白细胞介素17、33及1-磷酸鞘氨醇在支气管哮喘患者血清中的表达及临床意义研究

Expression and clinical significance of serum interleukin-17,interleukin-33 and sphingosine 1-phosphate in patients with bronchial asthma

目的:研究血清中白细胞介素17(IL-17)、白细胞介素33(IL-33)以及1-磷酸鞘氨醇(S1P)在支气管哮喘患者血清中的表达及临床意义。方法:选择2014年5月至2016年8月期间,我院就诊的82例支气管哮喘患者,根据喘息控制情况分为急性发作组(n=45)和临床缓解组(n=37),另外随机选择门诊健康人35例作为对照组,采用酶联免疫吸附法(ELISA)检测各组受试者血清中IL-17、IL-33、S1P水平。同时检测各组受试者的肺功能,记录FEV_1(%)、PEF(%)以及FEV_1/FVC值,并分析血清IL-17、IL-33以及S1P水平分别与FEV_1(%)、PEF(%)以及FEV_1/FVC的相关性。结果:(1)急性发作期组患者的血清IL-33以及S1P水平均显著高于临床缓解组,差异有统计学意义(t=8.915,21.501;P=0.000,0.000);临床缓解组患者的血清IL-17、IL-33以及S1P水平均显著高于对照组,差异均有统计学意义(t=11.306,6.433,16.257;P=0.000,0.000,0.000)。(2)急性发作期组患者的FEV_1(%)、PEF(%)以及FEV_1/FVC均显著低于临床缓解组,差异均有统计学意义(t=9.063,9.199,6.190;P=0.000,0.000,0.000);临床缓解组患者的FEV_1(%)、PEF(%)以及FEV_1/FVC均显著低于对照组,差异均有统计学意义(t=4.288,4.485,7.634;P=0.000,0.000,0.000)。(3)Pearson相关性分析显示,支气管哮喘患者血清IL-17水平与FEV_1(%)、PEF(%)以及FEV_1/FVC之间并无显著相关性(P>0.05),而IL-33水平与FEV_1(%)、PEF(%)以及FEV_1/FVC之间均呈负相关(r=-0.893,-0.842,-0.696;P<0.01)。S1P水平与FEV_1(%)、PEF(%)以及FEV_1/FVC之间均呈负相关(r=-0.656,-0.709,-0.775;P<0.01)。结论:支气管患者血清IL-17、IL-33、S1P表达均升高,IL-33、S1P可以作为气道炎症反应严重程度的指标。

Objective： To study the expression and clinical significance of serum interleukin-17（ IL-17）,interleukin-33（ IL-33） and serum sphingosine 1-phosphate（ S1 P） in patients with bronchial asthma.Methods： Eighty-two patients with bronchial asthma were enrolled in this study from May 2014 to August 2016.They were divided into acute attack group（ n = 45） and clinical remission group（ n = 37）. The levels of IL-17,IL-33 and S1 P in the serum of each group were detected by enzyme-linked immunosorbent assay（ ELISA）. At the same time,the pulmonary function of each group was measured,including FEV1（ %）,and FEV1/FVC values. And the correlation between the levels of serum IL-17,IL-33,S1 P and FEV1（ %）,PEF（ %） and FEV1/FVC were analyzed. Results：（1）The level of serum IL-33 and S1 P in acute attack group were significantly higher than those of clinical remission group（ t = 8. 915,21. 501; P = 0. 000,0. 000）. The levels of serum IL-17,IL-33 and S1 P in the clinical remission were significantly higher than those in the control group（ t = 11. 306,6. 433,16. 257; P = 0. 000,0. 000,0. 000）.（2） The FEV1（ %）,PEF（ %） and FEV1/FVC in acute exacerbation group were significantly lower than those in clinical remission group（ t = 9. 063,9. 199,6. 190; P = 0. 000,0. 000,0. 000）,the FEV1（ %）,PEF（ %） and FEV1/FVC in the clinical remission group were significantly lower than those in the control group（ t = 4. 288,4. 485,7. 634; P = 0. 000,0. 000,0. 000）.（3） Pearson correlation analysis showed that there was no significant correlation between serum IL-17 level and FEV1（ %）,PEF（ %） and FEV1/FVC in bronchial asthma patients（ P〈0. 05）. The levels of IL-33 were negatively correlated with FEV1（ %）,PEF（ %） and FEV1/FVC（ r =-0. 893,-0. 842,-0. 696;P〈0. 01）. There was a negative correlation between FEP1（ %）,PEF（ %） and FEV1/FVC（ r =-0. 656,-0. 709,-0. 775; P〈0. 01）. Conclusion： The levels of IL-17,IL-33 and S1 P in serum of bronchial patients are significantly increased,and IL-33,S1 P can be used as indicators of the severity of airway inflammation.