不同标志物差异在预测肥胖哮喘发病风险中的应用  

Application of different marker differences in predicting the risk of obesity asthma

作　　者：于晓梅[1] 王欣[2] 叶黎文 赵龙[2] 韩伟[2] YU Xiao-mei;WANG Xin;YE Li-wen;ZHAO Long;HAN Wei(Department of Clinical Medicine,Qingdao University,Shandong Province,Qingdao 266071,China;Department of Respiration,Qingdao Municipal Hospital Affiliated to Qingdao University,Shandong Province,Qingdao 266071,China;Department of Clinical Medicine,Taishan Medical University,Shandong Province,Tai′an 271000,China)

机构地区：[1]青岛大学临床医学系,山东青岛266071 [2]青岛大学附属青岛市市立医院呼吸科,山东青岛266071 [3]泰山医学院临床医学系,山东泰安271000

出　　处：《中国当代医药》2019年第14期4-7,共4页China Modern Medicine

基　　金：山东省青岛市市南区科技发展基金项目(2016-3-046-YY)

摘　　要：目的阐明不同表型肥胖哮喘的特征性生物标志物的差异,筛选出敏感、准确的病情预测标志物,为肥胖哮喘精准治疗提供客观的证据指导。方法选取2017年5月~2018年5月青岛市市立医院东院区呼吸科的196例哮喘患者作为研究对象,其中肥胖哮喘患者[体重指数(BMI)≥28kg/m^2] 70例,普通哮喘患者(BMI<24 kg/m2)126例。根据呼出气一氧化氮(FeNO)≥25 ppb,将肥胖哮喘患者分为高FeNO组(21例)和低FeNO组(49例)。比较不同表型哮喘组的免疫球蛋白E(IgE)、代谢指标[血糖、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、尿酸(UA)]、肺功能[第1秒用力呼气量(FEV1)/用力肺活量(FVC)、FEV1占预计值的百分比(FEV1%)、FVC占预计值的百分比(FVC%)、FVC改善值、FEV1绝对值增加]、哮喘控制评估(ACT)评分的差异。结果肥胖哮喘组患者的IgE、TC、TG水平均高于普通哮喘组,但差异无统计学意义(P>0.05);肥胖哮喘组患者的血糖、LDL-C、UA水平均高于普通哮喘组,HDL-C低于普通哮喘组,差异有统计学意义(P<0.05)。肥胖哮喘组患者的FEV1/FVC、FEV1%及ACT评分均低于普通哮喘组,差异有统计学意义(P<0.05);肥胖哮喘组患者的FVC%、FVC改善值、FEV1绝对值增加与普通哮喘组比较,差异无统计学意义(P>0.05)。低FeNO组患者的IgE、血糖、TC、TG、LDL-C、UA水平均高于高FeNO组,HDL-C水平低于高FeNO组,但差异无统计学意义(P>0.05)。低FeNO组患者的FEV1/FVC、FEV1%、FVC%、ACT评分均低于高FeNO组,差异有统计学意义(P<0.05);低FeNO组患者的FVC改善值、FEV1绝对值增加均低于高FeNO组,但差异无统计学意义(P>0.05)。结论代谢指标血糖、LDL-C、HDL-C、UA可以用作预测肥胖哮喘发病风险的生物标志物。肥胖哮喘低FeNO的肺功能和控制情况较差,需要更多医疗干预。Objective To elucidate the differences in characteristic biomarkers among different phenotypic obesity asthma, and to screen out sensitive and accurate predictive markers for disease, so as to provide objective evidence for the accurate treatment of obesity asthma. Methods A total of 196 patients with asthma in the Department of Respiratory Medicine of the Eastern Hospital of Qingdao Municipal Hospital from May 2017 to May 2018 were selected as subjects, including 70 patients with obese asthma (body mass index [BMI]≥28 kg/m2) and 126 patients with general asthma (BMI<24 kg/m2). According to fractional exhaled nitric oxide (FeNO)≥25 ppb, obese asthma patients were divided into high FeNO group (21 cases) and low FeNO group (49 cases). The differences in these aspects were compared of different phenotypic asthma groups such as immunoglobulin E (IgE), metabolic indicators (blood sugar, total cholesterol [TC], triglyceride [TG], low density lipoprotein cholesterol [LDL-C], high density lipoprotein cholesterol [HDL-C], uric acid [UA]), lung functions (1 second forced expiratory volume [FEV1]/forced vital capacity [FVC], FEV1 as a percentage of predicted value [FEV1%], FVC as a percentage of predicted value [FVC%], FVC improvement value, FEV1 absolute increase) and asthma control assessment (ACT) score. Results The levels of IgE, TC and TG in the obese asthma group were higher than those in the general asthma group, but the differences were not statistically significant (P>0.05). The levels of blood glucose, LDL-C and UA in the obese asthma group were higher than those in the general asthma group, and the HDL-C level was lower than that in the general asthma group, with statistically significant differences (P<0.05). The FEV1/FVC, FEV1% and ACT scores of the obese asthma group were lower than those of the general asthma group, and the differences were statistically significant (P<0.05). There were no significant differences in FVC%, FVC improvement value, and FEV1 absolute increase between the obese asthma group and

关 键 词：表型 肥胖 哮喘 标志物 

分 类 号：R562.2[医药卫生—呼吸系统]