哮喘患者外周血转化生长因子β1与呼吸阻抗关系的研究

目的探讨不同程度的支气管哮喘患者血清转化生长因子β1（TGF-β1）的变化及其与脉冲振荡技术（IOS）测定呼吸阻抗各主要指标之间的关系。方法用酶联免疫吸附试验（ELISA）测定56例不同程度的支气管哮喘患者的血清TGF-β1水平，同时作IOS肺功能检测，并设30例健康对照组。结果哮喘组血清TGF-β1浓度较对照组低，中重度组较轻度组低，各组间差异均有显著性（P〈0．05或P〈0．001）；哮喘组呼吸总阻抗（Zrs）、5Hz和20Hz黏性阻力（R5、R20），5Hz与20Hz时的黏性阻力差（R5—R20）、共振频率（Fres）、中心阻力（Rc）、周边阻力（Rp）与对照组比较均增高，5Hz振荡频率时的电抗（X5）降低；血清TGF-β1水平与呼吸阻抗指标Zrs、R5、R5—R20、Fres呈显著负相关，与X5呈显著正相关，其中Fres的相关性最为密切，与Rc无相关性。结论哮喘患者血清TGF-β1水平下降与呼吸阻抗的增高和病情严重程度有直接关系，通过血清TGF-β1水平能间接反映哮喘患者气道阻力的变化，可作为支气管哮喘诊断、病情判断的参考指标。

Study on the Relationship between TGF-β1 in Peripheral Blood and Respiratory Impedance in Asthmatics

Objective To investigate the change of serum TGF-β1 and the relationship between serum TGF-β1 and the main indictors of IOS in different severity asthmatics. Methods Measured TGF-β1 in peripheral blood with ELISA and IOS of 56 cases of asthma and 30 cases of healthy persons. Results The Serum TGF-β1 concentration of asthmatics was lower than that in normal control group. Serum TGF-β1 concentration in the moderate-severe asthmatics group was lower than that in the mild asthmatics group, and the difference was significant（P〈0. 05 or P〈0. 001）; There were significant increases in respiratory impedance （Zrs）, respiratory resistance 5 Hz and 20 Hz（R5, R20 ）, the difference of R5 and R20 （R5 - R20 ）, resonant frequency （Fres）, central resistance （Rc） ,peripheral resistance （Rp） in the asthma group than those in control group. Reactance in 5 Hz （X5）in the asthma group was lower than that in control group; There was a significant negative correlation between the serum TGF-β1 and the main indictors： Zrs, R5, R5- R20, Fres and a significant positive correlation between the serum TGF-β1 and X5. The serum TGF-β1 had the highest correlativity with Fres and no correlation with Rc. Conclusion Serum TGF-β1 level down has direct relation with the increase of lOS and the disease severity and serum TGF-β1 level could indirectly reflect the changes of airway resistance in asthma patients. It could be used as a reference index for diagnosis and judgment of patient＇s condition with asthma.