支气管哮喘急性发作患者血清NF-κB和FeNO变化及其意义探讨

Changes of serum NF-κB and FeNO in patients with acute attack of asthma and their significance

目的观察支气管哮喘急性发作患者血清核转录因子-κB(NF-κB)、呼出气一氧化氮(FeNO)变化,并探讨其临床意义。方法选取支气管哮喘急性发作患者78例、支气管哮喘持续期患者80例、支气管哮喘缓解期患者75例、健康志愿者76例分别记为发作组、持续组、缓解组、对照组,检测4组血清NF-κB、FeNO,对比4组差异;对比发作组患者中轻度、中度、重度病情患者血清NF-κB、FeNO;评价发作组近期预后,对比发作组近期预后不良、预后良好患者血清NF-κB、FeNO水平,分析血清NF-κB、FeNO水平对发作组近期预后不良的预测效能。结果4组血清NF-κB、FeNO差异均有统计学意义(P<0.05),其中发作组血清NF-κB、FeNO均高于其余3组,缓解组和持续组均高于对照组,持续组均高于缓解组,差异均有统计学意义(P<0.05);发作组不同病情患者血清NF-κB、FeNO差异均有统计学意义(P<0.05),其中重度患者血清NF-κB、FeNO均高于轻度和中度患者,中度患者均高于轻度患者,差异均有统计学意义(P<0.05);发作组近期预后不良发生率为24.36%,血清NF-κB、FeNO水平联合预测发作组近期预后不良的灵敏度和AUC均高于单独预测(P<0.05),且特异度与单独预测差异无统计学意义(P>0.05)。结论支气管哮喘急性发作患者血清NF-κB、FeNO普遍偏高,且与病情相关,二者联合可预测近期预后。

Objective To observe the changes of serum nuclear factor-κB(NF-κB)and exhaled nitric oxide(FeNO)in patients with acute attack of asthma,and to explore their clinical significance.Methods Seventy-eight patients with acute attack of asthma,80 patients with persistent asthma,75 patients with remission of asthma and 76 healthy volunteers were taken as attack group,persistent group,remission group and control group.The serum NF-κB,FeNO were measured in four groups.The serum NF-κB,FeNO of patients with mild,moderate and severe disease were compared.The short-term prognosis of seizure group was evaluated,and the serum levels of NF-κB and FeNO were compared between the attack group and the attack group.The predictive effect of serum NF-κB and FeNO levels on the short-term prognosis of seizure group was analyzed.Results The serum NF-κB,FeNO of the four groups were significantly different(P<0.05),of which the attack group were higher than those other three groups,and those in the remission group and the persistent group were higher than those in the control group,of which the persistent group were higher than those in the remission group,with statistically significant differences(P<0.05).There were statistically significant differences in serum NF-κB,FeNO among patients with different disease conditions in the attack group(P<0.05),among which,the serum NF-κB and FeNO in patients with severe disease were higher than those in patients with mild disease,and those in patients with moderate disease were higher than those in patients with mild disease,with statistically significant differences(P<0.05).The incidence of poor prognosis in attack group was 24.36%,and the sensitivity and AUC of serum NF-κB and FeNO levels in predicting short-term poor prognosis in seizure group were higher than those in single prediction group(P<0.05),and there was no significant difference in specificity between single prediction and single prediction(P>0.05).Conclusion The levels of NF-κB and FeNO in the serum of patients with acute attack of asthma are generally high,which are closely related to the conditions,and the combination of the two can predict the short-term prognosis.