老年肺炎支原体感染合并支气管哮喘患者血清TNF-α,IL-4和IgE的表达

Expression of serum TNF-α,IL-4 and Ig E in elderly patients with mycoplasma pneumonia Infection and bronchial asthma

目的观察血清肿瘤坏死因子(TNF)-α,白细胞介素(IL)-4和免疫球蛋白(Ig)E在合并哮喘或无哮喘的肺炎支原体感染老年患者的表达及临床意义。方法选择肺炎支原体老年患者(观察1组,45例)和肺炎支原体合并支气管哮喘老年患者(观察2组,50例);同时选择相匹配的50例老年体检者作为对照组;检测三组研究对象的血清TNF-α、IL-4和Ig E水平;比较三组FEV1占预计值百分比(FEV1%pred)、第一秒用力呼气容积(FEV1)/用力肺活量(FVC)、哮喘控制测试(ACT)评分和痰嗜酸粒细胞(EOS)计数;并分析以上指标间的相关性。结果观察2组患者血清TNF-α、IL-4和Ig E水平均显著高于观察1组(P<0.01);观察2组患者FEV1/FVC、FEV1%pred以及ACT评分均明显低于观察1组,而痰EOS显著高于观察1组(P<0.01);血清TNF-α、IL-4和Ig E水平与肺炎支原体哮喘相关指标FEV1/FVC、FEV1%pred和ACT评分呈负相关(P<0.01),而与痰EOS呈正相关(P<0.01);肺炎支原体感染合并哮喘老年患者血清TNF-α水平与IL-4和Ig E均呈正相关(P<0.01),血清Ig E水平与IL-4也呈正相关(P<0.01)。结论血清TNF-α、IL-4和Ig E水平变化可作为评估肺炎支原体感染老年哮喘患者病情严重程度的重要指标,且与肺功能负相关。

Objective To observe expression and its clinical significance analysis of serum tumor necrosis factor( TNF)-α,interleukin( IL)-4 and immune globulin( Ig) E in elderly patients with mycoplasma pneumonia infection merged asthma or not.Methods Elderly patients with mycoplasma pneumonia infection in Dept.of Respiratory Internal Medicine of the hospital( observation 1 group,45 cases),elderly patients with mycoplasma pneumonia infection merged asthma( observation 2 group,50 cases) and 50 elderly medical examination patients matched were selected.Serum TNF-α,IL-4 and Ig E were detected.FEV1 percentage of expected value( FEV1% pred),the first second forced expiratory volume( FEV1) / forced vital capacity( FVC) asthma control test( ACT) scores and sputum eosinophilia granulocyte count( EOS) of 3 groups were compared.Correlation analysis of indexes above were completed.Results Serum TNF-α,IL-4 and Ig E in group of observation 2 group were obviously higher than those of observation 1 group( P<0.01).FEV1 / FVC,FEV1% pred and ACT scores in observation 2 group were obviously lower than those of group,while sputum EOS was evidently higher than that of observation 1 group( P<0.01).Negative correlation between serum TNF-α,IL-4,Ig E and mycoplasma pneumonia asthma related indicators of FEV1 / FVC,FEV1% pred and ACT scores,while positive correlation between serum TNF-α,IL-4,Ig E and sputum EOS were analyzed( P<0.01).Serum TNF-α in elderly patients with mycoplasma pneumonia infection and bronchial asthma had a positive correlation with IL-4 and Ig E,while serum Ig E had a negative correlation with IL-4( P<0.01).Conclusions Change level of serum TNF-α,IL-4 and Ig E could be an important index of evaluating severity of patient's condition of mycoplasma pneumonia infection merged elderly patients with bronchial asthma and negatively related to the lung function.