慢性阻塞性肺疾病患者血清组织蛋白酶水平与病情关系的研究

doi:10.11958/20260087

天津医药 ›› 2026, Vol. 54 ›› Issue (10): 1030-1034.doi: 10.11958/20260087

慢性阻塞性肺疾病患者血清组织蛋白酶水平与病情关系的研究

郭立娟¹(), 康肖菲², 王辉³^,^△()

¹ 河北省胸科医院呼吸科（邮编 050000）
² 衡水市第六人民医院急诊科
³ 河北大学附属医院结核科

收稿日期:2026-01-06 修回日期:2026-02-25 出版日期:2026-10-15 发布日期:2026-10-10
通讯作者: △E-mail：18132727097@163.com
作者简介:郭立娟（1988），女，主治医师，主要从事呼吸病学方面研究。E-mail：bpc389819@163.com
基金资助:
河北省医学科学研究课题计划(20231499)

The relationship between serum cathepsin levels and disease severity in patients with chronic obstructive pulmonary disease

GUO Lijuan¹(), KANG Xiaofei², WANG Hui³^,^△()

¹ Department of Respiratory, Hebei Chest Hospital, Shijiazhuang 050000, China
² Department of Emergency Service, Hengshui Sixth People's Hospital
³ Department of Tuberculosis, Affiliated Hospital of Hebei University

Received:2026-01-06 Revised:2026-02-25 Published:2026-10-15 Online:2026-10-10
Contact: △E-mail：18132727097@163.com

郭立娟, 康肖菲, 王辉. 慢性阻塞性肺疾病患者血清组织蛋白酶水平与病情关系的研究[J]. 天津医药, 2026, 54(10): 1030-1034.

GUO Lijuan, KANG Xiaofei, WANG Hui. The relationship between serum cathepsin levels and disease severity in patients with chronic obstructive pulmonary disease[J]. Tianjin Medical Journal, 2026, 54(10): 1030-1034.

摘要/Abstract

摘要：

目的探讨慢性阻塞性肺疾病（COPD）患者血清组织蛋白酶（Cat）B、Cat-L、Cat-S水平与炎性因子以及病情急性加重的关系。方法纳入2022年1月—2024年12月河北省胸科医院呼吸科收治的224例COPD患者（研究组）及同期62例健康体检者（对照组）。根据病情将研究组分为急性加重组（71例）与稳定组（153例）。采用呼吸困难指数（mMRC）、第1秒用力呼气容积/用力肺活量（FEV1/FVC）及改良COPD评估测试（CAT）评分评估病情；酶联免疫吸附试验检测血清Cat-B、Cat-L、Cat-S水平；Pearson法分析Cat-B、Cat-L、Cat-S与C-反应蛋白（CRP）、白细胞介素（IL）-8、肿瘤坏死因子-α（TNF-α）、IL-10的相关性；Logistic回归分析COPD急性加重的影响因素。结果与对照组相比，研究组血清Cat-B降低，其中急性加重组低于稳定组（P<0.05），Cat-L、Cat-S升高，其中急性加重组高于稳定组（P<0.05）。Cat-B与CRP、IL-8、TNF-α、mMRC、CAT评分呈负相关，与IL-10、FEV1/FVC呈正相关（P<0.05）；Cat-L、Cat-S与上述指标的相关性则与Cat-B相反（P<0.05）。Cat-L、Cat-S水平升高是COPD患者病情急性加重的独立危险因素（P<0.05），FEV1/FVC、Cat-B水平升高是其独立保护因素（P<0.05）。结论 Cat-B、Cat-L与Cat-S作为关键生物标志物，通过介导炎症反应参与COPD进程，其水平变化对病情急性加重具有显著影响。

关键词: 肺疾病, 慢性阻塞性, 组织蛋白酶B, 组织蛋白酶L, 组织蛋白酶S, 急性加重, 炎性因子

Abstract:

Objective To explore the relationship between serum cathepsin (Cat) B, Cat-L, Cat-S and inflammatory factors in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods A total of 224 COPD patients admitted to the respiratory department of Hebei Provincial Chest Hospital from January 2022 to December 2024 were collected as the research group, and 62 individuals participated in the health check-up during the same period were selected as the control group. The research group was divided into the acute exacerbation group (71 cases) and the stable group (153 cases) based on changes in the patient's condition. The modified medical research council (mMRC), forced expiratory volume in one second / forced vital capacity (FEV1/FVC) and COPD assessment test (CAT) score were used to assess respiratory distress. Enzyme linked immunosorbent assay was used to detect serum Cat-B, Cat-L and Cat-S levels. Pearson method was used to analyze the correlation between serum Cat-B, Cat-L, Cat-S and serum C-reactive protein (CRP), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10). Logistic multiple regression model was used to analyze the influencing factors of aggravation of COPD. Results Compared with the control group, the serum Cat-B level in the study group decreased, with levels in the acute exacerbation subgroup being lower than those in the stable subgroup (P<0.05). In contrast, Cat-L and Cat-S levels were increased in the study group, in which the acute exacerbation subgroup was higher than that in the stable subgroup (P<0.05). Cat-B was negatively correlated with CRP, IL-8, TNF-α, mMRC and CAT score (P<0.05), and Cat-B was positively correlated with IL-10 and FEV1/FVC (P<0.05). Cat-L and Cat-S showed correlations opposite to those of Cat-B with the above indicators (P<0.05). Elevated levels of Cat-L and Cat-S were identified as independent risk factors for acute exacerbation in COPD patients (P<0.05), whereas elevated FEV1/FVC ratio and Cat-B levels were independent protective factors (P<0.05). Conclusion Cat-B, Cat-L and Cat-S, as key biomarkers, participate in the progress of COPD by mediating inflammatory responses. Their dynamic changes have a significant impact on the acute exacerbation of the disease.

Key words: pulmonary disease, chronic obstructive, cathepsin B, cathepsin L, cathepsin S, acute exacerbation, inflammatory factor

中图分类号:

R563

图/表 5

参考文献 23

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组别	n	Cat-B	Cat-L	Cat-S
对照组	62	1.43±0.31	1.75±0.27	13.06±2.19
研究组	224	0.95±0.28	6.33±0.99	28.53±3.48
t		11.788^＊＊	61.284^＊＊	42.726^＊＊

组别	n	Cat-B	Cat-L	Cat-S
对照组	62	1.43±0.31	1.75±0.27	13.06±2.19
研究组	224	0.95±0.28	6.33±0.99	28.53±3.48
t		11.788^＊＊	61.284^＊＊	42.726^＊＊

组别	n		年龄/岁		性别				BMI/（kg/m²）		病程/年		基础疾病
组别	n		年龄/岁		男		女		BMI/（kg/m²）		病程/年		高血压		过敏性鼻炎		肺心病
稳定组	153		61.14±5.54		92（60.13）		61（39.87）		22.39±1.62		2.28±0.45		10（6.54）		9（5.88）		14（9.15）
急性加重组	71		59.96±5.46		44（61.97）		27（38.03）		22.41±1.65		2.32±0.47		9（12.68）		8（11.27）		7（9.86）
χ²或t			1.490		0.069				0.128		0.653		2.355		2.005		0.029
组别		COPD家族史				生活习惯						mMRC/级		FEV1/FVC/%		CAT评分/分
组别		有		无		吸烟		饮酒		熬夜		mMRC/级		FEV1/FVC/%		CAT评分/分
稳定组		17（11.11）		136（88.89）		96（62.75）		92（60.13）		79（51.63）		1.26±0.44		70.34±8.79		13.14±3.25
急性加重组		14（19.72）		57（80.28）		44（61.97）		35（49.30）		30（42.25）		3.54±0.50		45.86±8.49		26.52±3.57
χ²或t		3.013				0.012		2.319		1.708		32.737^＊＊		19.607^＊＊		27.786^＊＊
组别		CRP/（mg/L）				IL-8/（ng/L）		TNF-α/（ng/L）		IL-10/（ng/L）		Cat-B/（μg/L）		Cat-L/（μg/L）		Cat-S/（μg/L）
稳定组		15.43±2.94				196.42±25.35		145.78±20.33		126.34±15.65		1.07±0.25		5.82±0.63		27.79±3.29
急性加重组		19.65±3.12				247.21±25.40		185.05±20.35		98.82±15.53		0.72±0.16		7.44±0.65		30.14±3.35
t		9.842＊＊				13.938＊＊		13.449＊＊		12.278＊＊		12.843＊＊		17.896＊＊		4.938＊＊

组别	n		年龄/岁		性别				BMI/（kg/m²）		病程/年		基础疾病
组别	n		年龄/岁		男		女		BMI/（kg/m²）		病程/年		高血压		过敏性鼻炎		肺心病
稳定组	153		61.14±5.54		92（60.13）		61（39.87）		22.39±1.62		2.28±0.45		10（6.54）		9（5.88）		14（9.15）
急性加重组	71		59.96±5.46		44（61.97）		27（38.03）		22.41±1.65		2.32±0.47		9（12.68）		8（11.27）		7（9.86）
χ²或t			1.490		0.069				0.128		0.653		2.355		2.005		0.029
组别		COPD家族史				生活习惯						mMRC/级		FEV1/FVC/%		CAT评分/分
组别		有		无		吸烟		饮酒		熬夜		mMRC/级		FEV1/FVC/%		CAT评分/分
稳定组		17（11.11）		136（88.89）		96（62.75）		92（60.13）		79（51.63）		1.26±0.44		70.34±8.79		13.14±3.25
急性加重组		14（19.72）		57（80.28）		44（61.97）		35（49.30）		30（42.25）		3.54±0.50		45.86±8.49		26.52±3.57
χ²或t		3.013				0.012		2.319		1.708		32.737^＊＊		19.607^＊＊		27.786^＊＊
组别		CRP/（mg/L）				IL-8/（ng/L）		TNF-α/（ng/L）		IL-10/（ng/L）		Cat-B/（μg/L）		Cat-L/（μg/L）		Cat-S/（μg/L）
稳定组		15.43±2.94				196.42±25.35		145.78±20.33		126.34±15.65		1.07±0.25		5.82±0.63		27.79±3.29
急性加重组		19.65±3.12				247.21±25.40		185.05±20.35		98.82±15.53		0.72±0.16		7.44±0.65		30.14±3.35
t		9.842＊＊				13.938＊＊		13.449＊＊		12.278＊＊		12.843＊＊		17.896＊＊		4.938＊＊

指标	CRP	IL-8	TNF-α	IL-10
Cat-B	-0.459^＊＊	-0.442^＊＊	-0.435^＊＊	0.411^＊＊
Cat-L	0.602^＊＊	0.589^＊＊	0.593^＊＊	-0.584^＊＊
Cat-S	0.571^＊＊	0.565^＊＊	0.576^＊＊	-0.590^＊＊

慢性阻塞性肺疾病患者血清组织蛋白酶水平与病情关系的研究

The relationship between serum cathepsin levels and disease severity in patients with chronic obstructive pulmonary disease

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参考文献 23

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指标	mMRC	FEV1/FVC	CAT评分
Cat-B	-0.472^＊＊	0.485^＊＊	-0.469^＊＊
Cat-L	0.512^＊＊	-0.507^＊＊	0.534^＊＊
Cat-S	0.499^＊＊	-0.503^＊＊	0.482^＊＊

指标	β	SE	Wald χ²	P	OR	OR 95%CI
FEV1/FVC	-0.083	0.018	21.458	<0.001	0.920	0.888~0.953
Cat-B	-0.205	0.069	8.790	0.003	0.815	0.712~0.933
Cat-L	1.140	0.398	8.205	0.004	3.127	1.433~6.822
Cat-S	1.197	0.405	8.735	0.003	3.310	1.497~7.321
常数项	-3.689	0.911	16.397	<0.001	0.025	-

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