支气管哮喘患者呼出气冷凝液中炎性因子水平与病情程度相关性分析

The relationship between the inflammatory factors levels in exhaled breath condensate and condition of asthma patients

目的:研究支气管哮喘患者呼出气冷凝液(EBC)中炎性因子水平与患者病情的相关性。方法:选择40例确诊为支气管哮喘的患者将其纳入哮喘组,并以同期40名体检人员作为健康对照组。收集哮喘组患者急性发作期、缓解期以及健康对照组的EBC,比较两组EBC中白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平,探讨呼出气中IL-6和TNF-α水平与哮喘患者病情、肺功能及血气等指标的相关性。结果:哮喘组急性发作期患者EBC中TNF-α和IL-6水平分别为(36.29±4.62)ng/ml和(10.46±1.25)ng/ml,明显高于健康对照组和缓解期,差异有统计学意义(t=9.57,t=8.85,t=3.87;P<0.05),缓解期EBC中TNF-α水平明显高于健康对照组,差异有统计学意义(t=16.53;P<0.05)。TNF-α和IL-6均与哮喘病情程度成正相关、与FEV1/FVC、PEF成负相关(r=-0.514,r=-0.275,r=-0.31;P<0.05),与用力肺活量(FVC)、酸碱度(pH)、氧分压(PaO_2)及二氧化碳分压(PaCO_2)水平无明显相关性。结论:EBC中TNF-α和IL-6水平可以反应哮喘患者病情严重程度,有助于评价哮喘患者病情,值得临床推广运用。

Objective： To study on the correlation between the inflammatory factors in exhaled breath condensate and condition of patients with bronchial asthma. Methods： 40 patients with bronchial asthma in our hospital from September 2014 to September were selected for study, and 40 healthy in the same period were enrolled as control group. To collect the acute attack stage, remission stage and EBC, the level of IL-6 and TNF-α in exhaled breath condensate were compared, and detect the relationship between the level of IL-6 and TNF-α in EBC and the condition of asthma. Results： The level of TNF-α and IL-6 in EBC patients in acute asthma attack stage were 36.29±4.62 and 10.46±1.25, significantly higher than the control group and remission stage. The differences were statistically significant（t=9.57, t=8.85, t=3.87; P〈0.05）. The TNF-α level of EBC in remission stage was significantly higher than the control group, and the difference was significant（t=16.53, P〈0.05）. The level of TNF-α and IL-6 had a positive correlation with the condition of the patients with bronchial asthma, but had negative correlation with the level of FEV1 and PEF（r=-0.514, r=-0.275, r=-0.31; P〈0.05）. It had no significant correlation with FVC, pH, PaO2 and PaCO2. Conclusion： The level of TNF-α and IL-6 in EBC can reflect the severity of asthma patients, and help to assess the condition of patients with asthma. It is worth popularizing in clinical application.