支气管哮喘患者血清肿瘤坏死因子α及超敏C反应蛋白水平变化及临床意义
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摘要
目的:探讨支气管哮喘患者血清肿瘤坏死因子α(TNF-α)和超敏C-反应蛋白(hs-CRP)水平变化与FEV1%pre(第一秒用力呼气量占预计值百分比)、血清总IgE、外周血嗜酸粒细胞计数(PBEC)的关系。
方法:自2007年3月至2008年5月收集支气管哮喘急性发作期患者34例;正常对照组20例,检测哮喘患者治疗前后及正常对照组血清TNF-α、hs-CRP、血清总IgE、外周血嗜酸粒细胞和肺功能。
结果:(1)支气管哮喘急性发作期患者治疗前血清TNF-α水平为[(310.25±224.69)ng/L],明显高于治疗后[(125.42±45.39)ng/L],差异有统计学意义(t值为5.886 ,P<0.05);(2)血清总IgE水平治疗前为([719.01±880.89)IU/mL],明显高于治疗后([204.73±195.74)IU/mL]和正常对照组[(29.53±13.56)IU/mL],差异具有统计学意义(t值分别为5.52,7.136,P<0.05)。治疗后的总IgE水平为[(204.73±195.74)IU/ml]也明显高于正常对照组[( 29.53±13.56) IU/mL],差异有统计学意义(t值为16.01,P<0.05)。哮喘患者急性发作期轻中度组和重度组血清总IgE水平分别为[(503.58±538.17)IU/mL]和[(396.28±467.80)IU/mL],均明显高于正常对照组,差异具有统计学意义(P< 0.05) ,但轻中度组和重度组比较,差异无统计学意义(P>0.05);(3)外周血嗜酸粒细胞计数治疗前水平为[(0.47士0.55)×10?/L],明显高于治疗后[(0.144士0.147)×10?/L]和正常对照组[(0.1士3.4)×10?/L],差异有统计学意义(t值分别为6.641,7.136,P<0.05)。治疗后外周血嗜酸粒细胞水平和正常对照组相比,差异无统计学意义(t值为1.322,P>0.05)。哮喘患者急性发作期轻中度组和重度组外周血嗜酸粒细胞水平分别为[(0.52±0.64)×10?/L]和[(0.36±0.34)×10?/L],明显高于正常对照组,差异有统计学意义(P<0.05),但轻中度组和重度组比较差异无统计学意义(P>0.05);(4)支气管哮喘患者发作期治疗前血清TNF-α水平与总IgE水平呈正相关,与肺功能FEV?%和FEV?/FVC呈负相关(r=0.799,- 0.693,-0.674,P<0.05),与外周血嗜酸粒细胞计数未发现明显相关性;(5)血清hs-CRP水平治疗前[(1.62±1.14)mg/L]明显高于治疗后[(0.50±0.45)mg/L]和正常对照组[(0.49±0.17)mg/L],差异具有统计学意义(t值为分别为9.654,14.65,P<0.05)。重度组哮喘患者血清hs-CRP水平[(3.33±1.74)mg/L]明显高于轻中度组[(0.58±0.35)mg/L]和正常对照组[(0.49±0.17)mg/L],差异具有统计学意义(t值分别为4.467,10.266,P<0.05),轻中度组hs-CRP水平[(0.58±0.35)mg/L]也明显高于对照组[(0.49±0.17)mg/L],差异具有统计学意义(t值为7.404,P<0.05);(6)哮喘患者发作期轻中度血清hs-CRP水平与轻中度血清总IgE水平呈正相关(r=0.656,P<0.05),与临床其它指标如嗜酸粒细胞、肺功能等未发现具有明显相关性(P>0.05)。
结论:
1、血清TNF-α可以反应哮喘的炎症程度,结合TIgE、嗜酸粒细胞计数和肺功能更为客观的评估哮喘病情,有望为临床提供一个新的诊治思路。
2、血清hs-CRP可作为炎性标志物反映哮喘的炎症程度,对哮喘有一定的临床预测防治价值。
Objective:To study the changes and correlation of serum hs-CRP、TNF-α、total IgE and peripheral blood eosinophil counts in asthma.
Methods: 34 astnmatic patients and 20 healthy adult people were selected between March in 2007 to May in 2008.Detect the levels of TNF-α、TIgE and PBEC.
Results:(1)The results illustrate that the level of serum TNF-αduring the attact period pretheraphy group[(310.25±224.69)ng/L] was significantly higher than that during the post-treatment group,the difference had highly statistical significant(t=5.886,P<0.05) ;(2)The level of serum total IgE was([719.01±880.89)IU/mL], during the attack period pretheraphy group,it was obviously higher in the pretheraphy group than that in the post-group[(204.73±195.74)IU/mL] and their normal control group [(29.53±13.56) IU/mL], the difference had highly statistical (t=5.52,7.136,P<0.05),The level of serum total IgE in the post-treatment group,were still higher than those in normal control group and the difference had highly statistical significant too(t=16.01,P<0.05).The level of serum TIgE during the light midrange group was[(503.58±538.17)IU/mL]and the heavy goup was[(396.28±467.80)IU/mL] were obviously higher than that during the normal control group,the difference had highly statistical(P < 0.05),but there was no statistical between the light midrange group and the heavy group(P>0.05).(3) The level of PBEC were[(0.47±0.55)×10?/L]during the attack period pretheraphy group,It was obviously higher in the pretheraphy group than that in the post- group [(0.144±0.147)×10?/L]and their normal control group[( 0.14±0.09)×10?/L],the difference had highly statistical(t=12.31,6.641, P<0.05). The level of serum PBEC during the light midrange group was[ ( 0.52±0.64 )×10?/L]and the heavy goup was [(0.36±0.34)×10?/L] were obviously higher than that during the normal control group,the difference had highly statistical(P<0.05),but there was no statistical between the light midrange group and the heavy group(P>0.05). (4)The level of serum TNF-α(attack period pretheraphy group ) correlated positively with serum TIgE and correlated negatively correlated with FEV1% and FEV1/FVC(r=0.799,-0.693,-0.674 , P<0.05).(5)The level of serum hs-CRP was[ ( 1.62±1.14 ) mg/L] during the attack period pretheraphy group,it was obviously higher in the pretheraphy group than that in the post-treatment group([0.50±0.45)mg/L] and their normal control group[(0.49±0.17)mg/L],the difference had highly statistical significant(t=9.654,14.65,P<0.05).(6) The level of serum hs-CRP(attack period lightmidrang group )correlated positively with serum TIgE (r=0.656,P<0.05).
Conclusion:
1.The serum of TNF-αcan react the inflammation of asthma,conbine the TIgE、PBEC、and pulmonary function can evaculate the asthma patient’s condition objectively,which is promising for future management an preven- tion and therapy of asthma.
2.The findings suggest that hs-CRP might be a potential surrogate marker can react the the degree inflammation of asthma,which is promising for future management an prevention of asthma.
方法:自2007年3月至2008年5月收集支气管哮喘急性发作期患者34例;正常对照组20例,检测哮喘患者治疗前后及正常对照组血清TNF-α、hs-CRP、血清总IgE、外周血嗜酸粒细胞和肺功能。
结果:(1)支气管哮喘急性发作期患者治疗前血清TNF-α水平为[(310.25±224.69)ng/L],明显高于治疗后[(125.42±45.39)ng/L],差异有统计学意义(t值为5.886 ,P<0.05);(2)血清总IgE水平治疗前为([719.01±880.89)IU/mL],明显高于治疗后([204.73±195.74)IU/mL]和正常对照组[(29.53±13.56)IU/mL],差异具有统计学意义(t值分别为5.52,7.136,P<0.05)。治疗后的总IgE水平为[(204.73±195.74)IU/ml]也明显高于正常对照组[( 29.53±13.56) IU/mL],差异有统计学意义(t值为16.01,P<0.05)。哮喘患者急性发作期轻中度组和重度组血清总IgE水平分别为[(503.58±538.17)IU/mL]和[(396.28±467.80)IU/mL],均明显高于正常对照组,差异具有统计学意义(P< 0.05) ,但轻中度组和重度组比较,差异无统计学意义(P>0.05);(3)外周血嗜酸粒细胞计数治疗前水平为[(0.47士0.55)×10?/L],明显高于治疗后[(0.144士0.147)×10?/L]和正常对照组[(0.1士3.4)×10?/L],差异有统计学意义(t值分别为6.641,7.136,P<0.05)。治疗后外周血嗜酸粒细胞水平和正常对照组相比,差异无统计学意义(t值为1.322,P>0.05)。哮喘患者急性发作期轻中度组和重度组外周血嗜酸粒细胞水平分别为[(0.52±0.64)×10?/L]和[(0.36±0.34)×10?/L],明显高于正常对照组,差异有统计学意义(P<0.05),但轻中度组和重度组比较差异无统计学意义(P>0.05);(4)支气管哮喘患者发作期治疗前血清TNF-α水平与总IgE水平呈正相关,与肺功能FEV?%和FEV?/FVC呈负相关(r=0.799,- 0.693,-0.674,P<0.05),与外周血嗜酸粒细胞计数未发现明显相关性;(5)血清hs-CRP水平治疗前[(1.62±1.14)mg/L]明显高于治疗后[(0.50±0.45)mg/L]和正常对照组[(0.49±0.17)mg/L],差异具有统计学意义(t值为分别为9.654,14.65,P<0.05)。重度组哮喘患者血清hs-CRP水平[(3.33±1.74)mg/L]明显高于轻中度组[(0.58±0.35)mg/L]和正常对照组[(0.49±0.17)mg/L],差异具有统计学意义(t值分别为4.467,10.266,P<0.05),轻中度组hs-CRP水平[(0.58±0.35)mg/L]也明显高于对照组[(0.49±0.17)mg/L],差异具有统计学意义(t值为7.404,P<0.05);(6)哮喘患者发作期轻中度血清hs-CRP水平与轻中度血清总IgE水平呈正相关(r=0.656,P<0.05),与临床其它指标如嗜酸粒细胞、肺功能等未发现具有明显相关性(P>0.05)。
结论:
1、血清TNF-α可以反应哮喘的炎症程度,结合TIgE、嗜酸粒细胞计数和肺功能更为客观的评估哮喘病情,有望为临床提供一个新的诊治思路。
2、血清hs-CRP可作为炎性标志物反映哮喘的炎症程度,对哮喘有一定的临床预测防治价值。
Objective:To study the changes and correlation of serum hs-CRP、TNF-α、total IgE and peripheral blood eosinophil counts in asthma.
Methods: 34 astnmatic patients and 20 healthy adult people were selected between March in 2007 to May in 2008.Detect the levels of TNF-α、TIgE and PBEC.
Results:(1)The results illustrate that the level of serum TNF-αduring the attact period pretheraphy group[(310.25±224.69)ng/L] was significantly higher than that during the post-treatment group,the difference had highly statistical significant(t=5.886,P<0.05) ;(2)The level of serum total IgE was([719.01±880.89)IU/mL], during the attack period pretheraphy group,it was obviously higher in the pretheraphy group than that in the post-group[(204.73±195.74)IU/mL] and their normal control group [(29.53±13.56) IU/mL], the difference had highly statistical (t=5.52,7.136,P<0.05),The level of serum total IgE in the post-treatment group,were still higher than those in normal control group and the difference had highly statistical significant too(t=16.01,P<0.05).The level of serum TIgE during the light midrange group was[(503.58±538.17)IU/mL]and the heavy goup was[(396.28±467.80)IU/mL] were obviously higher than that during the normal control group,the difference had highly statistical(P < 0.05),but there was no statistical between the light midrange group and the heavy group(P>0.05).(3) The level of PBEC were[(0.47±0.55)×10?/L]during the attack period pretheraphy group,It was obviously higher in the pretheraphy group than that in the post- group [(0.144±0.147)×10?/L]and their normal control group[( 0.14±0.09)×10?/L],the difference had highly statistical(t=12.31,6.641, P<0.05). The level of serum PBEC during the light midrange group was[ ( 0.52±0.64 )×10?/L]and the heavy goup was [(0.36±0.34)×10?/L] were obviously higher than that during the normal control group,the difference had highly statistical(P<0.05),but there was no statistical between the light midrange group and the heavy group(P>0.05). (4)The level of serum TNF-α(attack period pretheraphy group ) correlated positively with serum TIgE and correlated negatively correlated with FEV1% and FEV1/FVC(r=0.799,-0.693,-0.674 , P<0.05).(5)The level of serum hs-CRP was[ ( 1.62±1.14 ) mg/L] during the attack period pretheraphy group,it was obviously higher in the pretheraphy group than that in the post-treatment group([0.50±0.45)mg/L] and their normal control group[(0.49±0.17)mg/L],the difference had highly statistical significant(t=9.654,14.65,P<0.05).(6) The level of serum hs-CRP(attack period lightmidrang group )correlated positively with serum TIgE (r=0.656,P<0.05).
Conclusion:
1.The serum of TNF-αcan react the inflammation of asthma,conbine the TIgE、PBEC、and pulmonary function can evaculate the asthma patient’s condition objectively,which is promising for future management an preven- tion and therapy of asthma.
2.The findings suggest that hs-CRP might be a potential surrogate marker can react the the degree inflammation of asthma,which is promising for future management an prevention of asthma.
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