支气管哮喘患者血清中白介素-25的水平与肺功能的相关性研究

发布时间：2018-09-18 13:00

【摘要】：目的：通过分别检测支气管哮喘患者急性发作期外周血中白细胞介素-25、嗜酸性粒细胞、白细胞总数、中性粒细胞和肺功能的水平，研究支气管哮喘患者IL-25及嗜酸性粒细胞与肺功能的关系，以及这些指标与支气管哮喘之间的相关性，进而分析这些指标在支气管哮喘临床诊断中的作用，为支气管哮喘临床治疗寻找依据。方法：收集记录完整的36例支气管哮喘患者的个人资料（包括年龄、性别、病程、过敏史、过敏性鼻炎史、用药史等），检测外周血中白细胞总数、中性粒细胞数、嗜酸性粒细胞数水平，并且采用酶联免疫吸附法（ELISA）法检测样本中IL-25的水平。同时选取30名于大连医科大学附属第二医院体检中心进行体检的非支气管哮喘体检者作为对照组，并且除外其他与IL-25相关的因素，测定其外周血中白细胞介素-25、嗜酸性粒细胞、白细胞总数、中性粒细胞的水平。所有哮喘患者均行肺功能检查，测定其第一秒用力呼气容积（FEV1）、第一秒用力呼气容积占预计值百分比（FEV1%pre）、第一秒用力呼气容积占用力肺活量百分比（FEV1/FVC%）、用力呼气50%肺活量的瞬间流量占预计值的百分比（FEF50%pre）、用力呼气75%肺活量的瞬间流量占预计值的百分比（FEF75%pre）、用力呼气25-75%肺活量的平均流量占预计值的百分比（FEF25-75%pre）等值，比较这些肺功能指标与白细胞介素-25、嗜酸性粒细胞、白细胞总数、中性粒细胞等的相关性。结果：1.支气管哮喘组血清中IL-25、肺功能的检测水平及相关性：①支气管哮喘组血清中IL-25水平明显高于正常对照组（P0.05），且亚组间比较，中度和重度哮喘组IL-25水平明显高于轻度哮喘组，差异有显著统计学意义。②在支气管哮喘组中，IL-25水平与FEV1、FEV1%pre、FEV1/FVC%、FEF50%pre、FEF75%pre、FEF25-75%pre的水平存在负相关。 2、支气管哮喘组外周血中嗜酸性粒细胞的水平及与肺功能的相关性：支气管哮喘组中，EOS水平与FEV1、FEV1%pre、FEV1/FVC%、FEF50%pre、FEF75%pre、FEF25-75%pre的水平存在负相关。同时，在哮喘组各亚组中，中度组与轻度组EOS的水平有显著统计学差异（P0.05），，与重度组有显著统计学差异（P0.05）)。 3.哮喘组患者血清中IL-25水平与嗜酸性粒细胞的水平呈正相关，而与白细胞总数、中性粒细胞数无相关性。结论：1.哮喘组血清中IL-25水平明显高于正常对照组，且随着FEV1/FVC%、FEV1、FEV1%pre等大气道指标和FEF50%pre、FEF75%pre、FEF25-75%pre等小气道指标的下降而增加，呈负相关性，提示IL-25是同时反映大、小气道病变的敏感指标，可能作为临床辅助诊断及判断病情严重程度的指标之一。 2.哮喘组血清EOS水平亦随着FEV1/FVC%、FEV1%pre和FEF50%pre、FEF75%pre、FEF25-75%pre的下降而增加，呈负相关性，且IL-25水平与EOS水平呈正相关，推测IL-25可能是通过诱导EOS聚集来发挥其致炎作用的。
[Abstract]:Objective: to detect the levels of interleukin-25 (IL-25), eosinophils, total leukocytes, neutrophils and lung function in peripheral blood of patients with acute asthma. To study the relationship between IL-25, eosinophil and pulmonary function in patients with bronchial asthma, and the correlation between these indexes and asthma, and to analyze the role of these indexes in the clinical diagnosis of bronchial asthma. To find the basis for clinical treatment of bronchial asthma. Methods: the data of 36 patients with bronchial asthma (including age, sex, course of disease, allergic history, allergic rhinitis history, medication history, etc.) were collected and recorded. The total number of white blood cells and the number of neutrophils in peripheral blood were measured. Eosinophilic granulocyte number and IL-25 levels in the samples were detected by enzyme-linked immunosorbent assay (ELISA). Thirty patients with non-bronchial asthma were selected as control group and their peripheral blood interleukin-25 (IL-25) and eosinophilic granulocyte (eosinophilic granulocyte) were determined except for other factors related to IL-25. The total number of white blood cells and the level of neutrophils. All asthmatic patients underwent pulmonary function tests, The first second forced expiratory volume (FEV1), the first second forced expiratory volume as a percentage of the predicted value (FEV1%pre), the first second forced expiratory volume occupied vital capacity percentage (FEV1/FVC%), the forced expiratory volume of 50% vital capacity as a percentage of the predicted value was measured. (FEF50%pre), 75% of forced expiratory vital capacity as a percentage of predicted instantaneous flow (FEF75%pre), and 25 to 75% of forced expiratory vital capacity as a percentage of predicted value (FEF25-75%pre) equivalent. To compare the correlation between these pulmonary function indexes and interleukin-25, eosinophil, leukocyte count, neutrophil, etc. The result is 1: 1. The level and correlation of IL-25, pulmonary function in asthma group; the level of IL-25 in asthma group was significantly higher than that in normal control group (P0.05). The IL-25 level in moderate and severe asthma group was significantly higher than that in mild asthma group (P0.05). The level of IL-25 was negatively correlated with the level of FEV1,FEV1%pre,FEV1/FVC%,FEF50%pre,FEF75%pre,FEF25-75%pre in bronchial asthma group. 2. The level of eosinophil in peripheral blood and its correlation with lung function in bronchial asthma group: bronchitis There was a negative correlation between the level of EOS and the level of FEV1,FEV1%pre,FEV1/FVC%,FEF50%pre,FEF75%pre,FEF25-75%pre in tube asthma group. At the same time, the level of EOS in moderate group and mild group was significantly different from that in severe group (P0.05), and there was significant difference between severe group and moderate group (P0.05). 3). There was a positive correlation between serum IL-25 level and eosinophil level in asthmatic patients, but no correlation with total leukocyte count and neutrophil count. Conclusion 1. The level of serum IL-25 in asthma group was significantly higher than that in normal control group, and increased with the decrease of FEV1/FVC%,FEV1,FEV1%pre and FEF50%pre,FEF75%pre,FEF25-75%pre, indicating that IL-25 was a sensitive index reflecting the large and small airway lesions at the same time. It may be used as one of the indicators of clinical assistant diagnosis and judgement of severity of the disease. 2. 2. The serum EOS level in asthma group increased with the decrease of FEV1/FVC%,FEV1%pre and FEF50%pre,FEF75%pre,FEF25-75%pre, and the level of IL-25 was positively correlated with EOS level. It was speculated that IL-25 might play its role in inflammation by inducing EOS aggregation.
【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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