难治性哮喘患者血清肿瘤坏死因子-α的表达及其与肺功能和气道炎症的关系

发布时间：2018-02-15 09:38

本文关键词： 难治性哮喘肿瘤坏死因子-α 每秒用力呼气容积占预计值的百分比嗜酸性粒细胞 IgE　出处：《医学研究生学报》2014年01期 　论文类型：期刊论文

【摘要】：目的难治性哮喘患者血清中肿瘤坏死因子(tumor necrosis factor,TNF)-α的表达及其加重哮喘严重程度的具体机制研究尚不充分。文中探讨了难治性哮喘患者血清的TNF-α表达水平及其对肺功能和气道炎性反应的影响。方法选取2011年3月1日至2012年2月29日期间于南京军区南京总医院就诊的哮喘患者,根据中华医学会针对难治性哮喘定义筛选难治性哮喘、普通哮喘和健康对照组患者各10例。基础肺功能法检测计算每秒用力呼气容积占预计值的百分比(percentage of forced expiratory volume in first second to forced vital capacity,FEV1),免疫法检测血清总IgE水平,计数法检测外周血嗜酸性粒细胞(eosinophil,EOS)计数,ELISA法检测血清TNF-α浓度,相同指标间比较采用独立样本t检验,不同指标之间采用Pearson直线相关分析。结果难治性哮喘组患者血清TNF-α水平和外周血EOS计数[(9.64±2.07)pg/L、(0.39±0.08)×109]均显著高于普通哮喘组[(6.87±1.32)pg/L、(0.29±0.11)×109]和健康对照组[(5.47±1.01)pg/L、(0.26±0.07)×109](P0.05);难治性哮喘组血清总IgE水平[(556.31±268.68)IU/mL]虽明显高于健康对照组[(138.32±89.05)IU/mL](P0.05),但与普通哮喘组[(488.93±237.26)IU/mL]差异无统计学意义(P0.05)。难治性哮喘组肺功能FEV1[(62.57±13.06)%]均显著低于普通哮喘组[(82.64±10.90)%]和健康对照组[(88.62±3.81)%],差异有统计学意义(P0.05)。相关性分析显示血清TNF-α水平与FEV1呈负相关(r=-0.86,P0.05),与外周血EOS计数呈正相关(r=0.75,P0.05),与血清IgE水平无相关性(r=-0.24,P0.05)。结论难治性哮喘TNF-α表达水平较普通哮喘升高,并且TNF-α表达水平与肺功能负相关、与嗜酸性粒细胞炎症正相关,从而增加了难治性哮喘严重程度和治疗难度。
[Abstract]:Objective to investigate the expression of tumor necrosis factor-TNF- 伪 in serum of patients with refractory asthma and its mechanism of exacerbating the severity of asthma. The expression level of TNF- 伪 in serum of patients with refractory asthma and its effect on lung were discussed in this paper. Methods from March 1st 2011 to February 29th 2012, patients with asthma were selected from Nanjing General Hospital of Nanjing military region. According to the definition of refractory asthma by the Chinese Medical Association, The percentage of forced expiratory volume of forced expiratory volume in first second to forced vital capacity of FEV1 was measured by basic pulmonary function method, and the serum total IgE level was measured by immunoassay. Peripheral eosinophilic eosinophilic eosinophilus count Elisa was used to detect serum TNF- 伪 concentration, and independent sample t test was used to compare the same indexes. Results the serum TNF- 伪 level and peripheral blood EOS count in patients with refractory asthma [9.64 卤2.07 g / L] 脳 109 were significantly higher than those in the normal asthma group [6.87 卤1.32 g / L, 0.29 卤0.11) 脳 10 ~ 9] and the healthy control group [5.47 卤1.01g / L ~ 0.26 卤0.07 脳 10 ~ 9], and the total IgE level in the patients with refractory asthma [556.31 卤268.68 渭 g / L] was significantly higher than that in the control group [5.47 卤1.01g / L = 0.26 卤0.07 脳 10 ~ 9]. Although it was significantly higher than that in the healthy control group [138.32 卤89.05 渭 mol / mL], there was no significant difference between the two groups [488.93 卤237.26 渭 mol / mL]. The pulmonary function FEV1 in the refractory asthma group [62.57 卤13.06%] was significantly lower than that in the normal asthma group [82.64 卤10.90%] and the healthy control group (88.62 卤3.81%), and the correlation analysis was significant (P 0.05). There was a negative correlation between serum TNF- 伪 level and FEV1, a positive correlation between TNF- 伪 level and peripheral blood EOS count, and no correlation between TNF- 伪 level and serum IgE level. Conclusion the expression of TNF- 伪 in refractory asthma is higher than that in normal asthma. The expression of TNF- 伪 was negatively correlated with pulmonary function and eosinophil inflammation, which increased the severity of refractory asthma and the difficulty of treatment.
【作者单位】：南京军区南京总医院干部呼吸科;
【基金】：南京军区南京总医院科研基金(2011015)
【分类号】：R562.25

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