血清半乳凝素-7水平在支气管哮喘诊断中的临床价值

发布时间：2018-06-29 21:09

本文选题：半乳凝素-7 + 支气管哮喘　；参考：《大连医科大学》2013年硕士论文

【摘要】：目的：探讨血清半乳凝素-7水平在支气管哮喘诊断中的临床价值。方法：收集2011年7月至2012年8月于大连医科大学附属第二医院哮喘门诊就诊的哮喘患者71例（哮喘组），同期健康体检者17例（对照组）。哮喘组又分为轻度持续组（18例）、中度持续组（18例）、重度持续组（18例）和临床缓解组（17例）。慢性持续期的哮喘患者按照病程又分为≤1年组（13例）和＞1年组（41例）。哮喘的诊断标准、分级和分期参考全球哮喘防治创议（GINA2011版）和中华医学会呼吸病分会哮喘学组制定的支气管哮喘防治指南（2008版）。所有受试者均无吸烟史、咯血、气胸、肺大疱，近6周无呼吸道感染病史，无心功能不全、糖尿病、风湿免疫疾病以及肿瘤病史，无哮喘及鼻炎以外的过敏性疾病，未接受免疫抑制剂治疗。处于非急性发作期的患者每周均不同频度和（或）不同程度地出现症状（喘息、气急、胸闷、咳嗽等），近1周未使用吸入、口服、静点糖皮质激素，，未应用白三烯受体拮抗剂、茶碱类或抗组胺药，但可按需使用β2受体激动剂改善症状的哮喘患者为慢性持续组。经过治疗或未经治疗症状、体征消失，肺功能恢复到急性发作前水平，并维持3个月以上的哮喘患者为临床缓解组。采用酶联免疫吸附试验（ELISA）法检测受试者外周血血清半乳凝素-7的水平。采用ELITE.DE肺功能仪器测定受试者的第一秒用力呼气容积占预计值的百分比（FEV1pred％）。所得结果采用SPSS17.0软件进行统计分析，P0.05为差异有统计学意义。结果：1.慢性持续组、临床缓解组血清半乳凝素-7水平分别为1618.09±800.20pg/mL、1749.24±932.62pg/mL，分别与对照组（478.76±109.77pg/mL）比较，差异均有统计学意义（t’慢性持续组=10.16、t’临床缓解组=5.58，均P0.05）。哮喘组明显高于对照组。 2.慢性持续期哮喘病程≤1年组血清半乳凝素-7水平（2648.21±863.08pg/mL）明显高于病程＞1年组（1291.47±413.20pg/mL），存在统计学差异（t=5.76，P0.05）。慢性持续组哮喘病程≤1年组、病程＞1年组血清半乳凝素-7水平分别为2648.21±863.08pg/mL、1291.47±413.20pg/mL，分别与对照组（478.76±109.77pg/mL）比较，差异均有统计学意义（t’≤1年组=8.79、t’＞1年组=9.68，均P0.05）。哮喘病程≤1年组明显高于病程＞1年组及对照组。 3.轻度持续组血清半乳凝素-7水平（1348.00±495.04pg/mL）明显高于对照组（478.76±109.77pg/mL），差异有统计学意义（t’=7.26，P0.05）。重度持续组血清半乳凝素-7水平（2029.16±1075.21pg/mL）明显高于轻度持续组（1348.00±495.04pg/mL），差异有统计学意义（t’=-2.44，P0.05）。中度持续组血清半乳凝素-7水平（1477.12±563.86pg/mL）与轻度、重度持续组（1348.00±495.04pg/mL、2029.16±1075.21pg/mL）比较，差异均无统计学意义（t轻度持续组=-0.73、t’重度持续组=1.93，均P0.05）。 4.应用ROC曲线评估血清半乳凝素-7水平与FEV1pred%的诊断效能结果显示，血清半乳凝素-7曲线下面积（AUC）为0.84，FEV1pred%为0.69。当血清半乳凝素-7水平≥1485.10pg/mL时，诊断支气管哮喘的敏感度为94.40%，特异度为71.40%，准确率为65.80%；当FEV1pred%≤80%时，诊断支气管哮喘的敏感度为100.00%，特异度为52.90%，准确率为52.90%。结论：血清半乳凝素-7水平可以作为评价哮喘炎症水平的潜在标志物并有助于哮喘的早期诊断，对于哮喘病情严重程度的判断价值还需要进一步研究。
[Abstract]:Objective: To investigate the clinical value of serum galactoin -7 level in the diagnosis of bronchial asthma.
Methods: 71 asthma patients (asthma group) were collected from July 2011 to August 2012 at the Second Affiliated Hospital of Dalian Medical University, and 17 cases (control group) were examined. The asthma group was divided into mild continuous group (18 cases), moderate persistent group (18 cases), severe persistent group (18 cases) and clinical remission group (17 cases). The asthma patients were divided into 1 years (13 cases) and 1 year group (41 cases). The diagnostic criteria of asthma, classification and staging refer to the global guidelines for asthma prevention (GINA2011 Edition) and the guidelines for the prevention and control of bronchial asthma (2008 Edition) developed by the asthma group of the Chinese Medical Association. All subjects have no smoking history, hemoptysis, pneumothorax, and bullous. In the last 6 weeks, there was no history of respiratory infection, inactive dysfunction, diabetes, rheumatic immune disease and the history of tumor, no allergic diseases other than asthma and rhinitis, and no immunosuppressant treatment. Patients in the non acute stage had different frequency and / or varying degrees of symptoms every week (wheezing, breath, chest tightness, cough, etc.), nearly 1 No inhalation, oral, static corticosteroids, no leukotriene receptor antagonists, theophylline, or antihistamine, but a chronic persistent group with symptomatic improvement of symptoms with beta 2 receptor agonists. After treatment or untreated symptoms, signs disappeared, lung function to pre acute level, and more than 3 months The level of hemagglutinin -7 in peripheral blood serum of the subjects was detected by enzyme linked immunosorbent assay (ELISA). The percentage of the subjects' first second forced expiratory volume (FEV1pred%) was measured by ELITE.DE lung function instrument (FEV1pred%). The results of the results were analyzed by SPSS17.0 software and P0.05 The difference was statistically significant.
Results: 1. the level of serum galactoin -7 in the chronic continuous group was 1618.09 + 800.20pg/mL, 1749.24 + 932.62pg/mL, respectively, compared with the control group (478.76 + 109.77pg/mL), the difference was statistically significant (t 'chronic continuous group =10.16, t' clinical remission group = 5.58, all P0.05).
2. the level of serum galacotin -7 (2648.21 + 863.08pg/mL) in the course of chronic persistent asthma (2648.21 + 863.08pg/mL) was significantly higher than that of the course > 1 years (1291.47 + 413.20pg/mL), and there were statistical differences (t=5.76, P0.05). The course of chronic persistent asthma was less than 1 years, and the level of serum hemagglutinin -7 was 2648.21 + 863.08pg/mL and 1291.47 + 413.20 in the course of the course > 1 years, respectively. Pg/mL, respectively, compared with the control group (478.76 + 109.77pg/mL), the difference was statistically significant (t '< 1 years group =8.79, t' > 1 year group =9.68, P0.05). The course of the asthma course less than 1 years was significantly higher than the course > 1 year group and the control group.
3. the level of serum galacotin -7 (1348 + 495.04pg/mL) in the mild continuous group was significantly higher than that in the control group (478.76 + 109.77pg/mL), and the difference was statistically significant (t '=7.26, P0.05). The level of serum galactoin -7 (2029.16 + 1075.21pg/mL) in severe continuous group was significantly higher than that in the mild sustained group (1348 + 495.04pg/mL), and the difference was statistically significant (t' =-2.44). P0.05). The level of serum galactocoagulin -7 (1477.12 + 563.86pg/mL) in moderate persistent group and mild, severe continuous group (1348 + 495.04pg/mL, 2029.16 + 1075.21pg/mL), the difference was not statistically significant (t mild continuous group =-0.73, t 'severe persistent group =1.93, all P0.05).
4. the diagnostic efficacy of serum galactoin -7 and FEV1pred% showed that the area of serum galactocoagulin -7 curve (AUC) was 0.84, and FEV1pred% was 0.69. when serum galactocoagulin -7 level was more than 1485.10pg/mL, and the sensitivity of diagnosis of bronchial asthma was 94.40%, specificity was 71.40%, and the accuracy rate was 65.80%; when FEV1pred% was 65.80%, FEV1pred% was 65.80%. FEV1pred% At or less than 80%, the sensitivity of diagnosing bronchial asthma was 100%, the specificity was 52.90%, and the accuracy rate was 52.90%.
Conclusion: the level of serum galactocoagulin -7 can be used as a potential marker for evaluating the level of asthma and is helpful to the early diagnosis of asthma. The value of the diagnosis of asthma severity needs further study.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R562.25

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