不同病情程度的支气管哮喘患儿VEGF、ET-1水平与气道炎症、肺功能的相关性分析  

Correlation of VEGF and ET-1 levels with airway inflammation and lung functionin children with different degrees of bronchial asthma

作　　者：王晶晶 王艳辉 黄歆 赵雪娇 李慧 WANG Jing-jing;WANG Yan-hui;HUANG Xin;ZHAO Xue-jiao;LI Hui(Department of Pediatrics,the Fourth People′s Hospital of Langfang City,Hebei Province,Langfang 065700,China;Department of Internal Medicine,the Fourth People′s Hospital of Langfang City,Hebei Province,Langfang 065700,China;Department of Orthopedics,the Fourth People′s Hospital of Langfang City,Hebei Province,Langfang 065700,China;Operating Room,the Fourth People′s Hospital of Langfang City,Hebei Province,Langfang 065700,China)

机构地区：[1]河北省廊坊市第四人民医院儿科,河北廊坊065700 [2]河北省廊坊市第四人民医院内科,河北廊坊065700 [3]河北省廊坊市第四人民医院骨科,河北廊坊065700 [4]河北省廊坊市第四人民医院手术室,河北廊坊065700

出　　处：《河北医科大学学报》2024年第5期530-536,共7页Journal of Hebei Medical University

基　　金：廊坊市科学技术研究与发展计划自敌经费项目(2022013115)。

摘　　要：目的探讨不同病情程度支气管哮喘患儿血管内皮生长因子(vascular endothelial growth factor,VEGF)、内皮素1(endothelin-1,ET-1)水平与气道炎症、肺功能的相关性,以期为临床早期评估病情、制定干预方案提供参考。方法选取我院80例支气管哮喘患儿作为研究对象,其中轻度44例,中-重度36例,统计所有患儿临床资料、肺功能[呼气峰流速(peak expiratory flow rate,PEF)、1秒内用力呼气容积(forced expiratory volume within 1 second,FEV1)、FEV1占预计值百分比(FEV1 as a percentage of expected value,FEV1%)]、痰液气道炎症指标[白细胞介素6(interleukin-6,IL-6)、白细胞介素10(interleukin-10,IL-10)、肿瘤坏死因子α(tumor necrosis factor-α,TNF)-α]、VEGF、ET-1水平,分析VEGF、ET-1水平与气道炎症、肺功能相关性及对支气管哮喘患儿病情的影响及评估价值。结果不同病情程度患儿肺功能指标(FEV1、FEV1%、PEF)、气道炎症指标(痰液IL-6、IL-10、TNF-α)及血清VEGF、ET-1水平比较差异有统计学意义(P<0.05);支气管哮喘患儿血清VEGF、ET-1与肺功能指标FEV1、FEV1%、PEF及痰液气道炎症指标IL-10呈负相关(P<0.05),与痰液气道炎症指标IL-6、TNF-α呈正相关(P<0.05);VEGF、ET-1水平联合评估支气管哮喘患儿病情程度的AUC值为0.912,大于单一指标评估;支气管哮喘患儿VEGF、ET-1高水平时,病情加重风险是低水平的2.922倍(95%CI:1.678~5.089)、2.641倍(95%CI:1.514~4.608);经Logistic回归分析,结果显示VEGF、ET-1均为支气管哮喘患者病情程度加重的危险因素(P<0.05);VEGF、ET-1在支气管哮喘患儿病情加重风险中存在正相加交互作用,二者同时存在时效应增强。结论VEGF、ET-1与支气管哮喘患儿气道炎症及肺功能具有显著相关性,临床可通过其水平变化早期评估病情,以针对性展开后续治疗,改善预后。Objective To investigate the correlation of the levels of vascular endothelial growth factor(VEGF)and endothelin-1(ET-1)with airway inflammation and lung function in children with different degrees of bronchial asthma,in order to provide a reference for early clinical assessment and development of intervention plans.Methods A total of 80 children with bronchial asthma were selected for the study,including 44 with mild and 36 with moderate-to-severe bronchial asthma.Clinical data,lung function[peak expiratory flow rate(PEF),forced expiratory volume within 1 second(FEV1),FEV1 as a percentage of expected value(FEV1%)],sputum airway inflammatory markers[interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)],VEGF and ET-1 levels were recorded,to analyse the correlation of VEGF and ET-1 levels with airway inflammation and lung function,their impact on the condition of children with bronchial asthma and their value in disease evaluation.Results There were significant differences in pulmonary function indexes(FEV1,FEV1%,PEF),airway inflammation indexes(sputum IL-6,IL-10,TNF-α)and serum levels of VEGF and ET-1 in children with different disease severity(P<0.05).In children with bronchial asthma,serum VEGF and ET-1 were negatively correlated with lung function indexes FEV1,FEV1%,PEF and sputum airway inflammation index IL-10(P<0.05),but positively correlated with sputum airway inflammation indexes IL-6 and TNF-α(P<0.05).The area under the receiver operating characteristic(ROC)curve(AUC)value of the combined assessment of VEGF and ET-1 was 0.912,which was higher than that of single index detection.When VEGF and ET-1 levels were high in children with bronchial asthma,the risk of disease exacerbation was 2.922 times(95%CI:1.678-5.089)and 2.641 times(95%CI:1.514-4.608)of those with low levels respectively.Results of Logistic regression analysis showed that VEGF and ET-1 were risk factors for exacerbation of the severity of bronchial asthma(P<0.05).VEGF and ET-1 have positive additive interaction in the r

关 键 词：哮喘 血管内皮生长因子 内皮缩血管肽1 

分 类 号：R562.25[医药卫生—呼吸系统]