胃食管反流诱发支气管哮喘患者外周血炎性细胞因子变化及意义  

Changes and Significance of Inflammatory Cytokines in Patients with Bronchial Asthma Induced by Gastroesophageal Reflux

作　　者：曾海珠[1] 高宏昌[1] 刘盼盼 王金睿 王雨濛 章华丽 顾钰霞 张雯 赵蕾[1] Zeng Haizhu;Gao Hongchang;Liu Panpan;Wang Jinrui;Wang Yumeng;Zhang Huali;Gu Yuxia;Zhang Wen;Zhao Lei(Department of Respiratory and Critical Care Medicine,Gongli Hospital in Pudong New District,Shanghai,200135,P.R.China)

机构地区：[1]上海市浦东新区公利医院呼吸与危重症医学科,上海200135

出　　处：《老年医学与保健》2020年第2期287-290,共4页Geriatrics & Health Care

基　　金：上海市浦东新区卫生和计划生育委员会科技发展专项基金资助(PW2016A-20)。

摘　　要：目的探讨胃食管反流(GRE)在支气管哮喘中诱发气道炎症可能的参与机制,并评估其作为诊断和预后的价值。方法选择2016年1月-2018年8月于上海市浦东新区公利医院住院治疗的GER相关支气管哮喘患者78例为观察组,非GER相关支气管哮喘患者86例为对照组,评估并比较2组外周血中细胞因子TNF-、TGF-、IFN-、IL-4、IL-8、IL-10及IL-17水平。依据年龄将78例GER相关支气管哮喘患者分成老年亚组和非老年亚组,评估并比较2亚组外周血中TNF-、TGF-、IFN-、IL-4、IL-8、IL-10及IL-17水平。结果观察组TNF-、TGF-、IFN-、IL-8及IL-17水平均明显高于对照组(P<0.05),而IL-4水平明显低于对照组(P<0.05);2组IL-10水平差异无统计学意义(P>0.05)。老年亚组TNF-、TGF-、IL-8及IL-17水平明显高于非老年亚组(P<0.05),而2亚组IL-4、IFN-、IL-10水平差异均无统计学意义(P>00.05)。结论 GER相关支气管哮喘更倾向于中性粒细胞性哮喘,为难治性哮喘的重要原因,尤其在老年GER相关支气管哮喘中更为突出。Objective To investigate the possible mechanism of gastroesophageal reflux(GRE) in bronchial asthma and to assess its diagnostic and prognostic values. Methods 78 patients with GER-related asthma were collected as the study group, while 86 patients without GER-related asthma as the control group. The levels of TNF-、TGF-、IFN-、IL-4、IL-8、IL-10 and IL-17 in peripheral blood were compared between two groups. According to age, 78 patients in the study group were divided into the elderly subgroup and the non-elderly subgroup, and the levels of TNF-、TGF-、IFN-、IL-4、IL-8、IL-10 and IL-17 in peripheral blood were compared between the two subgroups. Results The levels of TNF-、TGF-、IFN-、IL-8 and IL-17 in the study group were significantly higher than those in the control group(P<0.05), the level of IL-4 was significantly lower than that in the control group(P<0.05), but there was no significant difference in the level of IL-10 between the two groups(P>0.05). The levels of TNF-、TGF-, IL-8 and IL-17 in the elderly subgroup were higher than those in the non-elderly subgroup(P<0.05), but there were no significant difference in the level of IL-4、IFN-、IL-10 between the two subgroups(P>0.05).Conclusion GRE-related asthma is more likely to be neutrophil asthma, which is an important cause of refractory asthma, especially in the elderly.

关 键 词：老年 胃食管反流 哮喘 细胞因子 病因 

分 类 号：R562.25[医药卫生—呼吸系统] R571[医药卫生—内科学]