老年支气管哮喘患者Th17、IL-17水平与气道重塑的关系研究

The relationship between Th17,IL-17 and airway remodeling in elderly patients with bronchial asthma

目的研究老年支气管哮喘患者辅助性T细胞17(Helper T cell 17,Th17)、白介素-17(IL-17)水平与气道重塑的关系。方法收集2017年5月~2020年5月本院98例老年支气管哮喘患者,根据病情程度将98例患者分为轻中度组(54例)和重度组(44例)。比较两组患者Th17细胞和血清IL-17水平,测量患者支气管管壁厚度(wall airway thickness,Wat)和气道平滑肌厚度(wall airway musclethickness,Wam),分析Th17细胞、血清IL-17与Wat、Wam的关系。结果重度组患者Th17细胞比例为(25.09±6.87)%,轻中度组为(21.29±5.65)%,两组外周血中Th17细胞比例差异有统计学意义(P<0.05)。重度组患者血清IL-17水平为(74.92±5.76)ng/L,显著高于轻中度组(54.23±4.61)ng/L,差异有统计学意义(P<0.05)。轻中度组患者Wat、Wam水平显著低于重度组,差异均有统计学意义(P<0.05)。支气管哮喘患者Wat、Wam与Th17、血清IL-17水平呈显著正相关性(P<0.05)。多元线性回归分析结果显示Th17细胞水平、血清IL-17及肺功能分级是影响Wat的独立影响因素(P<0.05)。结论老年支气管哮喘患者Th17细胞、血清IL-17与气道重塑密切相关,监测Th17、IL-17有助于判断气道重塑程度。

Objective To study the relationship between Helper T cell 17(Th17),interleukin-17(IL-17(and airway remodeling in elderly patients with bronchial asthma.Methods The 98 cases of elderly patients with bronchial asthma from May 2017 to May 2020 were collected as the research objects,98 patients were divided into mild to moderate group(n=54)and severe group(n=44)&which accorded to the severity of the disease.The levels of Th17 cells and serum IL-17 were compared between the two groups,the patients of wall airway thickness(Wat)and the wall airway musclethickness(Wam)were measured.The relationship between Th17 cells&serum IL-17 and Wat,Wam were analyzed.Results The percentage of Th17 cells in severe group were(25.09±6.87)%,and those in mild and moderate group were(21.29±5.65)%,the proportion of Th17 cells in peripheral blood between the two groups was significantly different(P<0.05).The serum level of IL-17 in severe group were(74.92±5.76)ng/L,which were higher than those of the mild and moderate group of(54.23±4.61)ng/L,the difference was statistically significant(P<0.05).The levels of Wat and WAM in mild to moderate group were significantly lower than those in severe group,the difference were statistically significant(P<0.05).The Wat and WAM were positively correlated with Th17 and serum IL-17 levels in patients of elderly bronchial asthma(P<0.05).The Multiple linear regression analysis showed that the Th17 cell level,serum IL-17 and lung function grade were independent factors&which affected the Wat(P<0.05).Conclusion The Th17 cells and serum IL-17 are closely related to airway remodeling in elderly patients with bronchial asthma.It is helpful to judge the degree of airway remodeling by monitoring Th17 and IL-17.