哮喘患者气道过敏毒素C5a的变化  

Change of airway anaphylatoxin C5a in patients with asthma

作　　者：张静[1] 常春[1] 路明[1] 陈亚红[1] 姚婉贞[1] 

机构地区：[1]北京大学第三医院呼吸科,北京100191

出　　处：《北京大学学报（医学版）》2015年第1期145-148,共4页Journal of Peking University:Health Sciences

基　　金：国家自然科学基金(81170012)资助~~

摘　　要：目的：探讨诱导痰过敏毒素C5a在支气管哮喘中的变化特点。方法：2006年9月至2007年2月门诊和病房就诊的哮喘患者,急性发作组33例,经过临床治疗进入缓解期组25例,失访8例;对照组13例。患者在入选及回访时均测定肺功能,诱导痰进行分类计数,测定诱导痰上清液中C5a水平。结果：哮喘急性发作期诱导痰中C5a水平高于治疗后临床缓解期水平[0.85（0.68-2.13）μg/L vs.0.45（0.26-0.88）μg/L,Z=-2.193,P=0.013],且临床缓解期C5a水平高于对照组[0.14（0.06-0.45）μg/L,Z=-2.141,P=0.015]。轻、中、重度哮喘急性发作期C5a水平依次升高,分别为0.34（0.17-0.63）μg/L、0.85（0.55-1.67）μg/L、2.21（1.27-9.0）μg/L,差异有统计学意义（χ^2=12.330,P=0.001）。哮喘急性发作期患者诱导痰C5a水平与诱导痰细胞总数、中性粒细胞计数、巨噬细胞计数呈正相关（r=0.797,P=0.004;r=0.504,P=0.032;r=0.424,P=0.036）。结论：过敏毒素C5a作为先天免疫系统的重要组成部分,参与哮喘的发病,在哮喘慢性气道炎症中起促进作用。Objective： To investigate the role of anaphylatoxin C5 a in patients with asthma. Methods：A prospective study was performed between September 2006 and February 2007. A total of 33 patients with acute exacerbation of asthma and 13 healthy subjects were recruited into the study. The patients with acute exacerbation of asthma were also studied when they returned to the remission state. Levels of lung function,levels of C5 a in induced sputum and cell differential count in induced sputum were determined.Results： The level of C5 a in induced sputum was significantly higher in patients with acute exacerbation of asthma [0. 85（ 0. 68- 2. 13） μg / L] than that in patients with stable asthma [0. 45（ 0. 26- 0. 88）μg /L,Z =- 2. 193,P = 0. 013]; Sputum C5 a levels in stable asthma patients were significantly higher than those in healthy controls [0. 14（ 0. 06- 0. 45） μg / L,Z =- 2. 141,P = 0. 015]. The level of C5 a in patients with severe exacerbation [2. 21（ 1. 27- 9. 0） μg / L] was significantly higher than those in patients with mild exacerbation [0. 34（ 0. 17- 0. 63） μg / L] and moderate exacerbation [0. 85（ 0. 55-1. 67） μg / L,χ^2= 12. 330,P = 0. 001]. The level of C5 a in induced sputum was positively correlated with the number of total cells count（ r = 0. 797,P = 0. 004）,neutrophils（ r = 0. 504,P = 0. 032） and macrophages（ r = 0. 424,P = 0. 036） in acute exacerbation of asthma. Conclusion： C5 a levels in induced sputum could be identified as an important prognostic biomarker,which involved in asthma＇s pathogenesis.

关 键 词：过敏毒素类 哮喘 支气管 痰 

分 类 号：R562.25[医药卫生—呼吸系统]