血清骨膜蛋白、呼出气一氧化氮、痰及血嗜酸性粒细胞与哮喘的相关性研究

Study on the relationship between serum periosteal protein, exhaled nitric oxide, induced sputum, blood eosinophils and asthma

目的:观察哮喘患者血清骨膜蛋白浓度,探讨其与呼出气一氧化氮(FeNO)水平、诱导痰及外周血嗜酸性粒细胞(EOS)计数、肺功能指标第1秒用力呼气量(FEV1)占预计值(FVC)百分比的关系及其临床意义。方法:选择包头医学院第二附属医院呼吸内科病房哮喘急性发作期的患者65例作为哮喘组及门诊健康体检者25例作为健康组,分别检测两组患者的血清骨膜蛋白浓度、呼出气一氧化氮水平、外周血嗜酸性粒细胞百分比及肺功能FEV1/FVC;显微镜进行细胞分类及计数检测诱导痰EOS计数;Pearson直线相关分析血清骨膜蛋白与其他指标的相关性。结果:哮喘组患者血清骨膜蛋白浓度、FeNO水平及外周血和痰EOS百分比均高于健康组,哮喘组FEV1/FVC低于健康组(P<0.05);哮喘组患者血清骨膜蛋白浓度与FeNO水平、外周血及痰EOS百分比均呈正相关(r=0.565,P=0.000;r=0.541,P=0.000;r=0.268,P=0.000),与FEV1/FVC呈负相关性(r=-0.101,P=0.061);FeNO水平与外周血及痰EOS百分比均呈正相关(r=0.284,P=0.000;r=0.340,P=0.000);与FEV1/FVC无明显相关性(r=0.040,P=0.051)。结论:哮喘患者急性发作期血清骨膜蛋白浓度明显升高,FeNO水平也增高,可反映哮喘患者气道炎症水平,尤其是嗜酸性粒细胞性炎症。

Objective:To observe the concentration of serum periosteal protein in patients with asthma and to explore the relationship between serum periosteal protein and exhaled nitric oxide (FeNO) level, induced sputum and peripheral blood eosinophils (EOS) count, lung function index forced inspiratory volume in1second (FEV1) as a percentage of predicted (FVC) and its clinical significance. Methods: 65 patients with acute attack of asthma in the Department of Respiratory Medicine, the second affiliated Hospital of Baotou Medical College were selected as the asthma group and 25 healthy outpatients as the healthy group. The concentration of serum periosteal protein, the level of exhaled nitric oxide, the percentage of eosinophils in peripheral blood and pulmonary function FEV1/FVC were measured by light microscope to detect the EOS count of induced sputum. The correlation between serum periosteal protein and other indexes was analyzed by Pearson linear correlation analysis. Results: The concentration of serum periosteal protein, the level of FeNO and the percentage of EOS in peripheral blood and sputum in the asthma group were higher than those in the healthy group, and the FEV1/FVC in the asthma group was lower than that in the healthy group. In asthma group, the concentration of serum periosteal protein was positively correlated with the level of FeNO and the percentage of EOS in peripheral blood and sputum ( r =0.565, P =0.000, r =0.541, P =0.000), and negatively correlated with FEV1/FVC ( r =-0.101, P =0.061). The level of FeNO was positively correlated with the percentage of EOS in peripheral blood and sputum ( r =0.284, P =0.000;r =0.340, P =0.000). There was no significant correlation with FEV1/FVC ( r =0.040, P =0.051). Conclusion: The concentration of serum periosteal protein and the level of FeNO in patients with asthma are significantly higher than those in patients with asthma, which can reflect the level of airway inflammation, especially eosinophilic inflammation in patients with asthma.