、用力肺活量占预计值百分比（percentage of predicted forced vital capacity，FVC%）、一氧化碳弥散量
占预计值百分比（percentage of predicted diffusing capacity for carbon monoxide，DLCO%）（CC组除外）、血气分析等指标的差异，
同时检测血清和BALF中CCL2的水平，分析不同GAP组间CCL2水平、生存时间的差异以及CCL2与GAP评分之间的相关性。
结果：与CC组相比，IPF组血清和BALF中CCL2均升高。IPF组（Ⅰ、Ⅱ、Ⅲ期）与CC组4组间比较显示，氧合指数、FVC%、血清
和BALF中CCL2水平差异均有统计学意义，IPF组（Ⅰ、Ⅱ、Ⅲ期）3组间比较显示DLCO%有差异。相关性方面，BALF中CCL2
与FVC%、DLCO%均呈负相关，与GAP评分呈正相关。IPF组（Ⅰ、Ⅱ、Ⅲ期）3组间生存时间有差异。结论：本研究结果不仅验
证了BALF中CCL2和GAP评分对预测IPF预后的价值，同时首次揭示了不同GAP分期患者BALF中CCL2水平具有差异性，且
BALF中CCL2与GAP评分具有相关性。
［关键词］ 特发性肺纤维化；支气管肺泡灌洗液；趋化因子CCL2
［中图分类号］ R563.13 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）09⁃1271⁃08
doi：10.7655/NYDXBNS20220912

Prognostic value of CCL2 level in bronchoalveolar lavage fluid of patients with idiopathic
pulmonary fibrosis

*
WANG Xue，YI Qing，LIU Xiaoqin，ZHANG Yingwei ，ZHOU Yujie
Department of Respiratory and Critical Care Medicine，Gulou Clinical Medical College，Nanjing University of
Traditional Chinese Medicine，Nanjing 210008，China

［Abstract］ Objective：This study aims to explore the prognostic value of chemokine CCL2（C⁃C motif）in bronchoalveolar lavage
fluid（BALF）and gender⁃age⁃physiological index（GAP）scores for idiopathic pulmonary fibrosis（IPF）in clinical practice and the
correlation between them. Methods：Total 35 patients with IPF hospitalized in Nanjing Gulou Hospital from January 2017 to December
2019 were analyzed retrospectively. In the same period，10 outpatients with chronic cough（CC）but no other lung diseases or other
organ diseases were collected. The differences of gender，age，percentage of predicted forced vital capacity（FVC%），percentage of
predicted diffusing capacity for carbon monoxide（DLCO%）（except CC group），blood gas analysis and other indicators between the two
groups were compared. At the same time，the level of CCL2 in serum and BALF was detected，and the differences of CCL2 level and
survival time between different GAP groups and the correlation between CCL2 and GAP score were analyzed. Results：Compared with CC
group，CCL2 in serum and BALF increased in IPF group. The comparison between IPF group（phase Ⅰ，Ⅱ and Ⅲ）and CC group showed
that there were differences in oxygenation index，FVC%，CCL2 level in serum and BALF，and there were significant differences in
DLCO% among IPF group（phase Ⅰ，Ⅱ and Ⅲ）. In terms of correlation，CCL2 in BALF was negatively correlated with FVC% or

［基金项目］ 国家自然科学基金（81570055）
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通信作者（Corresponding author），E⁃mail：yingwei16@aliyun.com