表面活性物质衍生蛋白作为心力衰竭时肺泡膜损伤的标志物。
Surfactant-derived proteins as markers of alveolar membrane damage in heart failure.
作者信息
Gargiulo Paola, Banfi Cristina, Ghilardi Stefania, Magrì Damiano, Giovannardi Marta, Bonomi Alice, Salvioni Elisabetta, Battaia Elisa, Filardi Pasquale Perrone, Tremoli Elena, Agostoni Piergiuseppe
机构信息
Institute of Diagnostic and Nuclear Development, Naples, Italy.
Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.
出版信息
PLoS One. 2014 Dec 16;9(12):e115030. doi: 10.1371/journal.pone.0115030. eCollection 2014.
BACKGROUND
In heart failure (HF) alveolar-capillary membrane is abnormal. Surfactant-derived proteins (SPs) and plasma receptor for advanced-glycation-end-products (RAGE) have been proposed as lung damage markers.
METHODS
Eighty-nine chronic HF and 17 healthy subjects were evaluated by echocardiography, blood parameters, carbon monoxide lung diffusion (DLCO) and cardiopulmonary exercise test. We measured immature SP-B, mature SP-B, SP-A, SP-D and RAGE plasma levels.
RESULTS
Immature SP-B (arbitrary units), mature SP-A (ng/ml) and SP-D (ng/ml), but not mature SP-B (ng/ml) and RAGE (pg/ml) levels, were higher in HF than in controls [immature SP-B: 15.6 (13.1, 75th-25th interquartile range) Vs. 11.1 (6.4), p<0.01; SP-A, 29.6 (20.1) Vs. 18.3 (13.5), p = 0.01; SP-D: 125 (90) Vs. 78 (58), p<0.01]. Immature SP-B, SP-A, SP-D and RAGE values were related to DLCO, peak oxygen consumption, ventilatory efficiency, and brain natriuretic peptide (BNP), whereas plasma mature SP-B was not. The DLCO Vs. immature SP-B correlation was the strongest one. At multivariate analysis, RAGE was associated to age and creatinine, SP-A to DLCO and BNP, SP-D to BNP, mature SP-B to DLCO and creatinine, and immature SP-B only but strongly to DLCO.
CONCLUSIONS
Immature SP-B is the most reliable biological marker of alveolar-capillary membrane function in HF.
背景
在心力衰竭（HF）中，肺泡毛细血管膜是异常的。表面活性物质衍生蛋白（SPs）和晚期糖基化终产物血浆受体（RAGE）已被提议作为肺损伤标志物。
方法
通过超声心动图、血液参数、一氧化碳肺弥散（DLCO）和心肺运动试验对89例慢性HF患者和17名健康受试者进行评估。我们测量了未成熟的SP-B、成熟的SP-B、SP-A、SP-D和RAGE血浆水平。
结果
HF患者中未成熟的SP-B（任意单位）、成熟的SP-A（ng/ml）和SP-D（ng/ml）水平高于对照组，而成熟的SP-B（ng/ml）和RAGE（pg/ml）水平则不然[未成熟的SP-B：15.6（13.1，第75-25四分位数间距）对11.1（6.4），p<0.01；SP-A，29.6（20.1）对18.3（13.5），p = 0.01；SP-D：125（90）对78（58），p<0.01]。未成熟的SP-B、SP-A、SP-D和RAGE值与DLCO、峰值耗氧量、通气效率和脑钠肽（BNP）相关，而血浆成熟的SP-B则不然。DLCO与未成熟的SP-B之间的相关性最强。在多变量分析中，RAGE与年龄和肌酐相关，SP-A与DLCO和BNP相关，SP-D与BNP相关，成熟的SP-B与DLCO和肌酐相关，未成熟的SP-B仅与DLCO密切相关。
结论
未成熟的SP-B是HF中肺泡毛细血管膜功能最可靠的生物学标志物。
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