诱导痰中血管内皮生长因子、细胞因子对慢性阻塞性肺疾病合并哮喘诊断的临床意义

Clinical significance of vascular endothelial growth factor and cytokine in the diagnosis of COPD patients complicated with asthma

目的探究诱导痰中血管内皮生长因子(VEGF)、细胞间粘附分子(ICAM-1)、白细胞介素-13(IL-13)和白细胞介素-17(IL-17)对慢性阻塞性肺疾病(慢阻肺)合并哮喘诊断及鉴别诊断的意义。方法选取2014年1月—2016年1月我院收治的110例患者作为本次研究对象,将患者分为慢阻肺组、哮喘组和慢阻肺合并哮喘组。收集患者的吸烟史、一般资料,并对患者用力肺活量占预计值百分比(FVC%)、一秒钟用力呼气容积占预计值百分比(FEV1%)、峰值呼气流量占预计值的百分比(PEF%)进行观察记录,同时检测患者诱导痰中VEGF、ICAM-1、IL-13和IL-17的水平。结果慢阻肺组与慢阻肺合并哮喘组存在吸烟史的患者均明显多于哮喘组(P<0.05);慢阻肺组的FEV_1%、FVC%和PEF%指标(肺功能)最差,均显著低于哮喘组与慢阻肺合并哮喘组(P<0.05);慢阻肺合并哮喘组肺功能次之,其FEV1%、PEF%指标均显著差于哮喘组(P<0.05)慢阻肺合并哮喘组VEGF、ICAM-1、IL-13和IL-17的水平均显著高于慢阻肺组(P<0.05);慢阻肺合并哮喘组与哮喘组相比,VEGF水平的差异有统计学意义(P<0.05)。结论诱导痰VEGF水平的检测对慢阻肺合并哮喘的诊断有重要指导意义,而诱导痰ICAM-1、IL-13和IL-17水平的检测则对慢阻肺与哮喘的鉴别诊断有指导意义。

Objective To explore the expression of vascular endothelial growth factor induced sputum （ VEGF）, intercellular adhesion molecule （ ICAM-1 ） and interleukin -13 （ IL-13 ） and interleukin -17 （ IL-17 ） in the diagnosis of COPD patients complicated with asthma. Methods 110 patients admitted to our hospital from Janu- ary 2016 to January 2014 were selected as the subjects of this study. The patients were divided into the COPD group, the asthma group and the COPD combined asthma group. In general, smoking history was collected, and their FVC percent predicted （ FVC% ）, forced expiratory volume in one second percentage of predicted value （ FEV1% ）, and peak expiratory flow percentage of predicted value （ PEF% ） were recorded at the same time. The levels of induced sputum VEGF, ICAM-1, IL-13 and IL-17 were also detected. Results The patients with a history of smoking were obviously in the COPD group and the combined group than in the asthma group （P 〈0.05）. The value of FEV1% , FVC% and PEF% （lung function） was the lowest in the COPD group （P 〈0. 05）, and the value of FEVI% and PEF% was significantly lower in the combined group than in the asthma group （ P 〈0. 05 ）. The levels of VEGF, ICAM-1, IL-13 and IL-16 in the asthma group and the combined group were significantly higher than those in the COPD group （ P 〈 0.05 ） , there was significant difference in the level of VEGF between the asthma group and the combined group （P 〈 0. 05 ）. Conclusion The detection of induced sputum VEGF level has an important guiding significance for the diagnosis of COPD complicated with asthma, and the detection of ICAM-1, IL-13 and IL-17 levels in induced sputum has a guiding significance for the differential diagnosis between COPD and asthma.