重症哮喘患者血清MIP-1α和IL-13水平动态变化及其预后评估价值  

Dynamic changes of MIP-1α and IL-13 levels of patients with severe asthma and their values in prognosis evaluation

作　　者：吕秀云[1] 杨婷[1] 徐磊[1] 王立红[1] LYU Xiuyun;YANG Ting;XU Lei;WANG Lihong(Department of Respiratory Medicine,Affiliated Hospital,Inner Mongolia Medical University,Hohhot 010059,China)

机构地区：[1]内蒙古医科大学附属医院呼吸科

出　　处：《吉林大学学报（医学版）》2019年第6期1401-1407,共7页Journal of Jilin University：Medicine Edition

基　　金：内蒙古自治区自然科学基金资助课题(2012MS1118)

摘　　要：目的:分析重症哮喘患者血清巨噬细胞炎症蛋白1α(MIP-1α)和白细胞介素13(IL-13)水平的动态变化,评估其判断患者短期预后的临床价值。方法:102例哮喘患者按病情严重程度分为重症哮喘组(42例重症哮喘患者)和轻症哮喘组(60例轻中度哮喘患者),选择同时期健康体检者50人作为对照组。随访1年后根据是否发生未控制哮喘发作将重症哮喘组分为控制亚组与再发亚组。在治疗前与治疗后第1、3、7天分别测定3组研究对象血清IL-13、MIP-1α、白细胞介素6(IL-6)和肿瘤坏死因子α(TNF-α)水平,记录3组研究对象用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC、最大呼气中段流量(MMEF)和呼气峰流速(PEF)等肺功能指标,采用Pearson相关分析评估治疗第7天重症哮喘患者血清IL-13、MIP-1α与FEV1、MMEF及PEF的相关性,比较重症哮喘组中控制亚组与再发亚组患者治疗第7天时血清IL-13及MIP-1α水平,应用多元Logistic回归分析上述各临床指标与患者随访1年再发率的相关性,绘制受试者工作特征(ROC)曲线评估患者血清IL-13和MIP-1α水平对重症哮喘患者再发作的判断价值。结果:随治疗时间延长,重症哮喘组和轻症哮喘组患者血清IL-6、IL-13、TNF-α和MIP-1α水平逐渐降低(P<0.05),而FEV1、FEV1/FVC、MMEF和PEF逐渐增加(P<0.05);同一时间点重症哮喘组患者血清IL-6、IL-13、TNF-α和MIP-1α水平高于轻症哮喘组(P<0.05)和对照组(P<0.05),而重症哮喘组患者FEV1、FEV1/FVC、MMEF和PEF低于轻症哮喘组(P<0.05)和对照组(P<0.05)。Pearson相关分析,重症哮喘患者血清IL-13及MIP-1α与FEV1、MMEF及PEF呈负相关关系(P<0.05)。随访1年,重症哮喘组控制亚组患者血清IL-13及MIP-1α水平低于再发亚组(P<0.01)。多元Logistic回归分析,治疗前后重症哮喘患者血清IL-13及MIP-1α水平差值为再发作危险性因素(OR=2.867,P=0.023;OR=2.135,P=0.033)。结论:重症哮喘患者治疗过程中血清ILObjective:To analyze the dynamic changes of serum levels of macrophage inflammatory protein-1α(MIP-1α)and interleukin-13(IL-13)of thePatients with severe asthma,and to evaluate their clinical values in judgment of the short-termPrognosis in thePatients with severe asthma.Methods:A total of 102Patients with asthma were divided into severe asthma group(42 cases of severe asthma)and mild asthma group(60 cases of mild and moderate asthma)according to the degree of asthma;a total of 50 contemporaneous healthy examinees were selected as control group.After follow-up for one year,thePatients in severe asthma group were divided intoPreservation sub-group and recurrence sub-group.The serum levels of MIP-1α,IL-13,interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)of the subjects in three groups were detected before therapy and on the 1st,3rd,and 7th days after therapy respectively;thePulmonary indexes including forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),FEV1/FVC,maximum mid-expiratory flow(MMEF)andPeak expiratory flow(PEF)of the subjects in three groups were also detected and compared.The correlations between the serum levels of MIP-1αand IL-13 on the 7th day after therapy and FEV1,MMEF andPEF were confirmed byPearson linear correlation analysis.The serum levels of IL-13 and MIP-1αof thePatients in severe ashma group on the 7th day after therapy were compared betweenPreservation sub-group and recurrence sub-group,the relationships between the clinical indexes mentioned above and the recurrence rate of thePatients after 1-year follow-up were confirmed by multivariate Logistic analysis,and the diagnostic values of the serum levels of MIP-1αand IL-13 in the recurrence of thePatients with severe asthma were analyzed by receiver operating characteristic(ROC)curves.Results:With theProlongation of therapy time,the serum levels of-6,IL-13,TNF-α,and MIP-1αof thePatients in severe asthma group and mild asthma group were decreased(P<0.05),and FEV1,FEV1/FVC,MMEF andPEF of thePatients wer

关 键 词：重症哮喘 白细胞介素13 巨噬细胞炎症蛋白1Α 预后 受试者工作特征曲线 

分 类 号：R562.25[医药卫生—呼吸系统]