哮喘-慢性阻塞性肺疾病重叠综合征患者肺功能、中性粒细胞极性化及血清免疫球蛋白E水平分析  

Lung function,neutrophil polarization,and serum immunoglobulin E level in patients with asthma-chronic obstructive pulmonary disease overlap syndrome

作　　者：徐海玲 张克香 周河 马尚利 XU Hailing;ZHANG Kexiang;ZHOU He;MA Shangli(Department of Respiratory and Critical Care Medicine,Wuwei People’s Hospital,Wuwei,Gansu 733000,P.R.China)

机构地区：[1]武威市人民医院呼吸与危重症医学科,甘肃武威733000

出　　处：《华西医学》2022年第3期414-418,共5页West China Medical Journal

基　　金：武威市市列科技计划(WW2002086)。

摘　　要：目的探究支气管哮喘、慢性阻塞性肺疾病(慢阻肺)、哮喘-慢阻肺重叠(asthma-chronic obstructive pulmonary disease overlap,ACO)综合征患者肺功能、中性粒细胞极性化及血清总免疫球蛋白E(immunoglobulin E,IgE)水平的差异。方法回顾性分析2016年3月-2019年3月武威市人民医院诊治的呼吸系统疾病患者127例,其中支气管哮喘持续期中、重度患者45例为哮喘组,慢阻肺急性加重患者42例为慢阻肺组,ACO中度持续、重度持续患者40例为ACO组,另选取同期健康体检者48例为对照组。比较4组肺功能[第1秒用力呼气容积(forced expiratory volume in one second,FEV_(1))、用力肺活量(forced vital capacity,FVC)、FEV_(1)占FVC的百分比(FEV_(1)/FVC)、FEV_(1)占预计值百分比(FEV_(1)%pred)]、中性粒细胞极性化及血清总IgE水平的差异。结果对照组、ACO组、哮喘组及慢阻肺组的FEV_(1)分别为(3.65±0.79)、(2.04±0.58)、(1.81±0.46)、(1.59±0.43)L,FVC分别为(4.13±0.92)、(3.18±0.76)、(2.69±0.63)、(2.43±0.58)L,血清总IgE水平分别为(92.36±12.20)、(334.81±55.96)、(455.61±65.59)、(142.65±28.36)U/mL,组间两两比较差异均有统计学意义(P<0.05)。另哮喘组、慢阻肺组及ACO组的FEV_(1)/FVC分别为(67.93±11.51)%、(63.81±9.22)%、(61.28±9.23)%,FEV_(1)%pred水平为(74.55±11.70)%、(63.29±8.60)%、(61.34±7.91)%,均低于对照组[(83.60±7.18)%、(94.23±8.21)%],差异有统计学意义(P<0.05)。自发极性化率ACO组>哮喘组>慢阻肺组>对照组[(29.43±5.58)%、(25.11±4.09)%、(16.28±4.51)%、(7.18±2.12)%,P<0.05],任意极性化率ACO组>哮喘组>对照组>慢阻肺组[(30.01±5.29)%、(25.76±5.53)%、(21.42±4.36)%、(19.85±5.00)%,P<0.05],定向极性化率哮喘组>ACO组>对照组>慢阻肺组[(14.67±2.30)%、(8.21±1.81)%、(5.12±1.10)%、(2.52±0.63)%,P<0.05]。结论支气管哮喘、慢阻肺与ACO患者的肺功能、中性粒细胞极性化及血清总IgE水平具有一定差异。Objective To explore the differences in lung function,neutrophil polarization,and serum total immunoglobulin E(IgE)levels among bronchial asthma patients,chronic obstructive pulmonary disease(COPD)patients,and asthma-COPD overlap syndrome(ACO)patients.Methods The retrospective analysis enrolled 127 patients with respiratory system diseases diagnosed and treated in Wuwei People’s Hospital between March 2016 and March 2019.Among them,45 patients with moderate and severe bronchial asthma were in included the asthma group,42 patients with acute exacerbations of COPD were included in the COPD group,and 40 patients with moderately persistent and severely persistent ACO were included in the ACO group.Forty-eight healthy examinees in the same period were selected as the control group.The pulmonary function[forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),FEV_(1) to FVC(FEV_(1)/FVC)ratio,and percentage of FEV_(1) to predicted value(FEV_(1)%pred)],neutrophil polarization,and serum total IgE levels of the four groups were compared.Results In the control group,the ACO group,the asthma group,and the COPD group,the FEV_(1) values were(3.65±0.79),(2.04±0.58),(1.81±0.46),and(1.59±0.43)L,respectively,the FVC values were(4.13±0.92),(3.18±0.76),(2.69±0.63),and(2.43±0.58)L,respectively,the serum total IgE levels were(92.36±12.20),(334.81±55.96),(455.61±65.59),and(142.65±28.36)U/m L,respectively,and the between-group differences were all statistically significant(P<0.05).In addition,the FEV_(1)/FVC ratios in the asthma group,the COPD group,and the ACO group were(67.93±11.51)%,(63.81±9.22)%,and(61.28±9.23)%,respectively,the FEV_(1)%pred levels were(74.55±11.70)%,(63.29±8.60)%,and(61.34±7.91)%,respectively,which were lower than those in the control group[(83.60±7.18)%and(94.23±8.21)%](P<0.05).The spontaneous polarization rates in the ACO group,the asthma group,the COPD group,and the control group were(29.43±5.58)%,(25.11±4.09)%,(16.28±4.51)%,and(7.18±2.12)%,respectively,the arbitrary

关 键 词：哮喘-慢性阻塞性肺疾病重叠综合征 慢性阻塞性肺疾病 肺功能 中性粒细胞极性化 免疫球蛋白E 

分 类 号：R563.9[医药卫生—呼吸系统] R562.25[医药卫生—内科学]