支气管哮喘患者血清肿瘤坏死因子-α和透明质酸及羟脯氨酸水平表达及意义

Expressions and significances of tumor necrosis factor-α,hyaluronic acid and hydroxyproline in asthma

目的探讨支气管哮喘患者血清肿瘤坏死因子-α(tumour necrosis factor-a,TNF-α)、透明质酸(hyaluronic acid,HA)及羟脯氨酸(hydroxyproline,HP)水平变化,分析其与肺功能的相关性。方法支气管哮喘患者35例,处于发作期21例为发作期组,处于缓解期14例为缓解期组,同期11例体检健康者为对照组,测定3组血清TNF-α、HA、HP水平及用力肺活量(forced vital capacity,FVC)、第1秒钟用力呼气容积(forced expiratory volume in one second,FEV_1)、最大呼气峰值流速(peak expiratory flow,PEF)、最大呼气中期流速(maximal mid-expiratory flow,MMEF_(75/25))、FEV_1/FVC;分析TNF-α、HA及HP与肺功能指标的相关性。结果发作期组血清TNF-α[(1.49±0.40)μg/L]、HA[(92.69±7.04)μg/L]、HP[(1.90±0.21)mg/L]水平高于对照组[(0.99±0.08)μg/L、(34.84±9.61)μg/L、(1.41±0.78)mg/L](P<0.05);缓解期组血清TNF-α水平[(1.26±0.22)μg/L]高于对照组(P<0.05),HA[(38.99±9.56)μg/L]、HP[(1.96±0.61)mg/L]水平与对照组比较差异无统计学意义(P>0.05);发作期组血清TNF-α、HA水平高于缓解期组(P<0.05);发作期组FVC[(2.732±0.914)L]、FEV_1[(1.428±0.301)L]、FEV_1/FVC[(50.623±17.537)%]、PEF[(129.851±5.346)L/min]、MMEF_(75/25)[(0.359±0.090)L/s]均低于对照组[(3.216±0.869)L、(2.496±0.459)L、(59.796±16.438)%、(557.544±7.101)L/min、(2.355±0.353)L/s](P<0.05);缓解期组FVC[(3.314±0.589)L]高于对照组,FEV_1[(1.888±0.319)L]、PEF[(506.256±15.908)L/min]、MMEF_(75/25)[(0.603±0.095)L/s]低于对照组(P<0.05),FEV_1/FVC[(57.909±9.653)%]与对照组比较差异无统计学意义(P<0.05);发作期组FVC、FEV_1、PEF、MMEF_(75/25)低于缓解期组(P<0.05);Pearson相关分析结果显示,FVC、FEV_1、PEF、MMEF_(75/25)与TNF-α、HA、HP均呈负相关(P<0.01),FEV_1/FVC与HA、HP呈负相关(P<0.01),与TNF-α无相关性(P>0.05)。结论 TNF-α、HA、HP对评估哮喘气道炎症的发生及持续有重要价值。

Objective To investigate the changes of tumor necrosis factor-α （TNF-α）, hyaluronic acid （HA） and hydroxyproline （HP） levels in asthma and to analyze their correlation with pulmonary function. Methods In 35 patients with asthma, 21 patients were at exacerbation stage （exacerbation group） and 14 patients were at stable stage （stable group）. Another 11 healthy volunteers were as controls （control group）. The levels of TNF-α, HA, HP, forced vital capacity （FVC）, forced expiratory volume in one second （FEV1）, peak expiratory flow （PEF）, maximal mid-expiratory flow （MMEF75/25） and FEV1/FVC were detected in three groups to analyze the correlations of TNF-α, HA and HP with pulmonary function. Results The levels of TNF-α （（1.49±0.40）μg/L）, HA （（92.69±7.04） μg/L） and HP （（1.90± 0.21） mg/L） in exacerbation group were significantly higher than those in control group （（0.99±-0.08） μg/L, （34.84± 9.61）μg/L, （1.41±0.78） mg/L） （PH0.05）. The TNF-α level （（1.26±0.22） μg/L） was significantly higher in stable group than that in control group （PH 0.05）, and there were no significant differences in HA between stable group （（38.99±9.56） μg/L） and HP （（1.96±0.61） mg/L） and control group （P〈0.05）. The levels of TNF-α and HA were significantly higher in exacerbation group than those in stable group （PH0.05）, FVC （（2. 732±0. 914） L）, FEV1 （（1. 428±0. 301）L）, FEV1/FVC （（50. 623!17. 537）%） , PEF （（129. 851±5. 346） L/rain） and MMEFTs/2s （（0. 359± 0. 090） L/s） were significantly lower in exacerbation group than those in control group （（3. 216±0. 869） L, （2. 496± 0.459） L, （59. 796±16.438）%, （557. 544±7. 101） L/min, （2. 355±0.353） L/s） （PH0.05）. The level of FVC （（3.314±0. 589） L） was significantly higher, the levels of FEVl（（1.888±0.319） L）, PEF （（506. 256±15. 908） L/min） and MMEF75% （（0. 603±0. 095）L/s） in stable group were significantly lower than those in control group （PH 0.05）, and there was no significant difference in FEV1/FVC between stable group （（57. 909± 9. 653）%） and controlgroup （P^0.05）. The levels of FVC, FEV1 , PEF and MMEF15/25 were significantly lower in exacerbation group than those in stable group （P%0.05）. Pearson correlation analysis showed FVC, FEV1 , PEF and MMEF75/25 were negatively correlated with TNF-α, HA and HP （P〈0.01）, FEV1/FVC was negatively correlated with HA and HP （P〈0.01）, and FEV1/FVC was not correlated with TNF-α （P〉0.05）. Conclusion TNF-α, HA and HP play important roles in the occurrence and development of asthma.