摘要
目的分析支气管哮喘、咳嗽变异性哮喘(CVA)患者血清中YKL-40和炎症介质,及其与肺功能、哮喘控制测试(ACT)相关性以及血清YKL-40水平在哮喘未控制中的表达。方法筛选2017年5月至2019年5月300例哮喘患者入组研究组,分组按照2008年全球哮喘防治创议指南的哮喘诊断标准。对比不同组间血清YKL-40水平、白细胞介素(IL)-10、肿瘤坏死因子(TNF)、IgE及嗜酸性粒细脆(EOS)血清学指标水平,用力肺活量(FVC)、第1秒用力呼气量(FEV1)、FEV1/FVC肺功能指标和ACT评分差异及相关性。结果①血清YKL-40水平:支气管哮喘组高于正常对照组,CVA患者组也高于正常对照组。②IL-10、TNF、IgE及EOS水平:支气管哮喘组和CVA组IL-10、TNF、IgE的浓度及EOS%水平均高于正常对照组。③肺功能及ACT评分:支气管哮喘组和CVA组肺功能及ACT评分均低于对照组,支气管哮喘组和CVA组间差异无统计学意义。支气管哮喘未控制组与CVA未控制组患者血清中YKL-40水平与IL-10、TNF、IgE水平呈正相关,与EOS%无相关性,与FVC%、FEV1%呈负相关,与ACT评分呈负相关。结论YKL-40作为一种新的炎症因子,参与了哮喘的发病。提示哮喘症状未控制继续抗炎治疗十分必要的,对减少哮喘急性发作有极其重要的意义。哮喘患者在急性发作期YKL-40水平比缓解期有所增加,YKL-40随着病情的加重分泌增多,YKL-40可作为哮喘病情监测的临床指标。
Objective To investigate the profiles of YKL-40 and inflammatory mediators in serum of patients with bronchial asthma or cough-variant asthma(CVA),how they relate to the lung function and asthma control test,and the expression level of serum YKL-40 in uncontrolled asthma.Methods Between May 2017 and May 2019,a total of 300 patients with bronchial asthma and CVA were enrolled as subjects.The grouping of these subjects were based on diagnostic criteria for asthma by GINA 2008.Serological indicators including serum levels of YKL-40,IL-10,TNF,IgE,and EOS%,lung function parameters such as FVC,FEV1 and FEV1/FVC,and ACT scores were compared between groups.Results Comparisons among asthma group,CVA group and normal individuals showed that the serum YKL-40 level was higher in asthma group than in normal individuals,and so was for the CVA group;the levels of IL-10,TNF,IgE and EOS%in asthma group and CVA group were higher than those in normal individuals;the lung function and ACT scores in the asthma group and the CVA group were lower than those in normal individuals.There were no statistical differences in these values between the asthma and CVA groups.Among patients with uncontrolled asthma or CVA,the serum levels of YKL-40 were positively correlated with the levels of IL-10,TNF,and IgE but not with EOS%,and negatively correlated with FVC%,FEV1%,and ACT scores.Conclusion YKL-40,as a novel inflammatory factor,is involved in the pathogenesis of asthma,suggesting the paramount importance for continued anti-inflammatory treatment in uncontrolled asthma to reduce acute asthma exacerbation.The level of YKL-40 in patients with asthma increases during acute exacerbation compared with steady state of asthma.The increased production of YKL-40 along with disease severity suggests the potential for YKL-40 to be used as a clinical indicator for monitoring of asthma.
作者
王磊
崔艳芝
李洁
Wang Lei;Cui Yanzhi;Li Jie(Department of Respiratory and Critical Care Medicine,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Taiyuan 030032,China)
出处
《中国药物与临床》
CAS
2020年第9期1425-1427,共3页
Chinese Remedies & Clinics
基金
山西省卫生厅科研课题(201301048)。
