本文選題：哮喘 + 趨化素　； 參考：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:檢測支氣管哮喘患者循環(huán)血chemerin、omentin水平及Th17、Th9細(xì)胞的百分比,分析Th17和Th9細(xì)胞與Fe NO值的關(guān)系,并探討二者在介導(dǎo)哮喘炎癥病理中的相互關(guān)系。分析脂肪因子與Th17、Th9細(xì)胞的相關(guān)性,探討脂肪因子chemerin和omentin在哮喘發(fā)病機制中可能介導(dǎo)的免疫和炎癥調(diào)節(jié)作用。方法:收集支氣管哮喘患者76例,根據(jù)GINA指南將入組患者分為間歇與輕度持續(xù)組28例,中度持續(xù)組26例和重度持續(xù)組22例,另外選取20例健康志愿者為對照組。收集患者臨床資料,完成肺功能FEV1(%predicted)、FVC(%predicted)、FEV1/FVC(%)、PEF(%predicted)及Fe NO值的測定,FCM檢測外周血PBMC中Th17和Th9細(xì)胞百分比,Elisa檢測血漿脂肪因子chemerin和omentin濃度,并進(jìn)行相關(guān)性分析。結(jié)果:1.哮喘各組肺功能FEV1(%predicted)、FVC(%predicted)、FEV1/FVC(%)水平均無統(tǒng)計學(xué)差異(p0.05),中(81.55±18.81)、重度(75.53±26.09)持續(xù)組PEF(%predicted)較間歇與輕度持續(xù)組(87.66±26.41)明顯降低,差異有統(tǒng)計學(xué)意義(p0.05)。隨病情嚴(yán)重程度加重,Fe NO值依次升高。2.隨哮喘病情嚴(yán)重程度加重,Th17和Th9細(xì)胞比例升高。中(1.24±0.53%)、重度(1.69±0.52%)持續(xù)哮喘組Th17細(xì)胞比例明顯高于間歇與輕度持續(xù)組(0.72±0.31%)和健康對照組(0.53+0.17%)(p0.05)。間歇與輕度(0.74±0.40%)、中度(1.04±0.33%)及重度(2.11±0.44%)持續(xù)哮喘組Th9細(xì)胞百分比較健康對照組(0.51±0.36%)顯著升高(p0.05)。3.重度持續(xù)哮喘組(0.45±0.36 ng/ml)血漿chemerin濃度較健康對照組(0.18±0.06 ng/ml)明顯升高(p0.05),而間歇與輕度(0.24±0.15 ng/ml)、中度(0.30±0.19 ng/ml)持續(xù)組與健康對照組(0.18±0.06 ng/ml)之間比較,差異無統(tǒng)計學(xué)意義(p0.05)。中(4.07±2.91 ng/ml)、重度(3.72±2.82 ng/ml)持續(xù)哮喘組患者omentin濃度與健康對照組相比(9.74±4.87 ng/ml)明顯降低(p0.01),但間歇與輕度持續(xù)組(6.62±4.04 ng/ml)與健康對照組(9.74±4.87 ng/ml)無顯著統(tǒng)計學(xué)差別。Chemerin與omentin范圍在哮喘各亞組之間比較均無明顯差別(p0.05)。4.哮喘患者外周血PBMC中Th17與Th9細(xì)胞表達(dá)均與Fe NO值正相關(guān)(r=0.43,p0.01;r=0.53,p0.01),同時二者在哮喘患者外周血中的表達(dá)率正相關(guān)(r=0.864,p0.01)。5.哮喘患者血漿chemerin濃度與外周血PBMC中Th17、Th9細(xì)胞比例均呈明顯正相關(guān)(r=0.62,p0.01;r=0.71,p0.01);相反,血漿omentin水平與外周血PBMC中Th17、Th9細(xì)胞比例均顯著負(fù)相關(guān)(r=-0.50,p0.01;r=-0.66,p0.01)。結(jié)論:1.支氣管哮喘患者血漿中chemerin濃度升高,omentin濃度下降,提示chemerin和omentin與哮喘的發(fā)生發(fā)展有關(guān);2.Th17、Th9細(xì)胞在哮喘患者中高表達(dá),且與Fe NO值正相關(guān),表明Th17和Th9細(xì)胞與T細(xì)胞促成的系統(tǒng)性炎癥及維持氣道炎癥相關(guān);3.哮喘患者外周血PBMC中Th17與Th9細(xì)胞比例正相關(guān),提示Th17和Th9細(xì)胞在介導(dǎo)哮喘炎癥病理進(jìn)程中可能發(fā)揮協(xié)同致炎作用;4.哮喘患者血漿chemerin含量與Th17、Th9細(xì)胞比例呈正相關(guān),而omentin含量與Th17、Th9細(xì)胞比例呈負(fù)相關(guān),脂肪因子chemerin和omentin可能參與介導(dǎo)哮喘的炎癥應(yīng)答和免疫調(diào)節(jié)作用。
[Abstract]:Objective: to detect the level of chemerinomentin and the percentage of Th17 Th9 cells in bronchial asthma patients, to analyze the relationship between Th17 and Th9 cells and Fe no, and to explore the relationship between Th17 and Th9 cells in the pathogenesis of asthma inflammation. To analyze the relationship between fat factor and Th17 Th 9 cells and to explore the role of fat factor chemerin and omentin in the regulation of immune and inflammation in the pathogenesis of asthma. Methods: 76 patients with bronchial asthma were divided into intermittent and mild persistent group (n = 28), moderate persistent group (n = 26) and severe persistent group (n = 22) according to Gina guidelines, and 20 healthy volunteers were selected as control group. The clinical data of the patients were collected and the FEV1 (predicted) FVC (%) FEV1 / FVC (%) and FeNO value were measured. The percentage of Th17 and Th9 cells in peripheral blood PBMCs were detected by FCM-ELISA to detect the concentration of plasma fat factor chemerin and omentin, and the correlation analysis was carried out. The result is 1: 1. There was no significant difference in FEV1 (predicted) and FEV1 / FVC (%) levels between asthmatic groups (p0.05), moderate (81.55 鹵18.81), severe (75.53 鹵26.09) persistent group (75.53 鹵26.09) and intermittent group (87.66 鹵26.41), the difference was statistically significant (p0.05). The no value of Fe increased with the severity of the disease. The proportion of Th17 and Th9 cells increased with the severity of asthma. The percentage of Th17 cells in moderate (1.24 鹵0.53%) and severe (1.69 鹵0.52%) groups was significantly higher than that in intermittent and mild persistent groups (0.72 鹵0.31%) and healthy controls (0.53 0.17%, p0.05). The percentage of Th9 cells in intermittent and mild (0.74 鹵0.40%), moderate (1.04 鹵0.33%) and severe (2.11 鹵0.44%) groups was significantly higher than that in healthy controls (0.51 鹵0.36%) (p0.05). The concentration of plasma chemerin in severe asthma group (0.45 鹵0.36 ng/ml) was significantly higher than that in healthy control group (0.18 鹵0.06 ng/ml) (p0.05), but there was no significant difference between intermittent group and mild group (0.24 鹵0.15 ng/ml), moderate group (0.30 鹵0.19 ng/ml) and healthy control group (0.18 鹵0.06 ng/ml) (p0.05). The concentration of omentin in moderate (4.07 鹵2.91 ng/ml) and severe (3.72 鹵2.82 ng/ml) patients with persistent asthma was significantly lower than that in healthy controls (9.74 鹵4.87 ng/ml) (p0.01), but there was no significant difference between intermittent group and mild group (6.62 鹵4.04 ng/ml) and healthy control group (9.74 鹵4.87 ng/ml). There was no significant difference between the two groups (p0.05). The expression of Th17 and Th9 cells in peripheral blood PBMC of asthmatic patients were positively correlated with Fe no value (r = 0.43p 0.01), and the expression rate of Th17 and Th9 cells in peripheral blood of asthmatic patients was positively correlated with that of peripheral blood (r = 0.864p 0.01) .5.The expression of Th17 and Th9 cells in peripheral blood of asthmatic patients was positively correlated with Fe no. In asthmatic patients, there was a significant positive correlation between the concentration of chemerin and the proportion of Th17hTh9 cells in peripheral blood PBMCs (r 0.62%, P 0.01), but there was a significant negative correlation between the level of plasma omentin and the proportion of Th17P Th9 cells in peripheral blood PBMCs (r-0.50p0.01p0.01r-0.66p0.01). Conclusion 1. The increase of plasma chemerin concentration in patients with bronchial asthma indicates that chemerin and omentin are related to the occurrence and development of asthma. 2. Th17T9 cells are highly expressed in asthmatic patients, and positively correlated with Fe no. Th17 and Th9 cells are associated with T cell-induced systemic inflammation and maintenance of airway inflammation. The proportion of Th17 and Th9 cells in peripheral blood PBMC of asthmatic patients was positively correlated, suggesting that Th17 and Th9 cells may play a synergistic role in the pathogenesis of asthma inflammation. There was a positive correlation between plasma chemerin content and Th17 Th9 cell ratio in asthmatic patients, but a negative correlation between omentin content and Th17 Th 9 cell ratio. Chemerin and omentin may be involved in mediating the inflammatory response and immune regulation of asthma.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R562.25

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本文編號：2113850