目的:肺特异性可溶性凝集素,SP-A和SP-D已在临床上用于诊断间质性肺病,但其在COVID-19中的临床意义仍存在争议。这项研究是为了确定它们与其他凝集素(MBL和FCN1)的关系,疾病严重程度,和COVID-19患者的X光片。
方法:将2021年5月22日至9月19日在札幌医科大学医院收治的131例COVID-19患者纳入研究。数据包括人口统计,病史,症状,标志,实验室发现,和放射学图像是从患者的医疗记录中收集的。入院时进行胸部计算机断层扫描(CT)扫描。血清表面活性蛋白A和D(SP-A和SP-D)水平,使用酶联免疫吸附测定(ELISA)试剂盒测量甘露糖结合凝集素(MBL)和ficolin1(FCN1)。
结果:与对照组相比,COVID-19组入院时血清SP-A和FCN1水平显着升高(SP-A:59.60±38.89vs.35.61±11.22ng/ml;p<0.01,FCN1:542.45±506.04vs.250.6±161.1ng/ml;p<0.01)。COVID-19重症组的血清SP-D水平明显高于非重症组(SP-D:141.7±155.7vs.61.41±54.54ng/ml;p<0.01,MBL:1,670±1,240vs.2,170±1,140ng/ml;p<0.05)。SP-D强烈反映了影像学发现的程度,而SP-A表现出显著的相关性,尽管比SP-D稍弱相反,MBL和FNC1与影像学表现无明显相关性。
结论:在可溶性血清凝集素中,SP-A和SP-D可能比报道的疾病生物标志物(如IL-6、LDH、和CRP由于它们的肺特异性特征。
OBJECTIVE: The lung-specific soluble lectins, SP-A and SP-D have been clinically used to diagnose interstitial lung disease, but their clinical significance in COVID-19 remains controversial. This study was undertaken to determine their association with other lectins (MBL and FCN1), disease severity, and radiographs in COVID-19 patients.
METHODS: A total of 131 patients with COVID-19 admitted in the Sapporo Medical University Hospital between May 22 and September 19, 2021, were enrolled in the study. Data including demographics, medical history, symptoms, signs, laboratory findings, and radiological images were collected from the patients\' medical records. Chest computed tomography (CT) scanning was performed at admission. Serum levels of surfactant protein A and D (SP-A and SP-D), mannose-binding lectin (MBL) and ficolin1 (FCN1) were measured using enzyme-linked immunosorbent assay (ELISA) kits.
RESULTS: Compared to the control group, the COVID-19 group had significantly higher serum SP-A and FCN1 levels on admission (SP-A: 59.60±38.89 vs. 35.61±11.22 ng/ml; p<0.01, FCN1: 542.45±506.04 vs. 250.6±161.1 ng/ml; p<0.01). The severe group in COVID-19 had significantly higher serum SP-D and lower MBL levels than the non-severe group (SP-D: 141.7±155.7 vs. 61.41±54.54 ng/ml; p<0.01, MBL: 1,670±1,240 vs. 2,170±1,140 ng/ml; p<0.05). SP-D strongly reflected the degree of imaging findings, whereas SP-A showed a significant correlation, albeit slightly weaker than SP-D. Conversely, MBL and FNC1 were not significantly correlated with imaging findings.
CONCLUSIONS: Among soluble serum lectins, SP-A and SP-D may be more sensitive to CT findings than reported disease biomarkers such as IL-6, LDH, and CRP due to their lung-specific characteristics.