Objective: To investigate the association of plasma roundabout 4 concentration with pulmonary ventilation function decline in chronic obstructive pulmonary disease (COPD) patients. Methods: To get the effective data, the study was conducted in the outpatient department of West China Hospital from September 2017 to September 2018. The subjects meeting the inclusion and exclusion criteria were continuously included. Among them, the COPD group (75 cases) was from the respiratory outpatient department, and the healthy control group (57 cases) was from the health examination center at the same time. Data of basic demographic characteristics, clinical characteristics, pulmonary ventilation function parameters and blood samples were collected. The concentrations of roundabout 4, C reactive protein (CRP), interleukin (IL)-6, IL-8, IL-1b and tumor necrosis factor (TNF)-α in plasma were detected, and the differences among groups were compared, the correlation between plasma roundabout 4 and pulmonary ventilation function parameters and inflammatory factors was analyzed. The diagnostic efficiency of roundabout 4 to COPD was analyzed according to receiver operating characteristic (ROC) curve. Results: The plasma concentration of roundabout 4 in COPD group was significantly higher than that in healthy control group [(41.3±14.2) vs (27.7±13.3) ng/L; P<0.001], the sensitivity and specificity of roundabout 4 in the diagnosis of COPD were 0.827 and 0.702 respectively. Correlation analysis showed that the plasma concentration of roundabout 4 was negatively correlated with lung function parameters forced expiratory volume in one second/forced vital capacity (FEV(1)/FVC), the first second forced expiratory volume as a percentage of the estimated value (FEV(1)%pred), forced exhalation of 50% and 25% lung capacity (MEF50, MEF25) and maximal mid-expiratory flow (MMEF) (r=-0.399, -0.321, -0.439, -0.363, -0.458; all P<0.001), positively correlated with CRP (adjusted r=0.311, P<0.001). Conclusion: The increased concentration of roundabout 4 in plasma leads to the decline of pulmonary ventilation function in COPD patients.
目的： 探讨血浆环状物4浓度与慢阻肺患者肺通气功能下降的关系。 方法： 该研究于2017年9月至2018年9月在华西医院门诊进行。连续收集符合纳入排除标准的受试者，其中慢阻肺组（75例）来自呼吸专科门诊就诊人群，健康对照组（57例）来自同期体检中心健康体检人群。收集基本人口学特征、临床特征、肺通气功能相关指标和血浆。检测血浆中环状物4、C-反应蛋白（CRP）、白细胞介素（IL）-6、IL-8、IL-1b、肿瘤坏死因子（TNF）-α的浓度，比较两组间差异。分析血浆环状物4浓度与肺通气功能参数、CRP等炎症因子的相关性，通过受试者工作特征（ROC）曲线分析血浆环状物4浓度对慢阻肺的诊断效能。 结果： 慢阻肺组血浆环状物4浓度显著高于健康对照组[（41.3±14.2）比（27.7±13.3）ng/L；P<0.001）]，环状物4诊断慢阻肺的灵敏度为0.827，特异度为0.702。全部受试者血浆环状物4浓度与第1秒用力呼气容积（FEV(1)）与用力肺活量（FVC）的比值（FEV(1)/FVC）、FEV(1)占预计值百分比（FEV(1)%预计值）以及用力呼出50%、25%肺活量的呼气流量（MEF50、MEF25）和最大呼气中期流速（MMEF）均呈负相关（r=-0.399、-0.321、-0.439、-0.363、-0.458；均P<0.001），与CRP呈正相关（r=0.311，P<0.001）。 结论： 血浆环状物4浓度升高导致慢阻肺患者肺通气功能下降。.
Keywords: Lung function; Pulmonary disease, chronic obstructive; Roundabout 4.