诱导痰细胞因子与支气管哮喘患者哮喘严重程度和气道反应性的关系

目的探讨诱导痰中各种细胞因子与支气管哮喘严重程度和气道反应性的关系,为临床诊治提供科学依据。方法支气管哮喘患者130例,按照哮喘控制测试（ACT）评分分为3组,完全控制组24例,部分控制组72例,未控制组34例,采用酶联免疫吸附法检测诱导痰中细胞间黏附因子-1（ICAM-1）、嗜酸细胞阳离子蛋白（ECP）和白细胞介素-13（IL-13）浓度;采用高渗盐水雾化吸入行支气管激发试验测定患者的气道反应性。结果3组患者诱导痰中ECP浓度、气道反应性比较,差异均有统计学意义（P〈0.05）,完全控制组ECP浓度低于部分控制组、未控制组（P〈0.05）,部分控制组低于未控制组（P〈0.05）;完全控制组气道反应性雾化吸入高渗盐水量多于部分控制组、未控制组（P〈0.05）,部分控制组多于未控制组（P〈0.05）。3组诱导痰中ICAM-1、IL-13比较,差异均无统计学意义（P〉0.05）。诱导痰中ECP与患者ACT评分呈负相关关系（P〈0.05）,而ICAM-1、IL-13与ACT评分无相关关系（P〉0.05）;IL-13与气道反应性呈负相关关系（P〈0.05）,而ECP、ICAM-1与气道反应无相关（P〉0.05）。结论诱导痰中ECP可反映患者哮喘严重程度,IL-13可反映患者的气道反应性,两者对支气管哮喘的诊疗有指导作用。

Relationship between Cytokines in Induced Sputum and Severity of Asthma,Airway Responsiveness in Patients with Bronchial Asthma

Objective To investigate the relationship between cytokines in induced sputum and the severity of asthma,airway responsiveness in patients with bronchial asthma,and to provide a scientific basis for clinical diagnosis and treatment.Methods One hundred and thirty patients with bronchial asthma were divided into 3 groups in accordance with the asthma control test（ ACT） scores： control group of 24 cases,partial control group of 72 cases,and non-control group of 34 cases.Enzyme-linked immunosorbent assay was used to detect the concentrations of intercellular adhesion molecule-1（ ICAM-1）,eosinophil cationic protein（ ECP） and interleukin 13（ IL-13）,and the airway responsiveness was detected by inhalation for bronchial provocation test by aerosol inhalation of hypertonic saline. Results There were significant differences in the concentration of ECP in induced sputum and airway responsiveness among 3 groups（ P 〈 0. 05）,the concentration of ECP was lower in the control group in contrast with that in the partial control group or non-control group（ P 〈 0. 05）,which was lower in the partial control group than that in the non-control group（ P 〈 0. 05）. The hypertonic saline volume in aerosol inhalation in the control group was more than that in the partial control group or non-control group（ P 〈 0. 05）,which in the partial control group was more than that in the non-control group（ P 〈 0. 05）. There were no significant differences in ICAM-1,IL-13 in induced sputum among 3 groups（ P 〈 0. 05）. ECP in induced sputum negatively correlated with ACT scores（ P 〈 0. 05）,while ICAM-1 and IL-13 had no correlation with ACT scores（ P 〈 0. 05）. IL-13 negatively correlated with airway responsiveness（ P 〈 0. 05）,while ECP,ICAM-1 had no correlation with airway responsiveness（ P 〈 0. 05）.Conclusion ECP in induced sputum can reflect the severity of asthma and IL-13 can reflect the airway responsiveness,they play a guidance role on the diagnosis and treatment of asthma