Change and clinical significance of serum multidrug resistance protein 4 level in patients with chronic obstructive pulmonary disease complicated with pulmonary hypertension

Huang Fang; Yu Qian; Han Jing; Liu Weijia

doi:10.3760/j.issn.1673-4777.2024.09.009

Abstract：Objective To investigate the expression and clinical significance of multidrug resistance protein 4(MRP4)in serum of patients with chronic obstructive pulmonary disease(COPD)complicated with pulmonary hypertension(PH).Methods A total of 150 COPD patients hospitalized in Guizhou Provincial People's Hospital from February 13,2023 to February 13,2024 were selected.According to the results of echocardiography,COPD patients were divided into COPD group(50 cases)and COPD combined with PH group(COPD+PH group,100 cases).In addition,50 healthy subjects in the same period were selected as the control group.According to pulmonary artery systolic pressure(PASP),the COPD+PH group was divided into mild group(36 mmHg≤PASP≤50 mmHg),moderate group(51 mmHg≤PASP≤70 mmHg)and severe group(PASP＞70 mmHg).MRP4,pulmonary function,blood gas analysis,red cell volume distribution width(RDW),mean platelet volume(MPV),brain natriuretic peptide(BNP)and albumin levels were measured.Pearson correlation model was used for correlation analysis.The receiver operating characteristic(ROC)curve was used to evaluate the value of MRP4 in predicting COPD combined with PH.Results The level of MRP4 in COPD group was lower than that in control group,while the level of MRP4 in COPD+PH group was higher than that in control group and COPD group(both P＜0.05).The level of albumin in COPD+PH group was lower than that in COPD group,and the levels of RDW,MPV and BNP were higher than those in COPD group(all P＜0.05).The levels of MRP4,RDW,MPV and BNP in moderate group and severe group were higher than those in mild group,and those in severe group were higher than those in moderate group;the albumin level was lower in the mild group than in the severe group,and that in the severe group was lower than that in the moderate group(all P＜0.05).The level of MRP4 in COPD+PH group was positively correlated with BNP,PASP,RDW and MPV(r=0.72,0.85,0.70,0.62,all P＜0.01),and negatively correlated with albumin(r=-0.60,P＜0.01).ROC curve analysis showed that when the cut-off value of MRP4 was 2.895 μg/L,the area under the curve for predicting COPD combined with PH was 0.917(95％confidence interval:0.865-0.970),the sensitivity was 93.00％,and the specificity was 88.00％.Conclusion MRP4 is highly expressed in serum of patients with COPD complicated with PH,which may be a potential biomarker.