IL-8与FeNO在不同炎症表型的咳嗽变异性哮喘患者中的水平及临床意义

The level and clinical significance of fractional exhaled nitric oxide and Interleukin-8 in patients with different inflammatory phenotypes ofcough variant asthma

目的研究不同炎症表型咳嗽变异性哮喘(CVA)组的患者白细胞介素8(IL-8)、呼出气一氧化氮(FeNO)这两个炎症指标的水平,推测它们在不同炎症表型CVA病理生理中的具体可能机制。方法选取就诊于包头市中心医院呼吸科门诊的不同炎症表型的CVA的患者共87例进行回顾性分析,依据诱导痰炎症细胞分类结果将患者分为4组,分别是中性粒细胞(Neu)组、嗜酸粒细胞(Eos)组、混合细胞(Mix)组、寡粒细胞(Pau)组,同期在本院随机选取健康者25名作为对照组,所有入组对象均采集清晨空腹血,并分离出血清,进行FeNO及血清IL-8浓度的测定以及血清总免疫球蛋白E(IgE)的测定。分析不同炎症表型CVA患者IgE、IL-8浓度,FeNO值及肺功能的差异。结果(1)总体比较,5组数据的FeNO值差异有统计学意义(H=53.128,P<0.001),分别进行两两比较FeNO水平在Eos组和Mix组中明显高于其他3组,Mix组与Eos组比较差异无统计学意义,其余3组间相互比较差异均无统计学意义(P值均>0.05)。(2)在Eos组中血清总IgE与其他4组比较,差异均有统计学意义(P<0.001),血清总IgE值在Mix组和对照组差异有统计学意义(P<0.05),其他各组间进行两两比较差异均无统计学意义(P>0.05)。(3)总体比较血清IL-8浓度,5组血清IL-8浓度差异有统计学意义(H=55.840,P<0.001),两两进行比较时Neu组和Mix组中IL-8浓度明显高于其余3组,差异有统计学意义(P<0.001)。Neu组的IL-8也高于Mix组,差异有统计学意义(P<0.001)。Eos组的IL-8浓度高于对照组,而其他组间相互比较差异无统计学意义(P>0.05)。结论血清IgE、IL-8浓度和FeNO这3种炎症指标对不同炎症表型的CVA患者的鉴别提供新的理论依据,也为CVA诊断及治疗提供一定的临床价值。

Objective To study the levels of interleukin-8(IL-8)and fractional exhaled nitric oxide(FeNO)in patients with cough variant asthma(CVA)with different inflammation phenotypes,and to speculate on their specific mechanisms in the pathophysiology of CVA with different inflammation phenotypes.Methods A total of eighty-seven patients with CVA with different inflammation phenotypes were selected and divided into four groups according to the classification of induced sputum inflammatory cells[neutrophil(Neu),eosinophil(Eos),mixed granulocyte(Mix),pauci-granulocytic(Pau)].During the same period,25 healthy people were randomly selected as control group.All subjects in the group were collected fasting blood in the morning,and the bleeding serum was separated.FeNO and serum IL-8 levels were measured.Determination of serum total IgE.The levels of IgE,IL-8,FeNO and pulmonary function in CVA patients with different inflammation phenotypes were analyzed.Results(1)Overall,there were significant differences in FeNO values between the five groups(H=53.128,P<0.001).FeNO levels in Eos and Mix groups were significantly higher than those in the other three groups.There was no difference between Mix group and Eos group,and there was no difference among the other three groups(all P>0.05).(2)There was significant difference between Eos group and other four groups in serum total IgE(P<0.001).There was also difference in serum total IgE between Mix group and control group(P<0.05).There was no difference between other groups in two comparisons(P>0.05).(3)Comparing the serum IL-8 concentration in general,the serum IL-8 concentration in the five groups had significant difference(H=55.840,P<0.001).The serum IL-8 concentration in Neu group and Mix group was significantly higher than that in the other three groups,and the difference was statistically significant(P<0.001).IL-8 in Neu group was also higher than that in Mix group,with statistical significance(P<0.001).The concentration of IL-8 in Eos group was higher than that in control group,but there was no significant difference among other groups(P>0.05).Conclusions Serum IgE,IL-8 and FeNO provide new theoretical basis for differentiating CVA patients with different inflammation phenotypes,and also provide certain clinical value for the diagnosis and treatment of CVA.