激素抵抗型哮喘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表达水平的相关

Correlation between Treatment Response and Expression Level of Actin Depolymerization Factor in Peripheral Venous Blood of Glucocorticoid Hormone in Patients with Steroid Resistant Asthma

目的:分析研讨激素抵抗型哮喘(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:随机从本院2015年8月-2017年8月收治的支气管哮喘患者中抽取85例作为研究对象,回顾分析其病历资料,患者FEV1%≤75%,其中包含49例激素敏感型哮喘(SSA)患者(SSA组),36例SRA(SRA组),患者均口服泼尼松龙药物治疗。治疗前后测定其外周血ADF和肺功能指标,以及中性粒细胞计数百分比(S-NEU%)、诱导痰嗜酸性细胞(S-EOS%)、中性粒细胞计数百分比(B-NEU%)、嗜酸性粒细胞(B-EOS%),统计整理患者各项指标,如年龄、体重、糖尿病史、家族疾病史等,分析其相关性。结果:治疗前后,SRA组ADF均高于SSA组(P<0.05);SSA组治疗后低于治疗前(P<0.05),SRA组治疗后虽低于治疗前,但差异无统计学意义(P>0.05)。治疗后,SRA组S-NEU%、S-EOS%、B-EOS%、B-NEU%均高于SSA组,差异均有统计学意义(P<0.05)。治疗后ADF指标与FEV1%呈负相关(P<0.05),与PEF%、S-NEU%均呈正相关(P<0.05);治疗后,ADF与S-EOS%、B-NEU%、B-EOS%均无明显关系(P>0.05)。Logistic回归分析,影响哮喘患者发生激素抵抗因素包含高血脂、糖尿病史、高血压史、激素使用时间、激素抵抗型家族史。结论:临床可用ADF指标预测SRA患者对糖皮质激素治疗的反应性,此两者之间存在一定关联,且高血脂、糖尿病史、高血压史、激素使用时间、激素抵抗型家族史为影响哮喘患者发生激素抵抗型的独立危险因素。

Objective：To analyze and discuss the correlation between treatment response and expression level of actin depolymerization factor（ADF） in peripheral venous blood of glucocorticoid hormone in patients with steroid resistant asthma（SRA）.Method：85 patients with bronchial asthma and who treated in our hospital from August 2015 to August 2017 were selected as the research objects,and the medical records of patients with FEV1% less than or equal to 75% were retrospective analyzed,including 49 patients with steroid-sensitive asthma（SSA,SSA group）,and 36 cases of SRA（SRA group）,they were treated with Prednisolone.Then,the peripheral blood ADF and lung function indexes before and after treatment,the percentage of neutrophil counts（S-NEU%）,induced phlegm eosinophilic cells（S-EOS%）,neutrophil count percentage（B-NEU%）,eosinophil（B-EOS%）,the patients＇ s indexes, such as age, weight, history of diabetes, family history of disease, were analyzed.Result：Before and after treatment,the ADF in SRA group was higher than that in the SSA group（P〈0.05）.In the SRA group,after treatment was lower than before treatment（P〈0.05）.After treatment,the SRA group was lower than that before treatment,but the difference was not statistically significant（P〈0.05）.After treatment,S-NEU%,S-EOS%,B-EOS% and B-NEU% in SRA group were higher than those in SSA group,the differences were statistically significant（P〈0.05）.After treatment,ADF was negatively correlated with FEV1%（P〈0.05）,and were positively correlated with PEF% and S-NEU%（P〈0.05）.After treatment,there were no significant correlations between ADF and S-EOS%, B-NEU% and B-EOS%（P〈0.05）.After Logistic regression analysis,the factors affecting the hormone resistance in asthmatic patients include hyperlipidemia,diabetes history, hypertension history,hormone use time,and family history of hormone resistance.Conclusion：The clinical use of ADF indicators predicts the responsiveness of SRA patients to glucocorticoid therapy,which is associated with high blood lipid,history of diabetes,history of hypertension, time of hormone use,hormone resistance family history as an independent risk factor that affects the hormone resistant type of asthma patients.