诱导痰中性粒细胞S100A8/A9在支气管哮喘患儿中的表达及其临床意义

Expression and clinical significance of induced sputum neutrophil S100 A8/A9 in children with bronchial asthma

目的探讨诱导痰中性粒细胞S100A8/A9在支气管哮喘患儿中的表达及其临床意义。方法选取2014年10月—2015年10月南昌大学第四附属医院确诊的108例支气管哮喘患儿,根据疾病的严重程度分为轻度组(40例)、中度组(36例)和重度组(32例),另取同期20例健康检查者作为对照组。所有患儿给予布地奈德气雾剂规范治疗3个月,对照组以生理盐水雾化吸入。治疗前后采用第1秒用力呼气容积(FEV1)与用力肺活量(FVC)的比值(FEV1/FVC,FEV1%)评价2组的肺功能,哮喘控制问卷(AcQ-5)评分评价患者哮喘控制情况,荧光定量PCR检测诱导痰中性粒细胞S100A8/A9 mRNA的表达水平,并分析S100 A8/A9 mRNA表达与AcQ-5评分、FEV1%的相关性。结果治疗前随着哮喘程度的加重,轻、中、重度组AcQ-5评分升高,FEV1%降低,痰中性粒细胞S100A8/A9 mRNA表达升高,差异均有统计学意义(均P<0.01)。经过3个月治疗后,哮喘完全控制者60例、部分控制者31例、未控制者17例。随着治疗效果的改善,患者诱导痰中性粒细胞S100A8/A9 mRNA表达水平升高,差异有统计学意义(均P<0.01)。哮喘患者诱导痰中性粒细胞S100A8/A9 mRNA水平与FEV1%呈负相关(r分别为-0.327和-0.406,均P<0.05),与AcQ-5评分呈正相关(r分别为0.704和0.817,均P<0.05)。结论诱导痰中性粒细胞S100A8/A9表达水平与哮喘的严重程度呈正相关,可作为临床观察哮喘严重程度及疗效的指标。

Objective To investigate the expression and clinical significance of neutrophil S100A8/A9 in induced sputum in children with bronchial asthma. Methods A total of 108 cases of bronchial asthma patients in the Fourth Affiliated Hospital of Nanchang University were involved in the study form October 2014 to October 2015. According to the severity of the disease, the patients were divided into mild group (n=40), moderate group (n=36) and severe group (n=32).Twenty health children were taken as control group at the same period. All the patients were treated with budesonide aerosol for three months, and the control group was received aerosol inhalation for normal saline (NS). The ratio of forced expiratory volume in one second and forced vital capacity (FEV1/FVC, FEV1%) were used to evaluate the pulmonary function in two groups. The asthma control questionnaire (AcQ-5) score was used to estimate the asthma control effects. The expression level of neutrophil S100A8/A9 mRNA in induced sputum was detected by real-time PCR. The correlation of S100A8/A9 mRNA, AcQ-5 score and FEV1% was analyzed. Results Before the treatment, the FEV1% decreased, while the AcQ-5 score and express level of S100A8/A9 mRNA significantly increased with the severity of disease (all P < 0.01). Three months after treatment, asthma was completely controlled in 60 patients, partial controlled in 31 cases and uncontrolled in 17 cases.With the improvement of the therapeutic efficacy, the FEV1% significantly decreased, while the express level of S100A8/A9 mRNA significantly increased (all P < 0.01). The express level of S100A8/A9 mRNA in induced sputum neutrophils was negatively correlated with FEV1% (r=-0.327 and -0.406 respectively, P < 0.05), which was positively correlated with ACQ-5 score (r=0.704 and 0.817, P < 0.05). Conclusion The level of S100A8/A9 expression in induced sputum neutrophil is positively correlated with the severity of asthma, which can be used as clinical indicators of the severity and the efficacy of asthma.