血清白介素17、白介素33与慢性咳嗽相关性的研究

发布时间：2018-10-31 20:37

【摘要】：目的:通过检测慢性咳嗽患者外周血的血清IL-17及IL-33的水平,探讨其与慢性咳嗽患者呼出气NO浓度、肺功能的关系,评估IL-17及IL-33在慢性咳嗽发病机制中的作用。方法:选择在2016年1月-2017年1月因慢性咳嗽长于8周就诊于吉林大学第一医院呼吸科门诊的患者160例作为慢性咳嗽组,全部慢性咳嗽的诊断均符合中华医学会呼吸病学分会哮喘学组制订的《咳嗽的诊断与治疗指南》,患者以咳嗽为唯一或主要症状、病程大于8周、胸部X线或胸部CT检查未见明显异常者。年龄17-70岁,性别不限,初次就诊。所有患者均符合以下排除标准:(1)有吸烟史;(2)就诊前4周内曾应用糖皮质激素;(3)不能配合Fe NO测定或肺功能检查;(4)患有心理疾病者,服用ACEI类药物者;(5)近6个月出现心脑血管意外、接受大手术治疗、大创伤等应激因素。(6)检查当天剧烈运动,检查前饮用酒精、咖啡等饮料,服用高硝酸盐食物者。此外健康对照组为我院体检健康者60例。所有被选定对象均检测血清IL-17及IL-33,所有慢性咳嗽组完成肺功能检测、Fe NO的测定、综合过敏原检测。所有数据采用Graph Pad Prism统计软件进行处理。比较两组的血清IL-17、IL-33水平;分析IL-17及IL-33水平与肺功能、呼出气NO水平的相关性。结果:(1)共选取入组的慢性咳嗽患者160例,其中男性70例,女性90例,年龄(42.83±5.48)岁;入组的健康对照者60人,其中男性20例,女性40例,年龄(43.00±5.30)岁;各组间在年龄及性别无统计学差异(P0.05)。(2)慢性咳嗽组患者血清IL-17(64.01±4.70)高于健康对照组(28.14±2.34),差异存在统计学意义(t=6.829,P0.05);血清IL-33(58.06±6.02)高于健康对照组(31.86±2.66),差异存在统计学意义(t=4.041,P0.05)。(3)慢性咳嗽患者血清IL-17水平与患者FEV1%呈负相关(r=-0.6245,P0.0001);慢性咳嗽患者血清IL-33水平与患者FEV1%呈负相关(r=-0.6722,P0.0001)。(4)慢性咳嗽组Fe NO50ppb组患者血清IL-33水平高于Fe NO25-50ppb,Fe NO 25-50ppb组患者血清IL-33水平高于Fe NO25ppb,每两组间差异存在统计学意义(P0.05);IL-17水平在Fe NO25ppb;25-50ppb;50ppb三个等级中每两组间P值均大于0.05。(5)慢性咳嗽患者血清IL-33水平与患者Fe NO浓度有相关性,且呈正相关,Fe NO浓度越高,患者血清IL-33水平越高(rs=0.758,P0.05)。(6)慢性咳嗽患者中总Ig E100IU/ml组的Fe NO的几何均数(33ppb)明显低于总Ig E200IU/ml组(78ppb)和总Ig E100IU/ml-200IU/ml(69ppb)组,P值均小于0.001;后两组比较,P=0.0824。结论:(1)血清IL-17、IL-33可能作为一种促炎因子参与慢性咳嗽的发病机制。(2)血清IL-17、IL-33水平与肺通气功能改变呈负相关性。(3)血清IL-33升高可能预测嗜酸粒细胞性气道炎症及反映严重程度。
[Abstract]:Objective: to investigate the relationship between serum IL-17 and IL-33 levels in peripheral blood of chronic cough patients and their relationship with exhalation NO concentration and pulmonary function, and to evaluate the role of IL-17 and IL-33 in the pathogenesis of chronic cough. Methods: 160 patients with chronic cough from January 2016 to January 2017 who had been admitted to the Department of Respiratory Department of the first Hospital of Jilin University for 8 weeks were selected as the chronic cough group. All the diagnoses of chronic cough were in accordance with the "guidelines for the diagnosis and treatment of cough" formulated by the Asthma Section of the Chinese Medical Association Respiratory Society. Cough was the only or main symptom in the patients, and the course of disease was longer than 8 weeks. Chest X-ray or chest CT showed no obvious abnormality. The age is 17-70 years old, the gender is not limited, the first visit. All patients met the following exclusion criteria: (1) smoking history; (2) use of glucocorticoid within 4 weeks before treatment; (3) failure to cooperate with Fe NO test or pulmonary function test; (4) patients with mental illness, who took ACEI drugs; (5) there were cardiovascular and cerebrovascular accidents in the last 6 months. (6) those who had severe exercise on the day of examination, who drank alcohol, coffee and high nitrate food before examination. In addition, the healthy control group consisted of 60 healthy persons in our hospital. All the selected subjects were tested for serum IL-17 and IL-33,. All chronic cough groups were tested for pulmonary function, Fe NO and comprehensive allergen. All data are processed by Graph Pad Prism statistical software. Serum IL-17,IL-33 levels were compared, and the correlation between IL-17 and IL-33 levels and pulmonary function, exhalation and NO levels were analyzed. Results: (1) 160 patients with chronic cough were selected, including 70 males and 90 females, aged (42.83 卤5.48) years. There were 60 healthy controls, including 20 males and 40 females, aged (43.00 卤5.30) years. There was no significant difference in age and sex among the groups (P0.05). (2). The serum IL-17 of chronic cough group (64.01 卤4.70) was higher than that of healthy control group (28.14 卤2.34), and the difference was statistically significant (P 0.05). Serum IL-33 (58.06 卤6.02) was significantly higher than that in healthy controls (31.86 卤2.66). P0.05). (3) the level of serum IL-17 in patients with chronic cough was negatively correlated with FEV1% (r = 0.6245, P 0.0001). The serum IL-33 level in chronic cough patients was negatively correlated with FEV1% (r = -0.6722, P 0.0001). (4). The serum IL-33 level of chronic cough group in Fe NO50ppb group was higher than that in Fe NO25-50ppb, group. The level of serum IL-33 in Fe NO 25-50ppb group was significantly higher than that in Fe NO25ppb, group (P0.05). IL-17 level in Fe NO25ppb;25-50ppb; P value in each of the three grades of 50ppb was greater than 0.05. (5) there was a correlation between serum IL-33 level and Fe NO concentration in patients with chronic cough, and the higher the positive correlation, Fe NO concentration was, the higher the serum IL-33 level was (rs=0.758,). P0.05). (6) the geometric mean of Fe NO (33ppb) in total Ig E100IU/ml group was significantly lower than that in total Ig E200IU/ml group (78ppb) and total Ig E100IU/ml-200IU/ml (69ppb) group (P < 0.001). Compared with the latter two groups, Pu 0.0824. Conclusion: (1) Serum IL-17,IL-33 may be a proinflammatory factor involved in the pathogenesis of chronic cough. (2) Serum IL-17,. (3) elevated serum IL-33 may predict eosinophils airway inflammation and reflect severity.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R56

【相似文献】