摘要
目的研究咳嗽变异性哮喘(CVA)与呼出气一氧化氮(FeNO)、胸腺基质淋巴细胞生成素(TSLP)的相关性,推测其在CVA病理生理中的可能机制。方法收集2016年7月至2018年12月就诊于包头市中心医院呼吸科门诊及住院的病例:CVA患者67例(CVA组),嗜酸性粒细胞支气管炎(EB)患者8例(EB组)。选择同期健康体检者14名(健康对照组)。分别进行FeNO及血清TSLP的含量测定。采用单因素方差分析比较3组间上述资料的差异,不同组间的两两比较采用LSD-t检验法。采用Pearson相关分析分析CVA组FeNO与TSLP指标间的相关性。采用多元线性回归分析分析影响CVA组FeNO水平的因素,采用逐步法筛选变量(α入=0.10,α出=0.15)纳入合适的变量。结果FeNO水平在CVA组、EB组和健康对照组之间差异具有统计学意义(F=7.344,P=0.001);CVA患者FeNO水平显著高于健康对照组[(60.88±42.85)×10^-9 mol/L vs(17.64±4.91)×10^-9 mol/L],差异具有统计学意义(t=4.35,P<0.001);EB组FeNO水平高于健康对照组[(66.50±42.35)×10^-9 mol/L vs(17.64±4.91)×10^-9 mol/L)],差异具有统计学意义(t=2.71,P=0.008);CVA组患者和EB组患者比较,差异无统计学意义(P>0.05)。CVA组TSLP水平明显高于EB组[(421.60±111.65)ng/L vs(338.81±119.98)ng/L];EB组TSLP水平明显高于健康对照组[(338.81±119.98)ng/L vs(233.34±51.39)ng/L];CVA组血清TSLP水平显著高于健康对照组,差异均具有统计学意义(t=4.11、7.36、5.88,P均<0.001)。血清总IgE浓度在CVA组、EB组和健康对照组中比较,差异均无统计学意义(P>0.05)。CVA组FeNo与血清TSPL值呈正相关(r=0.258,P=0.035)。TSPL值、身高对FeNO水平均有影响。结论(1)FeNO和血清TSLP水平均与气道炎症相关。(2)单一的FeNO测定可能不能作为CVA与EB的鉴别标准。(3)血清TSLP水平参与了气道炎症的发生和发展,有助于慢性咳嗽CVA和EB的诊断和鉴别诊断。
Objective To investigate the correlation of fractional exhaled nitric oxide measurement(FeNO)and thymic stromal lymphopoietin(TSLP)with cough variant asthma(CVA)to reveal their possible role in the pathophysiology of CVA.Methods From July 2016 to December 2018,67 CVA patients and 8 eosinophilic bronchitis(EB)patients were collected at the Department of Respiratory Medicine of Baotou Central Hospital.Fourteen healthy subjects were also included as a control group.The contents of FeNO and serum TSLP were determined in all subjects.One-way ANOVA was used to compare the differences of the above data among the three groups,and LSD-t test was used for pairwise comparison between different groups.Pearson correlation was used to analyze the correlation between FeNO and TSLP in the CVA group.Factors influencing FeNO levels in the CVA group were analyzed by multiple linear regression,and variables(αin=0.10,αout=0.15)were screened by stepwise method to include appropriate variables.Results There were statistically significant differences in FeNO levels among CVA patients,EB patients,and healthy controls(F=7.344,P=0.001).FeNO levels in CVA patients and EB patients were significantly higher than that in healthy controls[(60.88±42.85)×10^-9 mol/L vs(17.64±4.91)×10^-9 mol/L;t=4.35,P<0.001;(66.50±42.35)×10^-9 mol/L vs(17.64±4.91)×10^-9 mol/L;t=2.71,P=0.008];however,there was no difference between CVA and EB patients(P>0.05).TSLP level was significantly higher in the CVA group than in the EB group[(421.60±111.65)ng/L vs(338.81±119.98)ng/L,t=4.11,P<0.001],in the EB group than in the control group[(338.81±119.98)ng/L vs(233.34±51.39)ng/L,t=7.36,P<0.001],and in the CVA group than in the healthy control group(t=5.88,P<0.001).There was no significant difference in serum total IgE concentration among the CVA,EB,and control groups(P>0.05).CVA group FeNo was positively correlated with serm TSPL in the CVA group(r=0.258,P=0.035).There was a positive correlation between TSPL,height,and FeNO level.Conclusion Both FeNO and seru
作者
胡晓丽
杨勇
王渊
郭建华
常晓悦
Hu Xiaoli;Yang Yong;Wang Yuan;Guo Jianhua;Chang Xiaoyue(Department of Respiratory and Critical Care Medicine,Baotou Central Hospital,Baotou 014040,China)
出处
《中华临床医师杂志（电子版）》
CAS
2020年第4期250-254,共5页
Chinese Journal of Clinicians(Electronic Edition)
