武汉云克隆科技股份有限公司

Abstract: Some patients with idiopathic pulmonary fibrosis experience acute exacerbations in their respiratory status leading to substantial morbidity and mortality. Occult aspiration of gastric contents has been proposed as one possible mechanism leading to these acute exacerbations. We sought to determine if pepsin, a marker of gastric aspiration, is elevated in bronchoalveolar lavage fluid obtained from patients during acute exacerbation of idiopathic pulmonary fibrosis compared to stable disease. Lavage samples were obtained in a case-control study of well-characterized patients. Acute exacerbation was defined using standard criteria. Levels of lavage pepsin were compared in cases and controls, and were correlated with clinical features and disease course. Twenty-four cases with acute exacerbations and 30 stable controls were identified. There were no significant differences in baseline demographics between the two groups. Pepsin level was an indicator of acute exacerbation status (p value = 0.04). On average, pepsin appeared higher in patients with acute exacerbations compared to stable controls. This difference was driven by a subgroup of eight patients (33%) with pepsin levels ≥ 70 ng/ml. Pepsin level was not an independent predictor of survival time. These results suggest occult aspiration may play a role in some cases of acute exacerbation of idiopathic pulmonary fibrosis.

摘要：一些特发性肺纤维化患者的呼吸状态急剧恶化，导致相当大的发病率和死亡率。已经提出将胃内容物的隐匿性抽吸作为导致这些急性恶化的一种可能机制。我们试图确定与稳定疾病相比，在患有特发性肺纤维化的急性加重期患者中获得的支气管肺泡灌洗液中，胃吸入的标志物胃蛋白酶是否升高。在充分表征的患者的病例对照研究中获得了灌洗样品。使用标准标准定义急性加重。在病例和对照中比较灌洗胃蛋白酶的水平，并且与临床特征和疾病过程相关。确定了24例急性加重病例和30例稳定对照。两组之间的基线人口统计数据没有显着差异。胃蛋白酶水平是急性加重状态的指标（p值= 0.04）。与稳定对照相比，急性加重患者平均胃蛋白酶水平更高。这种差异是由8名胃蛋白酶水平≥70 ng / ml的患者（33％）组成。胃蛋白酶水平不是生存时间的独立预测因子。这些结果表明，隐匿性误吸可能在某些特发性肺纤维化急性加重的病例中发挥作用。

使用试剂原文信息：BAL pepsin levels were measured using a commercially available ELISA (USCN Life Science, Inc.).