摘要
目的分析激素抵抗型哮喘(SRA)患者对糖皮质激素治疗反应性与其外周静脉血肌动蛋白解聚因子(ADF)表达水平的相关性。方法收集FEV1%≤75%的支气管哮喘患者120例作为研究对象,包括SRA患者13例、激素敏感型哮喘(SSA)患者107例。治疗前填写ACQ5量表,行肺功能检查,记录白天、夜间症状评分,检测诱导痰、外周血嗜酸性粒细胞和中性粒细胞计数百分比(S-EOS%、B-EOS%、S-NEU%、B-NEU%)及外周静脉血ADF的表达水平。所有患者均给予足量(40 mg/d)、足疗程(2周)泼尼松龙口服治疗,治疗后再行肺功能、外周血ADF水平检测。比较治疗前后SRA组与SSA组患者各项指标的差异,并分析ADF水平与肺功能、嗜酸性粒细胞和中性粒细胞计数等的相关性。结果治疗前SRA组与SSA组ACQ5评分、白天症状评分、夜间症状评分、S-EOS%、B-NEU%、B-EOS%比较差异无统计学意义(P>0.05),而SRA组S-NEU%显著高于SSA组(P<0.05)。治疗前,SRA组与SSA组FEV1%、PEF%差异无统计学意义(P>0.05)。治疗后SSA组FEV1%、PEF%均明显升高(P<0.05),而SRA组FEV1%、PEF%无明显变化(P>0.05)。治疗前SRA组患者ADF表达水平显著高于SSA组(P<0.05)。治疗后SSA组ADF表达水平显著下降(P<0.05),而SRA组患者ADF表达水平无明显变化(P>0.05)。治疗前外周血ADF表达水平与B-EOS%、B-NEU%、S-EOS%均无明显相关性(r=0.27、0.09、-0.23,P=0.20、0.68、0.31)。治疗前外周血ADF表达水平与ΔFEV1%呈负相关,而与S-NEU%及ΔPEF%呈正相关(r=-0.40、0.41、0.39,P=0.03、0.02、0.04)。结论 ADF水平与哮喘患者糖皮质激素治疗的反应性相关,ADF水平可能作为SRA患者对糖皮质激素治疗反应性的预测因子。
Objective To investigate the correlation between treatment reactivity on steroid resistant asthma (SRA) and expression of actin depolymerization factor (ADF). Methods Thirty - four asthma cases, whose FEV1% were lower than 75%. Among them, 10 cases were SRA and the other 24 cases were steroid - sensitive asthma. The ACQ5 scores, lung function, and symptom scores at day and night were recorded. Induced sputum, peripheral eosinophil count percentage, peripheral neutrophil count percentage and peripheral blood ADF were also measured before treatment. All cases were given with sufficient treatment of prednisolone for 2 weeks. Lung function and ADF expression were as- sessed again after treatment. Results Before treatment, no significantly difference was observed in ACQ score, symptom scores at day and night, EOS% , B - NEU% , or B - EOS% between SRA and SSA groups ( P 〉 0.05 ) ; while S - NEU% in SRA group was significantly higher than SSA group (P 〈 0. 05). Neither significant difference in FEV1% or PEF% was observed between SRA and SSA groups at baseline ( P 〉 0. 05 ). Significant improvements in FEV1% and PEF% were only observed in SSA group after treatment (P 〈 0. 05 ). The ADF expression in SAR group was significantly higher than SSA group before treatment ( P 〈 0. 05 ) , but no significant difference was observed after treatment ( P 〈 0. 05 ) , as it was significantly reduced in SSA group after treatment ( P 〈 0. 05 ). The ADF expression level showed no sig- nificant correlation with B - EOS%, B - NEU%, or S - EOS% before treatment (r = 0. 27, 0. 09 and - 0. 23, P = 0. 20, 0.68 and 0.31 ). The ADF expression level of peripheral blood was negatively correlated with FEV1% and positively cor- related with S - NEU% and PEF% prior treatment (r = - 0. 40, 0.41 and 0. 39, P = 0. 03, 0. 02 and 0. 04). Conclu- sion The ADF expression level is correlate with treatment reactivity of RSA, and it could be the predictive factor to the treatment reactivity of GC.
作者
梁永锋
LIANG Yong -feng.(Respiratory Apparatus, Nanhai District People's Hospital of Foshan City, Foshan 528200, Guangdong, Chin)
出处
《广东医学》
CAS
北大核心
2017年第20期3112-3115,3119,共5页
Guangdong Medical Journal
基金
佛山市科技局医学类科技攻关项目(编号:2015AB000482)