本文選題：半乳凝素-7 + 支氣管哮喘　； 參考：《大連醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：探討血清半乳凝素-7水平在支氣管哮喘診斷中的臨床價(jià)值。 方法：收集2011年7月至2012年8月于大連醫(yī)科大學(xué)附屬第二醫(yī)院哮喘門診就診的哮喘患者71例（哮喘組），同期健康體檢者17例（對照組）。哮喘組又分為輕度持續(xù)組（18例）、中度持續(xù)組（18例）、重度持續(xù)組（18例）和臨床緩解組（17例）。慢性持續(xù)期的哮喘患者按照病程又分為≤1年組（13例）和＞1年組（41例）。哮喘的診斷標(biāo)準(zhǔn)、分級和分期參考全球哮喘防治創(chuàng)議（GINA2011版）和中華醫(yī)學(xué)會呼吸病分會哮喘學(xué)組制定的支氣管哮喘防治指南（2008版）。所有受試者均無吸煙史、咯血、氣胸、肺大皰，近6周無呼吸道感染病史，無心功能不全、糖尿病、風(fēng)濕免疫疾病以及腫瘤病史，無哮喘及鼻炎以外的過敏性疾病，未接受免疫抑制劑治療。處于非急性發(fā)作期的患者每周均不同頻度和（或）不同程度地出現(xiàn)癥狀（喘息、氣急、胸悶、咳嗽等），近1周未使用吸入、口服、靜點(diǎn)糖皮質(zhì)激素，，未應(yīng)用白三烯受體拮抗劑、茶堿類或抗組胺藥，但可按需使用β2受體激動劑改善癥狀的哮喘患者為慢性持續(xù)組。經(jīng)過治療或未經(jīng)治療癥狀、體征消失，肺功能恢復(fù)到急性發(fā)作前水平，并維持3個月以上的哮喘患者為臨床緩解組。采用酶聯(lián)免疫吸附試驗(yàn)（ELISA）法檢測受試者外周血血清半乳凝素-7的水平。采用ELITE.DE肺功能儀器測定受試者的第一秒用力呼氣容積占預(yù)計(jì)值的百分比（FEV1pred％）。所得結(jié)果采用SPSS17.0軟件進(jìn)行統(tǒng)計(jì)分析，P0.05為差異有統(tǒng)計(jì)學(xué)意義。 結(jié)果：1.慢性持續(xù)組、臨床緩解組血清半乳凝素-7水平分別為1618.09±800.20pg/mL、1749.24±932.62pg/mL，分別與對照組（478.76±109.77pg/mL）比較，差異均有統(tǒng)計(jì)學(xué)意義（t’慢性持續(xù)組=10.16、t’臨床緩解組=5.58，均P0.05）。哮喘組明顯高于對照組。 2.慢性持續(xù)期哮喘病程≤1年組血清半乳凝素-7水平（2648.21±863.08pg/mL）明顯高于病程＞1年組（1291.47±413.20pg/mL），存在統(tǒng)計(jì)學(xué)差異（t=5.76，P0.05）。慢性持續(xù)組哮喘病程≤1年組、病程＞1年組血清半乳凝素-7水平分別為2648.21±863.08pg/mL、1291.47±413.20pg/mL，分別與對照組（478.76±109.77pg/mL）比較，差異均有統(tǒng)計(jì)學(xué)意義（t’≤1年組=8.79、t’＞1年組=9.68，均P0.05）。哮喘病程≤1年組明顯高于病程＞1年組及對照組。 3.輕度持續(xù)組血清半乳凝素-7水平（1348.00±495.04pg/mL）明顯高于對照組（478.76±109.77pg/mL），差異有統(tǒng)計(jì)學(xué)意義（t’=7.26，P0.05）。重度持續(xù)組血清半乳凝素-7水平（2029.16±1075.21pg/mL）明顯高于輕度持續(xù)組（1348.00±495.04pg/mL），差異有統(tǒng)計(jì)學(xué)意義（t’=-2.44，P0.05）。中度持續(xù)組血清半乳凝素-7水平（1477.12±563.86pg/mL）與輕度、重度持續(xù)組（1348.00±495.04pg/mL、2029.16±1075.21pg/mL）比較，差異均無統(tǒng)計(jì)學(xué)意義（t輕度持續(xù)組=-0.73、t’重度持續(xù)組=1.93，均P0.05）。 4.應(yīng)用ROC曲線評估血清半乳凝素-7水平與FEV1pred%的診斷效能結(jié)果顯示，血清半乳凝素-7曲線下面積（AUC）為0.84，F(xiàn)EV1pred%為0.69。當(dāng)血清半乳凝素-7水平≥1485.10pg/mL時，診斷支氣管哮喘的敏感度為94.40%，特異度為71.40%，準(zhǔn)確率為65.80%；當(dāng)FEV1pred%≤80%時，診斷支氣管哮喘的敏感度為100.00%，特異度為52.90%，準(zhǔn)確率為52.90%。 結(jié)論：血清半乳凝素-7水平可以作為評價(jià)哮喘炎癥水平的潛在標(biāo)志物并有助于哮喘的早期診斷，對于哮喘病情嚴(yán)重程度的判斷價(jià)值還需要進(jìn)一步研究。
[Abstract]:Objective: To investigate the clinical value of serum galactoin -7 level in the diagnosis of bronchial asthma.
Methods: 71 asthma patients (asthma group) were collected from July 2011 to August 2012 at the Second Affiliated Hospital of Dalian Medical University, and 17 cases (control group) were examined. The asthma group was divided into mild continuous group (18 cases), moderate persistent group (18 cases), severe persistent group (18 cases) and clinical remission group (17 cases). The asthma patients were divided into 1 years (13 cases) and 1 year group (41 cases). The diagnostic criteria of asthma, classification and staging refer to the global guidelines for asthma prevention (GINA2011 Edition) and the guidelines for the prevention and control of bronchial asthma (2008 Edition) developed by the asthma group of the Chinese Medical Association. All subjects have no smoking history, hemoptysis, pneumothorax, and bullous. In the last 6 weeks, there was no history of respiratory infection, inactive dysfunction, diabetes, rheumatic immune disease and the history of tumor, no allergic diseases other than asthma and rhinitis, and no immunosuppressant treatment. Patients in the non acute stage had different frequency and / or varying degrees of symptoms every week (wheezing, breath, chest tightness, cough, etc.), nearly 1 No inhalation, oral, static corticosteroids, no leukotriene receptor antagonists, theophylline, or antihistamine, but a chronic persistent group with symptomatic improvement of symptoms with beta 2 receptor agonists. After treatment or untreated symptoms, signs disappeared, lung function to pre acute level, and more than 3 months The level of hemagglutinin -7 in peripheral blood serum of the subjects was detected by enzyme linked immunosorbent assay (ELISA). The percentage of the subjects' first second forced expiratory volume (FEV1pred%) was measured by ELITE.DE lung function instrument (FEV1pred%). The results of the results were analyzed by SPSS17.0 software and P0.05 The difference was statistically significant.
Results: 1. the level of serum galactoin -7 in the chronic continuous group was 1618.09 + 800.20pg/mL, 1749.24 + 932.62pg/mL, respectively, compared with the control group (478.76 + 109.77pg/mL), the difference was statistically significant (t 'chronic continuous group =10.16, t' clinical remission group = 5.58, all P0.05).
2. the level of serum galacotin -7 (2648.21 + 863.08pg/mL) in the course of chronic persistent asthma (2648.21 + 863.08pg/mL) was significantly higher than that of the course > 1 years (1291.47 + 413.20pg/mL), and there were statistical differences (t=5.76, P0.05). The course of chronic persistent asthma was less than 1 years, and the level of serum hemagglutinin -7 was 2648.21 + 863.08pg/mL and 1291.47 + 413.20 in the course of the course > 1 years, respectively. Pg/mL, respectively, compared with the control group (478.76 + 109.77pg/mL), the difference was statistically significant (t '< 1 years group =8.79, t' > 1 year group =9.68, P0.05). The course of the asthma course less than 1 years was significantly higher than the course > 1 year group and the control group.
3. the level of serum galacotin -7 (1348 + 495.04pg/mL) in the mild continuous group was significantly higher than that in the control group (478.76 + 109.77pg/mL), and the difference was statistically significant (t '=7.26, P0.05). The level of serum galactoin -7 (2029.16 + 1075.21pg/mL) in severe continuous group was significantly higher than that in the mild sustained group (1348 + 495.04pg/mL), and the difference was statistically significant (t' =-2.44). P0.05). The level of serum galactocoagulin -7 (1477.12 + 563.86pg/mL) in moderate persistent group and mild, severe continuous group (1348 + 495.04pg/mL, 2029.16 + 1075.21pg/mL), the difference was not statistically significant (t mild continuous group =-0.73, t 'severe persistent group =1.93, all P0.05).
4. the diagnostic efficacy of serum galactoin -7 and FEV1pred% showed that the area of serum galactocoagulin -7 curve (AUC) was 0.84, and FEV1pred% was 0.69. when serum galactocoagulin -7 level was more than 1485.10pg/mL, and the sensitivity of diagnosis of bronchial asthma was 94.40%, specificity was 71.40%, and the accuracy rate was 65.80%; when FEV1pred% was 65.80%, FEV1pred% was 65.80%. FEV1pred% At or less than 80%, the sensitivity of diagnosing bronchial asthma was 100%, the specificity was 52.90%, and the accuracy rate was 52.90%.
Conclusion: the level of serum galactocoagulin -7 can be used as a potential marker for evaluating the level of asthma and is helpful to the early diagnosis of asthma. The value of the diagnosis of asthma severity needs further study.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R562.25

【參考文獻(xiàn)】

相關(guān)期刊論文 前7條

1 王劍;袁向亮;薛劍;李美星;沈立松;;半乳凝素-10在CD4~+ CD25~+ CD127~(low/-)調(diào)節(jié)性T細(xì)胞中的表達(dá)與意義[J];臨床檢驗(yàn)雜志;2008年05期

2 朱毅,周林福,殷凱生;氟達(dá)拉濱吸入治療小鼠氣道炎癥的實(shí)驗(yàn)研究[J];南京醫(yī)科大學(xué)學(xué)報(bào)(自然科學(xué)版);2005年02期

3 田潔;王勝軍;許化溪;;Th9細(xì)胞:一種新型效應(yīng)性CD4~+ T細(xì)胞亞群[J];細(xì)胞與分子免疫學(xué)雜志;2009年09期

4 唐艷;楊銘;;半乳凝素-3促血管生成素-2肝腸黏連蛋白與消化道腫瘤的關(guān)系[J];現(xiàn)代醫(yī)藥衛(wèi)生;2012年04期

5 印根權(quán);趙順英;郭素萍;趙宇紅;劉璽誠;江載芳;;Galectin-7在哮喘患兒支氣管上皮細(xì)胞凋亡中的作用[J];中華兒科雜志;2006年07期

6 安寧;王建軍;;半乳凝素-9蛋白在肺腺癌、鱗癌中的表達(dá)及意義[J];中華臨床醫(yī)師雜志(電子版);2011年24期

7 趙玉環(huán);董玉清;;支氣管哮喘的護(hù)理[J];吉林中醫(yī)藥;2007年08期

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