尘螨过敏性哮喘患者治疗前后特异性IgG4水平变化及意义  被引量:4

Changes and significance of serum dust mite specific immunoglobulin G4 in dust mite allergic asthma

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作  者:施丽泳[1] 曾奕明[1] 陈晓阳[1] 刘燕辉 Shi Liyong;Zeng Yiming;Chen Xiaoyang;Liu Yanhui(Department of Respiratory and Critzcal Care Medicine,the Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China)

机构地区:[1]福建医科大学附属第二医院呼吸与危重症医学科,泉州362000

出  处:《国际呼吸杂志》2018年第24期1854-1858,共5页International Journal of Respiration

基  金:泉州市科技计划项目(2014246).

摘  要:目的 探讨血清特异性免疫球蛋白G4 (sIgG4)对过敏性支气管哮喘 (简称哮喘)患者气道炎症及疗效评价的价值。方法 选取在2015年9月至2016年9月福建医科大学附属第二医院诊治的65例过敏性哮喘轻、中度发作期患者为研究对象 (呼吸控制测试表评分<20分),治疗后均进入缓解期 (呼吸控制测试表评分>20分)。选取30例健康者为对照组。测定哮喘组发作期、哮喘组缓解期及对照组血清sIgG4、总免疫球蛋白 (TIgE)水平,同时测定第1秒用力呼气容积 (FEV1)、呼气峰流速 (PEF)、皮肤点刺试验、嗜酸粒细胞 (EOS)、呼出气一氧化氮 (FeNO)水平。结果 哮喘组发作期、哮喘组缓解期与对照组相比,sIgG4、TIgE、sIgG4/TIgE均升高 (F 值分别为112.93、42.826、4.092,P 值均<0.05)。哮喘组缓解期sIgG4、sIgG4/TIgE水平较哮喘组发作期升高,TIgE较哮喘组发作期降低 (t值分别为-11.446、7.750、-2.444,P 值均<0.05)。哮喘组缓放期FEV1、PEF、FeNO、EOS较哮喘组发作期显著改善,差异均有统计学意义 (t值分别为15.044、11.744、22.202、11.645,P 值均<0.001)。结论 sIgG4能间接反映尘螨过敏哮喘患者的气道炎症,对病情监测、疗效评估及治疗方案的调整有一定的指导意义。Objective To explore the pathogenesis of respiratory inflammation in allergic asthma and investigate the most effective evaluation of therapeutic efficiency by observing the serum level of specific immunoglobulin G4 (sIgG4).Methods 65 patients with allergic asthma from September 2015 to September 2016 in the Second Affiliated Hospital of Fujian Medical University were selected with acute attacks from mild to moderate degree (Asthma Control Test score<20 points),and all go into remission after treatment (Asthma Control Test score>20 points).Another 30 healthy subjects were chosen as control group.Measure and compare the serum sIgG4,total immunoglobulin E (TIgE),and also forced expiratory volume in the first second (FEV1),peak expiratory flow (PEF),skin prick test,eosinophils (EOS),fractional of exhaled nitric oxide (FeNO)in acute attack stage of asthma group,remission stage of asthma group and control group.Results Serum sIgG4,TIgE,sIgG4/TIgE were higher in remission stage of asthma group and acute attack stage of asthma group than control group (F =112.93,42.826,4.092, all P <0.05).The levels of sIgG4 and sIgG4/TIgE in remission stage ofasthma group were higher than those in acute attack stage of asthma group,TIgE was lower in acute attack stage of asthma group (t = -11.446,7.750,-2.444,all P <0.05).The levels of FEV1 ,PEF,FeNO and EOS in remission stage of asthma group were significantly better than those in acute attack stage of asthma group,and the differences were statistically significant (t =15.044,11.744,22.202,11.645,alI P <0.001).Conclusions sIgG4 can indirectly reflect the respiratory inflammation in dust mite allergic asthma and have monitoring and treatment guiding value on them.

关 键 词:哮喘 特异性免疫球蛋白G4 呼吸功能试验 临床疗效 

分 类 号:R562.25[医药卫生—呼吸系统]

 

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