支气管哮喘患者eotaxin-3基因多态性对吸入糖皮质激素的影响

发布时间：2019-01-01 12:38

【摘要】：目的探讨eotaxin-3单核苷酸多态性(SNP)对吸入糖皮质激素(ICS)治疗效果的影响,为eotaxin-3作为支气管哮喘治疗靶点提供临床依据。方法收集哮喘患者(n=196)及对照者(n=196)的外周血标本,采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)法检测eotaxin-3+2497TG,+77CT各种基因型,比较各种基因型的哮喘患者对ICS治疗的反应性和ACT评分的变化情况。结果哮喘患者为+2497位TG基因型时,外周血嗜酸性粒细胞(EOS)计数、诱导痰EOS比例和外周血总IgE与TT型相比均明显下降,且差异有统计学意义(P0.05),TG型哮喘患者的第1秒用力呼气容积下降20%所需的最低累积剂量(PD20)水平[(0.07±0.03)mg]明显高于TT型[(0.03±0.01)mg],差异具有统计学意义(t=2.45,P=0.048);而上述指标在+77位3种基因型间的差异均无统计学意义。+2497位TT型哮喘患者在ICS治疗过程中,第1秒用力呼气量、PD20值和ACT评分均较TG型哮喘患者明显改善,差异具有统计学意义(P0.01)。结论 +2497位TT型哮喘患者对ICS治疗更敏感,规律ICS治疗能显著改善该类患者的肺功能和临床症状评分。
[Abstract]:Objective to investigate the effect of eotaxin-3 single nucleotide polymorphisms (SNP) on the treatment of inhaled glucocorticoid (ICS) and to provide clinical evidence for eotaxin-3 as a therapeutic target for bronchial asthma. Methods Peripheral blood samples from asthmatic patients (nhm196) and control subjects (nhs196) were collected. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect eotaxin-3 2497TGand 77CT genotypes. To compare the response to ICS therapy and ACT score in asthmatic patients with different genotypes. Results the eosinophil (EOS) count, the percentage of induced sputum EOS and total IgE in peripheral blood decreased significantly in 2497 TG genotypes of asthmatic patients compared with TT genotype (P0.05). The minimum cumulative dose (PD20) level of forced expiratory volume reduction of 20% in patients with TG asthma was significantly higher than that in TT type [(0.07 卤0.03) mg], and the difference was statistically significant (t = 2.45). P0. 048); However, there was no significant difference among the three genotypes in the 77 position. The forced expiratory volume, PD20 value and ACT score in 2497 patients with TT asthma were significantly improved in the course of ICS treatment compared with those in TG asthma patients (P0.01). Conclusion 2497 patients with TT asthma are more sensitive to ICS treatment. Regular ICS therapy can significantly improve the pulmonary function and clinical symptom score of these patients.
【作者单位】：三峡大学第一临床医学院/湖北省宜昌市中心医院呼吸内科;
【基金】：湖北省教育厅科研计划项目(B2015254)
【分类号】：R562.25

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