血清ECP、CRP和FeNO联合检测在支气管哮喘诊治中的应用
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摘要
目的探讨血清嗜酸性粒细胞阳离子蛋白(ECP)、C反应蛋白(CRP)和呼出气一氧化氮(FeNO)联合检测在支气管哮喘诊治中的应用。方法选取2014年10月至2016年10月唐山市协和医院接诊的50例支气管哮喘患者作为研究对象,并选择同期在该院接受体检的50例健康人员作为对照组。使用酶联免疫吸附试验法检测血清ECP、CRP的表达,使用FeNO检测仪检测FeNO水平。比较支气管哮喘组和对照组血清ECP、CRP、FeNO的表达,并比较不同病情程度支气管哮喘患者血清ECP、CRP、FeNO的表达;支气管哮喘组在接受3个月的对症治疗后,比较不同疗效结果患者血清ECP、CRP、FeNO的表达。结果支气管哮喘组血清ECP、CRP、FeNO水平[(15.86±1.47)ng/L、(4.87±0.52)mg/L、(61.23±11.52)ppb]均明显比对照组高[(6.62±0.63)ng/L、(1.04±0.23)mg/L、(23.58±3.40)ppb],差异有统计学意义(P<0.05);急性发作期支气管哮喘患者血清ECP、CRP、FeNO[(18.56±1.85)ng/L、(5.74±0.70)mg/L、(66.93±10.62)ppb]明显比缓解期患者高[(12.34±1.47)ng/L、(3.69±0.37)mg/L、(54.54±8.02)ppb],差异有统计学意义(P<0.05);支气管哮喘患者在治疗3个月后,临床控制28例,部分控制18例,未控制4例,临床控制组血清ECP、CRP和FeNO明显低于部分控制组及未控制组,差异有统计学意义(P<0.05)。结论通过联合检测支气管哮喘患者血清ECP、CRP、FeNO的表达有助于了解疾病严重程度,在疾病的早期诊治中具有积极意义。
Objective To study the application of combined detection of serum eosinophil cationic protein(ECP),C reactive protein(CRP)and fractional exhaled nitric oxide(FeNO)in the bronchial asthma.Methods 50 patients of bronchial asthma who received therapy from October 2014 to October 2016 in Tangshan city union hospital were selected as research objects,and selected 50 healthy people who received physical examination at the same time in the hospital as control group.The expression of serum ECP and CRP was detected by enzyme-linked immunosorbent assay,and the FeNO concentration was detected using FeNO detector.The expressions of serum ECP,CRP and FeNO between the bronchial asthma group and the control group were compared,and the expressions of serum ECP,CRP and FeNO in patients with different severity of bronchial asthma were compared;the bronchial asthma group received 3 months of symptomatic treatment,The expression of serum ECP,CRP and FeNO in patients with different therapeutic effects were compared.ResultsThe serum ECP,CRP and FeNO in the bronchial asthma group [(15.86±1.47)ng/L,(4.87±0.52)mg/L,(61.23±11.52)ppb]were significantly higher than those in the control group[(6.62±0.63)ng/L,(1.04±0.23)mg/L,(23.58±3.40)ppb],the difference was statistically significant(P<0.05);The serum ECP,CRP and FeNO in the acute attack of bronchial asthma[(18.56±1.85)ng/L,(5.74±0.70)mg/L,(66.93±10.62)ppb]were higher than those in the remission stage[(12.34±1.47)ng/L,(3.69±0.37)mg/L,(54.54±8.02)ppb],the difference was statistically significant(P<0.05);The patients with bronchial asthma were treated 3 months later,clinical control in 28 cases,partial control in 18 cases,uncontrolled in 4 cases,the serum ECP,CRP and FeNO in the clinical control group were significantly lower than those in the partial control group and the uncontrolled group,the difference was statistically significant(P<0.05).Conclusion The combined detection of serum ECP,CRP and FeNO expression in patients with bronchial asthma is helpful to understand the severity of the disease,it′s of positive significance in the early diagnosis and treatment of diseases.
Objective To study the application of combined detection of serum eosinophil cationic protein(ECP),C reactive protein(CRP)and fractional exhaled nitric oxide(FeNO)in the bronchial asthma.Methods 50 patients of bronchial asthma who received therapy from October 2014 to October 2016 in Tangshan city union hospital were selected as research objects,and selected 50 healthy people who received physical examination at the same time in the hospital as control group.The expression of serum ECP and CRP was detected by enzyme-linked immunosorbent assay,and the FeNO concentration was detected using FeNO detector.The expressions of serum ECP,CRP and FeNO between the bronchial asthma group and the control group were compared,and the expressions of serum ECP,CRP and FeNO in patients with different severity of bronchial asthma were compared;the bronchial asthma group received 3 months of symptomatic treatment,The expression of serum ECP,CRP and FeNO in patients with different therapeutic effects were compared.ResultsThe serum ECP,CRP and FeNO in the bronchial asthma group [(15.86±1.47)ng/L,(4.87±0.52)mg/L,(61.23±11.52)ppb]were significantly higher than those in the control group[(6.62±0.63)ng/L,(1.04±0.23)mg/L,(23.58±3.40)ppb],the difference was statistically significant(P<0.05);The serum ECP,CRP and FeNO in the acute attack of bronchial asthma[(18.56±1.85)ng/L,(5.74±0.70)mg/L,(66.93±10.62)ppb]were higher than those in the remission stage[(12.34±1.47)ng/L,(3.69±0.37)mg/L,(54.54±8.02)ppb],the difference was statistically significant(P<0.05);The patients with bronchial asthma were treated 3 months later,clinical control in 28 cases,partial control in 18 cases,uncontrolled in 4 cases,the serum ECP,CRP and FeNO in the clinical control group were significantly lower than those in the partial control group and the uncontrolled group,the difference was statistically significant(P<0.05).Conclusion The combined detection of serum ECP,CRP and FeNO expression in patients with bronchial asthma is helpful to understand the severity of the disease,it′s of positive significance in the early diagnosis and treatment of diseases.
引文
[1]栗丽丽,师强华,梁淑芬,等.支气管哮喘发病机制的研究进展[J].中医临床研究,2014,6(36):27-29.
[2]RAMADAN W H,SARKIS A T.Patterns of use of dry powder inhalers versus pressurized metered-dose inhalers devices in adult patients with chronic obstructive pulmonary disease or asthma:An observational comparative study[J].Chron Respir Dis,2017,14(3):309-320.
[3]苏楠,林江涛,刘国梁,等.我国8省市支气管哮喘患者控制水平的流行病学调查[J].中华内科杂志,2014,53(8):601-606.
[4]王平,高云,王利民,等.支气管哮喘患儿血清IL-17、ECP及IgE的水平测定及相关性研究[J].中国妇幼保健,2014,29(21):3443-3445.
[5]YANG L Y,LI X,LI W T,et al.V gamma l(+)gamma delta T Cells are correlated with increasing expression of Eosinophil cationic protein and metalloproteinase-7 in chronic rhinosinusitis with nasal polyps inducing the formation of edema[J].Allergy Asthma Immunol Res,2017,9(2):142-151.
[6]夏清,潘频华,王展,等.呼出气一氧化氮检测在支气管炎症性肺疾病中的临床应用[J].中南大学学报:医学版,2014,39(4):365-370.
[7]中华医学会呼吸病学分会哮喘学组,中华医学会全科医学分会.中国支气管哮喘防治指南(基层版)[J].中国实用内科杂志,2013,33(8):615.
[8]李学良,许朝霞,王忆勤.支气管哮喘发病机制的研究进展[J].中华中医药学刊,2012,22(9):1960-1963.
[9]HASEGAWA W,YAMAUCHI Y,YASUNAGA H A,et al.Prognostic nomogram for inpatients with asthma exacerbation[J].BMC Pulm Med,2017,17(1):108.
[10]庄蒙丽,白生龙,韩晓华.支气管哮喘发生的危险因素及诊治进展[J].中国中西医结合儿科学,2015,7(2):105-109.
[11]MOGENSEN I,ALVING K,BJERG A,et al.Simultaneously elevated exhaled nitric oxide and serum-eosinophil cationic protein Relate to recent asthma events in asthmatics in a cross-sectional population-based study[J].Clin Experi Aller,2016,46(12):1540-1548.
[12]王仲秋,林荣军,车淑玉.支气管哮喘患儿血清ECP及IgE水平的测定及其临床意义[J].海南医学院学报,2014,20(11):1590-1592.
[13]YU H Y,LI X Y,CAI Z F,et al.Eosinophil cationic protein mRNA expression in children with bronchial asthma[J].Gene Mole Res,2015,14(4):14279-14285.
[14]BAZAN-SOCHA S,MASTALERZ L,CYBULSKA A,et al.Prothrombotic state in asthma is related to increased levels of inflammatory cytokines,IL-6and TNF alpha,in peripheral blood[J].Inflammation,2017,40(4):1225-1235.
[15]陈春杰,谭世繁,陈春秀,等.PCT,CRP在支气管哮喘合并呼吸道感染中的诊断价值[J].中外医学研究,2014,12(2):51-52.
[16]SINGH M,GUPTA N,KUMAR R.Effect of obesity and metabolic syndrome on severity,quality of Life,sleep quality and inflammatory markers in patients of asthma in India[J].Pneumonol Alergol Pol,2016,84(5):258-264.
[17]覃毅华.支气管哮喘急性发作期患者白细胞介素(IL-17)及超敏C反应蛋白的水平变化及临床意义[J].中国现代医生,2014,52(18):23-25.
[18]WILLIAMS N C,HUNTER K A,SHAW D E,et al.Comparable reductions in hyperpnoea-induced bronchoconstriction and markers of airway inflammation after supplementation with 6·2and 3·1g/d of long-chain n-3PUFA in adults with asthma[J].Br J Nutr,2017,117(10):1379-1389.
[19]陈凤佳,严英硕,周燕斌.呼出气一氧化氮监测对支气管哮喘的诊断及治疗评估价值研究[J].中国全科医学,2014,17(29):3430-3434.
[20]李叶宁.无创正压通气联合间断雾化吸入可比特对重症支气管哮喘患者FeNO和血清Hs-CRP的影响[J].中国实用医药,2012,7(24):18-20.
[2]RAMADAN W H,SARKIS A T.Patterns of use of dry powder inhalers versus pressurized metered-dose inhalers devices in adult patients with chronic obstructive pulmonary disease or asthma:An observational comparative study[J].Chron Respir Dis,2017,14(3):309-320.
[3]苏楠,林江涛,刘国梁,等.我国8省市支气管哮喘患者控制水平的流行病学调查[J].中华内科杂志,2014,53(8):601-606.
[4]王平,高云,王利民,等.支气管哮喘患儿血清IL-17、ECP及IgE的水平测定及相关性研究[J].中国妇幼保健,2014,29(21):3443-3445.
[5]YANG L Y,LI X,LI W T,et al.V gamma l(+)gamma delta T Cells are correlated with increasing expression of Eosinophil cationic protein and metalloproteinase-7 in chronic rhinosinusitis with nasal polyps inducing the formation of edema[J].Allergy Asthma Immunol Res,2017,9(2):142-151.
[6]夏清,潘频华,王展,等.呼出气一氧化氮检测在支气管炎症性肺疾病中的临床应用[J].中南大学学报:医学版,2014,39(4):365-370.
[7]中华医学会呼吸病学分会哮喘学组,中华医学会全科医学分会.中国支气管哮喘防治指南(基层版)[J].中国实用内科杂志,2013,33(8):615.
[8]李学良,许朝霞,王忆勤.支气管哮喘发病机制的研究进展[J].中华中医药学刊,2012,22(9):1960-1963.
[9]HASEGAWA W,YAMAUCHI Y,YASUNAGA H A,et al.Prognostic nomogram for inpatients with asthma exacerbation[J].BMC Pulm Med,2017,17(1):108.
[10]庄蒙丽,白生龙,韩晓华.支气管哮喘发生的危险因素及诊治进展[J].中国中西医结合儿科学,2015,7(2):105-109.
[11]MOGENSEN I,ALVING K,BJERG A,et al.Simultaneously elevated exhaled nitric oxide and serum-eosinophil cationic protein Relate to recent asthma events in asthmatics in a cross-sectional population-based study[J].Clin Experi Aller,2016,46(12):1540-1548.
[12]王仲秋,林荣军,车淑玉.支气管哮喘患儿血清ECP及IgE水平的测定及其临床意义[J].海南医学院学报,2014,20(11):1590-1592.
[13]YU H Y,LI X Y,CAI Z F,et al.Eosinophil cationic protein mRNA expression in children with bronchial asthma[J].Gene Mole Res,2015,14(4):14279-14285.
[14]BAZAN-SOCHA S,MASTALERZ L,CYBULSKA A,et al.Prothrombotic state in asthma is related to increased levels of inflammatory cytokines,IL-6and TNF alpha,in peripheral blood[J].Inflammation,2017,40(4):1225-1235.
[15]陈春杰,谭世繁,陈春秀,等.PCT,CRP在支气管哮喘合并呼吸道感染中的诊断价值[J].中外医学研究,2014,12(2):51-52.
[16]SINGH M,GUPTA N,KUMAR R.Effect of obesity and metabolic syndrome on severity,quality of Life,sleep quality and inflammatory markers in patients of asthma in India[J].Pneumonol Alergol Pol,2016,84(5):258-264.
[17]覃毅华.支气管哮喘急性发作期患者白细胞介素(IL-17)及超敏C反应蛋白的水平变化及临床意义[J].中国现代医生,2014,52(18):23-25.
[18]WILLIAMS N C,HUNTER K A,SHAW D E,et al.Comparable reductions in hyperpnoea-induced bronchoconstriction and markers of airway inflammation after supplementation with 6·2and 3·1g/d of long-chain n-3PUFA in adults with asthma[J].Br J Nutr,2017,117(10):1379-1389.
[19]陈凤佳,严英硕,周燕斌.呼出气一氧化氮监测对支气管哮喘的诊断及治疗评估价值研究[J].中国全科医学,2014,17(29):3430-3434.
[20]李叶宁.无创正压通气联合间断雾化吸入可比特对重症支气管哮喘患者FeNO和血清Hs-CRP的影响[J].中国实用医药,2012,7(24):18-20.
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