骨膜蛋白与儿童哮喘气道重塑及肺功能的相关性分析  

Asociation of periosteal protein with airway remodeling and lung function in children with asthma

作　　者：苏维维[1] 张晓娟[1] 郁志伟[1] 厉加珍 过静娟[1] 李羚[1] SU Wei-wei;ZHANG Xiao-juan;YU Zhi-wei;LI Jia-zhen;GUO Jing-juan;LI Ling(Department of Respiratory,Wuxi Children＇s Hospital,Wuxi,Jiangsu 214000,China)

机构地区：[1]无锡市儿童医院儿童呼吸科,江苏无锡214000

出　　处：《中国临床研究》2018年第11期1538-1541,共4页Chinese Journal of Clinical Research

基　　金：南京医科大学科技发展基金面上项目(Jmu118);无锡市卫生局卫生科研项目(MS201761)

摘　　要：目的探讨骨膜蛋白(Periostin)与儿童哮喘气道重塑及肺功能的相关性。方法选取无锡市儿童医院2015年1月至2016年12月门诊及呼吸科病房收治的哮喘急性发作患儿62例(哮喘急性发作组),跟踪随访至缓解期(哮喘缓解期组),同时选取同期于儿保科进行健康体检儿童60例作为健康对照组,所有受检儿童均检测血清Periostin水平、肺功能[第1秒用力呼气容积与用力肺活量比值(FEV1%)、呼气峰值流速占预计值的百分比(PEF%)、最大呼气中期流量占预计值百分比(MMEF%)、免疫球蛋白(Ig)E及转化生长因子-β1(TGF-β1)、血管内皮生长因子(VEGF)等气道重塑标志物水平检测,观察Periostin水平与患儿肺功能及气道重塑的关系。结果哮喘急性发作组、哮喘缓解期组、健康对照组儿童的血清Periostin水平分别为(370. 71±6. 47) pg/ml、(243. 34±6. 88) pg/ml、(193. 10±3. 24) pg/ml,三组间比较差异有统计学意义(P <0. 01),且哮喘急性发作组患儿血清Periostin水平高于缓解期及对照组,缓解期高于对照组(P <0. 01);哮喘急性发作组IgE> 200 U/ml,100 U/ml≤IgE≤200 U/ml、IgE <100 U/ml占比与哮喘缓解组及健康对照组比较,差异有统计学意义(P <0. 01);哮喘急性发作组患儿FEV1%、PEF%、MMEF%、TGF-β1水平低于缓解组及健康对照组,VEGF水平明显高于缓解组及健康对照组(P <0. 01);哮喘患儿血清Periostin水平与IgE、VEGF呈正相关性(P <0. 05,P <0. 01),与FEV1%、PEF%、MMEF%、TGF-β1呈负相关性(P <0. 05,P <0. 01)。结论随着哮喘患儿Periostin水平的升高,患儿的肺功能将随之降低,气道重塑情况也愈发严重,临床上可将Periostin水平作为儿童哮喘初步筛查指标,根据患儿Periostin水平判断其肺功能及气道重塑情况,为其选择更为合理的救治方案。Objective To explore the associations of periostin with airway remodeling and lung function in children with asthma. Methods A total of 62 children with acute asthma attack treated in outpatient department and respiratory ward of Wuxi Children＇s Hospital from January 2015 to December 2016 were selected（acute asthma attack group） and given followup until the remission phase（asthma remission group）. At the same time,60 healthy children by physical examination were served as control group. The detection of airway remodeling markers including periostin level,pulmonary function[the ratio of forced expiratory volume to forced vital capacity in the first second（FEV1%）,Peak expiratory flow rate as a percentage of predicted value（PEF%）,maximum expiratory mid-flow rate as a percentage of predicted value（MMEF%）],immunoglobulin E and transforming growth factor-β1（TGF-β1）,vascular endothelial growth factor（VEGF） was performed in all patients to observe the associations of periostin level with lung function and airway remodeling. Results The levels of serum Periostin in acute asthma attack group,asthma remission group and control group were（370. 71 ± 6. 47） pg/ml,（243. 34 ± 6. 88）pg/ml and（193. 10 ± 3. 24）pg/ml respectively and decreased significantly in the order of acute attack group,remission group and control group（P〈0. 01）. Theproportions of IgE levels（IgE 〉200 U/ml,100 U/ml ≤ IgE ≤200 U/ml,IgE 〈100 U/ml） in acute attack group were significantly different from those in remission group and control group（all P〈0. 01）. FEV1%,PEF%,MMEF% and TGF-β1 in acute asthma attack were significantly lower than those in remission group and control group,and the level of VEGF was significantly higher than those in remission group and control group（P〈0. 01）. Serum periostin level was positively correlated with IgE and VEGF（P〈0. 05） and negatively correlated with FEV1%,PEF%,MMEF% and TGF-β1（P〈0. 05,P〈0. 01）. Conclusions With the increase of periosti

关 键 词：哮喘 儿童 骨膜蛋白 气道重塑 肺功能 作用机制 

分 类 号：R725.6[医药卫生—儿科]