毛细支气管炎患儿血清TGF-β1水平与病情严重程度及肺功能指标的关联性分析

Analysis on correlations between serum level of TGF-β1 and severity of bronchiolitis and pulmonary function indexes

目的:探讨不同严重程度毛细支气管炎患儿血清转化生长因子β1(TGF-β1)水平及其与潮气呼吸肺功能指标的关联性,阐明TGF-β1水平在毛细支气管炎诊疗中的意义。方法:选取84例毛细支气管炎患儿作为毛细支气管炎组,按病情严重程度分为轻度毛细支气管炎组(n=46)和中重度毛细支气管炎组(n=38),另以同期行体检的健康婴幼儿20人作为正常对照组。分别检测急性期毛细支气管炎患儿、恢复期毛细支气管炎患儿及正常对照婴幼儿血清TGF-β1水平及潮气呼吸肺功能指标,采用Pearson相关分析法分析血清TGF-β1水平与潮气呼吸肺功能指标的相关性。结果:急性期轻度毛细支气管炎组和中重度毛细支气管炎组患儿血清TGF-β1水平均明显高于正常对照组(P<0.01);与急性期轻度毛细支气管炎组比较,急性期中重度毛细支气管炎组患儿血清TGF-β1水平升高(P<0.01);与急性期比较,恢复期轻度和中重度毛细支气管炎组患儿血清TGF-β1水平均明显降低(P<0.01)。轻度和中重度毛细支气管炎组患儿达峰时间比(TPTEF/TE)及达峰容积比(VPEF/VE)均明显低于正常对照组(P<0.05);与轻度毛细支气管炎组比较,中重度毛细支气管炎组患儿TPTEF/TE和VPEF/VE明显降低(P<0.05)。3组研究对象每公斤体重潮气量(VT/kg)比较差异无统计学意义(P>0.05)。毛细支气管炎组患儿血清TGF-β1与TPTEF/TE及VPEF/VE均呈负相关关系(r=-0.552,P<0.01;r=-0.517,P<0.01)。结论:毛细支气管炎患儿血清TGF-β1水平能间接反映患儿的气道阻塞程度,可作为毛细支气管炎病情判断及肺功能预后评估的参考指标。

Objective:To investigate the levels of serum transformed growth factor beta 1(TGF-β1)in the bronchiolitis pediatric patients with different severities and its correlations with the indexes of tidal breathing pulmonary function,and to discuss the significance of TGF-β1 in the diagnosis and treatment of bronchiolitis.Methods:A total of 84 cases of pediatric patients with bronchiolitis were selected as bronchiolitis group,and they were divided into mild bronchiolitis group(n=46)and moderate-severe bronchiolitis group(n=38)according to the severity of the disease.Another 20 healthy infants who underwent physical examination at the same time were selected as healthy control group.The levels of serum TGF-β1 and the ridal breathing pulmonary function indexes of the pediatric patients at acute and convalescent phases and the subjects in healthy control group were detected,and Pearson correlation analysis was used to analyze the correlations between the serum level of TGF-β1 and the tidal breathing pulmonary function indexes.Results:The serum levels of TGF-β1 of the pediatric patients in mild bronchitis group and moderate-severe bronchiolitis group at acute phase were significantly higher than those in healthy control group(P<0.01).Compared with mild bronchitis group,the serum TGF-β1 level of the pediatric patients in moderate-severe bronchiolitis group at acute stage was significantly increased(P<0.01).Compared with acute stage,the serum TGF-β1 levels of the pediatric patients in mild and moderate-severe bronchiolitis groups at convalescence stage were significantly decreased(P<0.01).The TPTEF/TE and VPEF/VE of the pediatric patients in mild and moderate-severe bronchiolitis groups were significantly lower than those in healthy control group(P<0.05).Compared with mild bronchiolitis group,the TPTEF/TE and VPEF/VE of the pediatric patients in moderate-severe bronchiolitis group were significantly decreased(P<0.05).There was no significant difference in the tidal volume per kilogram of body weight among the subjects in three groups(P>0.05).The serum level of TGF-β1 of the bronchiolitis pediatric patients was negatively correlated with TPTEF/TE and VPEF/VE(r=-0.552,P<0.01;r=-0.517,P<0.01).Conclusion:The serum level of TGF-β1 in the bronchiolitis pediatric patients can indirectly reflect the degree of airway obstruction,which can be used as a reference indicator for the condition judgment of bronchiolitis and the prognosis evaluation of lung function.