循环纤维细胞在早产儿支气管肺发育不良中的检测及意义

Detection of circulating fibrocytes in bronchopulmonary dysplasia in the premature infants and its significance

摘要:

目的：探讨CD34、Ⅰ型胶原（collagen Ⅰ，COLⅠ）、CXCR4 在支气管肺发育不良（bronchopulmonary dysplasia，BPD）的表达及临床意义。方法：利用流式细胞仪（flow cytometry，FCM）检测61 例早产儿生后1、3、5、7、28 d外周血中 CD34、COLⅠ、CX－CR4 的表达，并比较 CD34、COLⅠ、CXCR4 在 BPD 组及非 BPD 组间表达的差异。结果：BPD 组患儿较非BPD 组患儿CXCR4 在生后第1天有明显增高[（61.4±13.37）%]。随着日龄的增大，BPD 患儿 COLⅠ水平在第28 天达到高峰[3.42（2.87，4.98）%]，而CD34、CXCR4 水平降至最低[（0.67±0.25）%；（31.9±13.48）%]。重复测量设计方差分析显示，日龄的增大及CD34、COLⅠ、CX－CR4 水平的变化对BPD的发生存在交互作用（F=77.66，P=0.000）。ROC曲线分析显示，COLⅠ的曲线下面积（area under the curve，AUC）为0.867，高于CD34、CXCR4，且当COLⅠ值为1.3%时，敏感度为69.7%，特异度为86%。不同时间点BPD 各组测量值比较均有统计学意义（P=0.000）。结论：循环纤维细胞的 COLⅠ 水平高表达及 CD34、CXCR4 水平持续降低与BPD 的发生密切相关。

Abstract:

Objective：To investigate the expression and clinical significance of CD34，COLⅠ and CXCR4 in bronchopulmonary dys－plasia（BPD）. Methods：Expressions of CD34，COLⅠ and CXCR4 in peripheral blood from 44 premature infants with BPD on the 1st，3rd，5th，7th and 28th d after birth were measured by flow cytometry（FCM） and the expression differences of CD34，COL I，CXCR4 between BPD group and the non- BPD group were compared. Results：On the 1st d after birth，the expression of CXCR4 increased greatly in BPD group compared with that of non-BPD group. With the increase of days after birth，COLⅠlevel peaked on 28th d in BPD group，while CD34 and CXCR4 levels reduced to the lowest. Data of ANOVA for repeated measurement showed that time and the changes in CD34，COL I and CXCR4 levels caused an interactive effect on the occurrence of BPD（F=77.66，P=0.000）. ROC curve displayed that area under the curve of COL I was 0.867，higher than those of CD34 and CXCR4. When COL I was 1.3%，the sensitivity was 69.7% and specificity was 86%. There were statistically significances in BPD group among different time points（P=0.000）. Conclusion：Circulating fibrocytes with increased level of COLⅠas well as decreased level of CD34 and CXCR4 are closely related with the occurrence of BPD.