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  本文關(guān)鍵詞： 難治性哮喘 腫瘤壞死因子-α 每秒用力呼氣容積占預(yù)計值的百分比 嗜酸性粒細(xì)胞 IgE　出處：《醫(yī)學(xué)研究生學(xué)報》2014年01期 　論文類型：期刊論文

【摘要】：目的難治性哮喘患者血清中腫瘤壞死因子(tumor necrosis factor,TNF)-α的表達(dá)及其加重哮喘嚴(yán)重程度的具體機(jī)制研究尚不充分。文中探討了難治性哮喘患者血清的TNF-α表達(dá)水平及其對肺功能和氣道炎性反應(yīng)的影響。方法選取2011年3月1日至2012年2月29日期間于南京軍區(qū)南京總醫(yī)院就診的哮喘患者,根據(jù)中華醫(yī)學(xué)會針對難治性哮喘定義篩選難治性哮喘、普通哮喘和健康對照組患者各10例�；A(chǔ)肺功能法檢測計算每秒用力呼氣容積占預(yù)計值的百分比(percentage of forced expiratory volume in first second to forced vital capacity,FEV1),免疫法檢測血清總IgE水平,計數(shù)法檢測外周血嗜酸性粒細(xì)胞(eosinophil,EOS)計數(shù),ELISA法檢測血清TNF-α濃度,相同指標(biāo)間比較采用獨(dú)立樣本t檢驗,不同指標(biāo)之間采用Pearson直線相關(guān)分析。結(jié)果難治性哮喘組患者血清TNF-α水平和外周血EOS計數(shù)[(9.64±2.07)pg/L、(0.39±0.08)×109]均顯著高于普通哮喘組[(6.87±1.32)pg/L、(0.29±0.11)×109]和健康對照組[(5.47±1.01)pg/L、(0.26±0.07)×109](P0.05);難治性哮喘組血清總IgE水平[(556.31±268.68)IU/mL]雖明顯高于健康對照組[(138.32±89.05)IU/mL](P0.05),但與普通哮喘組[(488.93±237.26)IU/mL]差異無統(tǒng)計學(xué)意義(P0.05)。難治性哮喘組肺功能FEV1[(62.57±13.06)%]均顯著低于普通哮喘組[(82.64±10.90)%]和健康對照組[(88.62±3.81)%],差異有統(tǒng)計學(xué)意義(P0.05)。相關(guān)性分析顯示血清TNF-α水平與FEV1呈負(fù)相關(guān)(r=-0.86,P0.05),與外周血EOS計數(shù)呈正相關(guān)(r=0.75,P0.05),與血清IgE水平無相關(guān)性(r=-0.24,P0.05)。結(jié)論難治性哮喘TNF-α表達(dá)水平較普通哮喘升高,并且TNF-α表達(dá)水平與肺功能負(fù)相關(guān)、與嗜酸性粒細(xì)胞炎癥正相關(guān),從而增加了難治性哮喘嚴(yán)重程度和治療難度。
[Abstract]:Objective to investigate the expression of tumor necrosis factor-TNF- 偽 in serum of patients with refractory asthma and its mechanism of exacerbating the severity of asthma. The expression level of TNF- 偽 in serum of patients with refractory asthma and its effect on lung were discussed in this paper. Methods from March 1st 2011 to February 29th 2012, patients with asthma were selected from Nanjing General Hospital of Nanjing military region. According to the definition of refractory asthma by the Chinese Medical Association, The percentage of forced expiratory volume of forced expiratory volume in first second to forced vital capacity of FEV1 was measured by basic pulmonary function method, and the serum total IgE level was measured by immunoassay. Peripheral eosinophilic eosinophilic eosinophilus count Elisa was used to detect serum TNF- 偽 concentration, and independent sample t test was used to compare the same indexes. Results the serum TNF- 偽 level and peripheral blood EOS count in patients with refractory asthma [9.64 鹵2.07 g / L] 脳 109 were significantly higher than those in the normal asthma group [6.87 鹵1.32 g / L, 0.29 鹵0.11) 脳 10 ~ 9] and the healthy control group [5.47 鹵1.01g / L ~ 0.26 鹵0.07 脳 10 ~ 9], and the total IgE level in the patients with refractory asthma [556.31 鹵268.68 渭 g / L] was significantly higher than that in the control group [5.47 鹵1.01g / L = 0.26 鹵0.07 脳 10 ~ 9]. Although it was significantly higher than that in the healthy control group [138.32 鹵89.05 渭 mol / mL], there was no significant difference between the two groups [488.93 鹵237.26 渭 mol / mL]. The pulmonary function FEV1 in the refractory asthma group [62.57 鹵13.06%] was significantly lower than that in the normal asthma group [82.64 鹵10.90%] and the healthy control group (88.62 鹵3.81%), and the correlation analysis was significant (P 0.05). There was a negative correlation between serum TNF- 偽 level and FEV1, a positive correlation between TNF- 偽 level and peripheral blood EOS count, and no correlation between TNF- 偽 level and serum IgE level. Conclusion the expression of TNF- 偽 in refractory asthma is higher than that in normal asthma. The expression of TNF- 偽 was negatively correlated with pulmonary function and eosinophil inflammation, which increased the severity of refractory asthma and the difficulty of treatment.
【作者單位】： 南京軍區(qū)南京總醫(yī)院干部呼吸科;
【基金】：南京軍區(qū)南京總醫(yī)院科研基金(2011015)
【分類號】：R562.25

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本文編號：1512972