摘要
目的难治性哮喘患者血清中肿瘤坏死因子(tumor necrosis factor,TNF)-α的表达及其加重哮喘严重程度的具体机制研究尚不充分。文中探讨了难治性哮喘患者血清的TNF-α表达水平及其对肺功能和气道炎性反应的影响。方法选取2011年3月1日至2012年2月29日期间于南京军区南京总医院就诊的哮喘患者,根据中华医学会针对难治性哮喘定义筛选难治性哮喘、普通哮喘和健康对照组患者各10例。基础肺功能法检测计算每秒用力呼气容积占预计值的百分比(percentage of forced expiratory volume in first second to forced vital capacity,FEV1),免疫法检测血清总IgE水平,计数法检测外周血嗜酸性粒细胞(eosinophil,EOS)计数,ELISA法检测血清TNF-α浓度,相同指标间比较采用独立样本t检验,不同指标之间采用Pearson直线相关分析。结果难治性哮喘组患者血清TNF-α水平和外周血EOS计数[(9.64±2.07)pg/L、(0.39±0.08)×109]均显著高于普通哮喘组[(6.87±1.32)pg/L、(0.29±0.11)×109]和健康对照组[(5.47±1.01)pg/L、(0.26±0.07)×109](P<0.05);难治性哮喘组血清总IgE水平[(556.31±268.68)IU/mL]虽明显高于健康对照组[(138.32±89.05)IU/mL](P<0.05),但与普通哮喘组[(488.93±237.26)IU/mL]差异无统计学意义(P>0.05)。难治性哮喘组肺功能FEV1[(62.57±13.06)%]均显著低于普通哮喘组[(82.64±10.90)%]和健康对照组[(88.62±3.81)%],差异有统计学意义(P<0.05)。相关性分析显示血清TNF-α水平与FEV1呈负相关(r=-0.86,P<0.05),与外周血EOS计数呈正相关(r=0.75,P<0.05),与血清IgE水平无相关性(r=-0.24,P>0.05)。结论难治性哮喘TNF-α表达水平较普通哮喘升高,并且TNF-α表达水平与肺功能负相关、与嗜酸性粒细胞炎症正相关,从而增加了难治性哮喘严重程度和治疗难度。
Objective The mechanisms of the tumor necrosis factor-or （TNF-a） expression and the aggravation degree of asthma induced by TNF-a have not been well understood. The aim of this study is to investigate the serum levels of TNF-a in refractory asthma patients and its impact on lung function and airway inflammation. Methods Ten patients diagnosed as refractory asthma, 10 common asthma patients and 10 healthy controls were recruited in the study. The percent of forced expiratory volume in first second to forced vital capacity （FEV1） was test by lung function equipment, the serum total IgE was detected by immunization, the eosinophil （EOS） was counted in peripheral blood, and the TNF-alevel was detected by ELISA. Results The serum level of TNF-ot and the count of peripheral EOS [ （9.64 ±2.07） pg/L, （0.39 ±0.08） x 10^9 ] in refractory asthma group were significantly higher than those in common asthma group [ （6.87 ±1.32） pg/L, （0.29 ± 0.11 ） x 10^9 ] and control group [ （ 5.47 ± 1.01 ） pg/L, （ 0.26 ± 0.07 ） x 10^9 ] （P 〈 0.05 ）. The total IgE level in refractory asthma group [ （556 ± 269 ）IU/ml ] was significantly higher than control group [ （138 ± 89） IU/ml] （P 〈 0.05）, but had no significant difference compared with common asthma group [ （489 ± 237）IU/ml] （P 〉 0.05 ）. FEV1 （ 62.6 ± 13.1% ） in refractory asthma group was significant lower than in common asthma group [ （ 82.6 ± 10.9 ） % ] and control group [ （88.6 ± 3.8） % ] （P 〈 0.05 ）. The serum level of TNF-a was negatively correlated with FEV1 （ r = - 0.86, P 〈 0.05 ） and positively correlated with EOS （ r = 0.75, P 〈 0.05）, but was not correlated with IgE （r = - 0.24, P 〉 0.05）. Conclusion The se-rum level of TNF-a is increased in refractory asthma than in common asthma, which is negatively correlated with the lung function and pos itively correlated with the EOS-mediated inflammation and thus exac erbates asthma severity and therapeutic efficacy.
出处
《医学研究生学报》
CAS
北大核心
2014年第1期55-57,共3页
Journal of Medical Postgraduates
基金
南京军区南京总医院科研基金(2011015)
