支气管哮喘患者血清白细胞介素35水平变化及意义

Change of Serum Interleukin 35 Concentration in Asthma and Its Significance

【目的】探讨支气管哮喘患者血清白细胞介素35水平变化及意义。【方法】将45例受试者分为支气管哮喘组(25例)和健康对照组(20例),测定支气管哮喘组患者未控制、部分控制后1周、控制后1周的血清白细胞介素35(IL-35)水平及各项主要肺功能指标[包括第一秒用力呼气容积(FEV1)与预计值的比值、用力肺活量(FVC)与预计值的比值、FEV1与FVC的比值、呼气峰流量(PEF)与预计值的比值],以及未控制阶段的FEV1下降20%的吸入药物累积浓度(PC20-FEV1),测定健康对照组血清IL-35水平,分析哮喘患者与健康人血清IL-35水平的差异及其与哮喘控制水平、气道反应性的相关性。【结果】支气管哮喘组未控制、部分控制以及控制阶段血清IL-35浓度(pg/mL)分别为141±45、260±84、366±94,健康对照组血清IL-35浓度(pg/mL)为396±120,支气管哮喘组未控制、部分控制阶段血清IL-35水平均低于健康对照组(P值均小于0.001),支气管哮喘组控制阶段与健康对照组血清IL-35水平差异无统计学意义(P=0.36)。血清IL-35水平在未控制阶段低于部分控制阶段(95%置信区间为-163.10～-73.65,P<0.001),部分控制阶段低于控制阶段(95%置信区间为-151.41～-61.97,P<0.001)。哮喘患者血清IL-35水平与哮喘控制水平呈正相关,与PC20-FEV1无相关性。【结论】健康人与哮喘患者血清中均存在IL-35表达,血清IL-35水平可能可以作为哮喘控制水平评估的免疫学参考指标。

[ Objective ] To explore changes and significance of serum interleukin-35 concentration in patients with bronchial asthma. [ Method] Forty-five subjects were divided into two groups： bronchial asthma group with 25 patients and control group with 20 healthy subjects. To detect serum IL-35 concentrations of those uncontrolled, partly controlled and controlled after a week in the asthma group and their main pulmonary function indicators （including FEV1/FEV1 predicted value, FVC/FVC predicted value, FEV1/FVC, PEF/PEF predicted value） and PC20-FEV1 during uncontrolled period, and detect the serum IL-35 concentration of control group, and then analyze the difference of serum IL-35 concentration between both groups and the relevance of serum IL-35 concentration with asthma controlled level and airway reactivity. [ Result] Serum IL-35 concentrations （pg/mL） during uncontrolled period, partly controlled period and controlled period were 141 ± 45, 260 ± 84, 366± 94. Serum IL-35 concentration （pg/mL） in control group was 396 ± 120. Serum IL-35 concentrations of asthma group during uncontrolled and partly controlled periods are lower than control group （t were respectively -9.427 and -4.458, P 〈 0.001 ）. There exists no significance difference between serum IL-35 concentrations in asthma group during controlled period and control group （P = 0.36）. Serum IL-35 concentration during uncontrolled period is lower than that during partly controlled period （95% Confidence Interval： -163.10- -73.65, P 〈 0.001 ）, and serum IL-35 concentration during partly controlled period is lower than that during controlled period （95% Confidence Interval： -151.41 - - 61.97, P 〈 0.001 ）. IL-35 level of asthma patients shows positive correlation with asthma controlled level and shows no correlation with PC20-FEV1. [ Conclusion ] There expresses IL-35 in serum of asthma patients and healthy persons. Serum IL-35 concentration may be used as index to test asthma controlled level.