血清IL-2、IL-4、IL-5和C反应蛋白水平与哮喘急性发作的关系

Relationship between serum interleukin and CRP levels with acute exacerbation of asthma

目的探讨血清白介素和C反应蛋白(CRP)水平与哮喘急性发作的关系。方法选取2018年1月~12月甘肃省第二人民医院收治的初诊哮喘患者82例,检测比较患者急性期和稳定期的血清白介素2(IL-2)、IL-4、IL-5和CRP水平。患者出院后均随访1年,统计随访期间哮喘急性发作情况和发作次数。采用Spearman分析法分析患者急性期和稳定期的血清IL-2、IL-4、IL-5和CRP水平与其哮喘急性发作和哮喘急性发作次数的关系,并采用受试者操作特性曲线(ROC)分析哮喘患者急性期和稳定期的血清IL-2、IL-4、IL-5和CRP水平单独和联合预测其哮喘急性发作的价值。结果与稳定期比较,患者急性期血清IL-4、IL-5和CRP水平均升高,而血清IL-2水平则降低,差异有统计学意义(P<0.05)。急性期,随着病情严重程度的增加,患者血清IL-4、IL-5和CRP水平升高而血清IL-2水平则降低,差异有统计学意义(P<0.05)。随访期间患者急性发作率和平均哮喘急性发作次数分别为68.29%(56/82)和(3.12±1.25)次。与无哮喘急性发作患者比较,出现哮喘急性发作患者急性期血清IL-4、IL-5和CRP水平均升高而血清IL-2水平则降低,差异有统计学意义(P<0.05)。Spearman分析结果显示,哮喘患者急性期和稳定期的血清IL-2水平与其哮喘急性发作和哮喘急性发作次数均呈负相关(P<0.05),血清IL-4、IL-5和CRP水平与其哮喘急性发作和哮喘急性发作次数则呈正相关(P<0.05)。ROC曲线分析结果显示,哮喘患者急性期和稳定期的血清IL-2、IL-4、IL-5和CRP水平单独和联合预测其哮喘急性发作的准确性均较高,其中以稳定期血清IL-2、IL-4、IL-5和CRP水平联合预测其哮喘急性发作的准确性最高。结论血清白介素和CRP水平与哮喘急性发作和急性发作频率均密切相关,加强哮喘炎症控制可能为哮喘急性发作预防的有效措施。

Objective To investigate the relationship between serum interleukin and C-reactive protein(CRP)with acute exacerbation of asthma.Methods A total of 82 newly diagnosed asthma patients in our hospital from January 2018 to December 2018 were selected.Serum interleukin-2(IL-2),IL-4,IL-5 and CRP levels in acute phase and stable phase of the patients were measured and compared.All of the patients were followed up for at least 1 year after discharge,and the number of patients with acute exacerbation of asthma and the times of acute exacerbation during follow-up were calculated.Serum IL-2,IL-4,IL-5 and CRP levels in the acute phase and stable phase of patients with different acute exacerbation of asthma occurrence condition were compared.Spearman analysis was used to analyze the relationship between serum IL-2,IL-4,IL-5 and CRP levels in the acute phase and stable phase with acute exacerbation of asthma,and the operator's characteristic curve(ROC)was applied in analyzing the value of serum IL-2,IL-4,IL-5 and CRP in the acute phase and stable phase of asthmatic alone and jointly predicting the acute exacerbation of asthma.Results Compared with the stable phase,acute phase serum IL-4,IL-5 and CRP levels were increased,while in the same time serum IL-2 level was decreased(P<0.05).In the acute stage,with the increase of the severity of the disease,theserum IL-4,IL-5 and CRP levels in the patients decreased,while the serum levels of IL-2 decreased(P<0.05).The acute exacerbation of asthma patients rate and times of acute exacerbation of asthma during follow-up were 68.29%(56/82)and(3.12±1.25)times respectively.Compared with patients without acute exacerbations of asthma,Serum IL-4,IL-5 and CRP levels of patients with acute exacerbations of asthma were elevated while serum IL-2 levels of patients with acute exacerbations of asthma were decreased(P<0.05).Spearman analysis showed that serum IL-2 levels in acute and stable asthma patients were negatively correlated with acute exacerbation of asthma and times of acute exacerbation of asthma(P<0.05);while serum IL-4,IL-5 and CRP levels were positively correlated with acute exacerbation of asthma and times of acute exacerbation of asthma(P<0.05).ROC curve analysis showed that the accuracy of serum IL-2,IL-4,IL-5 and CRP levels in acute and stable phase of asthmatic patients in alone and in combination predicting the acute exacerbation of asthma were excellent,in which the accuracy of stable phase serum IL-2,IL-4,IL-5 and CRP in combined predicting acute exacerbation of asthma was the highest.Conclusion Serum interleukin and CRP levels are closely related to the frequency of acute exacerbation of asthma,and strengthening the control of asthma inflammation may be an effective measure to prevent the acute attack of asthma.