慢性咳嗽患者血清中IL-17、IL-33水平和FeNO浓度检测及其临床意义

目的：探讨慢性咳嗽患者血清中白细胞介素17（IL-17）、白细胞介素33（IL-33）水平与呼出气一氧化氮（FeNO）浓度的关系，进一步评估其在慢性咳嗽发病机制中的作用。方法：选择因慢性咳嗽8周以上就诊的160例患者作为慢性咳嗽组，同期在本院体检中心体检的60名健康者作为健康对照组。所有被选定研究对象均检测血清IL-17和IL-33水平，完成肺功能、FeNO浓度和综合过敏原检测。所有数据采用GraphPad Prism统计软件进行处理。比较2组研究对象血清中IL-17和IL-33水平，分析慢性咳嗽患者血清IL-17及IL-33水平与肺功能和FeNO浓度的相关性。结果：慢性咳嗽组患者血清中IL-17和IL-33水平均高于健康对照组（P<0.05）。慢性咳嗽组患者血清IL-17和IL-33水平均与患者第一秒用力呼气容积占预计值的百分比（FEV1%）呈负相关关系（r=-0.6245，r=-0.6722，均P<0.01），血清IL-33水平与FeNO浓度呈正相关关系（r_s=0.758，P<0.05），FeNO浓度越高，患者血清IL-33水平越高。慢性咳嗽患者血清中总IgE<100IU·mL^-1组患者FeNO浓度的几何均数（33ppb）明显低于总IgE>200IU·mL^-1组（78ppb）和总IgE100~200IU·mL^-1（69ppb）组（P<0.01）；后2组间比较差异无统计学意义（P=0.0824）。结论：血清IL-17和IL-33可能作为促炎因子参与慢性咳嗽的发病机制。血清IL-17和IL-33水平与慢性咳嗽患者肺通气功能改变呈负相关关系，血清IL-33升高可能预测嗜酸粒细胞性气道炎症并反映其严重程度。

Detection of levels of serum interleukin-17, interleukin-33 and concentration of fractional exhaled nitric oxide in patients with chronic cough and its clinical significance

Objective:To investigate the relationships between the levels of serum interleukin-17 (IL-17),interleukin-33 (IL-33) and the concentration of fractional exhaled nitric oxide (FeNO) in the patients with chronic cough,and to further evaluate their effects in the pathogenesis of chronic cough.Methods:A total of 160 patients diagnosed with chronic cough for more than 8 weeks were chosen and used as chronic cough group.At the same time,60 healthy controls received physical examination were selected as healthy control group.The levels of serum IL-17 and IL-33 of the subjects were examined and pulmonary function test,FeNO concentration test and comprehensive allergen test were performed.All data were analyzed by GraphPad Prism statistical software.The levels of serum IL-17 and IL-33 were compared between chronic cough group and healthy control groups.The correlations between the levels of serum IL-17 or IL-33 and lung function or FeNO in the patients with chronic cough were further analyzed.Results:The serum IL-17 and IL-33 levels of the patients in chronic cough groups were higher than those in healthy control group (P＜0.05).The serum IL-17 and IL-33 levels in the patients with chronic cough showed a significant negative correlations with the percentage of the first second force expiratory volume to the estimated value (FEV1％) of the patients (r=-0.624 5,r=-0.672 2),and the level of serum IL-33 in the patients with chronic cough was positively correlated with the concentration of FeNO;the higher the concentration of FeNO,the higher the level of serum IL-33 (rs =0.758,P＜0.05).The FeNO concentration geometric mean of the patients with the serum total IgE＜100 IU · mL-1 (33 ppb) was significantly lower than those with the serum total IgE＞200 IU · mL-1 (78 ppb) and IgE 100-200 IU · mL 1 (69 ppb) among the chronic cough patients (P＜0.01),but there was no significant difference between the later two groups (P=0.082 4).Conclusion:The serum IL-17 and IL-33 may play an important role in the pathogenesis of chronic cough as proinflammatory factors.The levels of serum IL-17 or IL-33 have negative correlations with the pulmonary ventilation function in the patients with chronic cough.The increasing of serum IL-33 level may predict the formation of eosinophilic airway inflammation and reflect the severity of eosinophilic airway inflammation.