哮喘患者血清肿瘤坏死因子α水平与肺功能的相关性研究

目的：探讨哮喘患者血清肿瘤坏死因子α（TNF-α）水平变化对肺通气功能的影响。方法：正常人18例（A组）、哮喘患者急性发作期16例（B组）及缓解期16锄（C组）分别抽取其静脉血以酶联免疫吸附法（ELISA）测定血清TNF-α水平，并测定其与肺功能指标的相关性，结果进行统计分析。结果：三组间血清TNF-α水平有极显著性差异（F为26.27，P〈0.001）。q检验结果：B组患者血清TNF吨水平显著高于A组和C组，有极显著性差异（q’为6.378，3．654；P〈0.001），A组与C组比较，有非常显著性差异（q为5.875，P〈0.01）。肺功能指标与血清TNF-α的相关性分析结果显示哮喘患者血清TNF-α水平与FEV1％、FEV1/FVC呈负性相关（r值分别为-0．83，-0．69；均P〈0．05），但其与Vmax25出和Vmax50则无相关关系（，值分别为-0.27，-0.31；P〉0.05）。结论：前炎性细胞因子TNF-α在哮喘急性发作期参与气道炎症的形成和肺通气功能的下降；在哮喘缓解期，其作用在于参与气道炎症的维持。

Correlation study between the serum tumor necrosis factor-α level and pulmonary function in asthma

Objective：To evaluate the effects of the serum tumor necrosis factor alpha（ TNF-α）level on pulmonary ventilation function in asthma.Methods：All subjects were divided into three groups, including A（ 18 healthy volunteers as controls）, B （16 cases of bronchial asthma attacks）and C（16 cases in stable conditions）.Serun TNF-α levels were measured by ELISA. Statistical sinificance was analysed using analysis of variance and Student New-Keuls test and Duncan＇s new mul- tiple range method, we also assayed the correlation between TNF-α and pulmonary ventilation function.Results： The activity of TNF-α in group B was sinificantly higher than those of group A （q ＇= 6.378, P〈0.001 ） and C（q ＇= 3.654, P〈0.001）, there was abvious difference between group A and C （q= 5.875, P〈0.01 ）. There was negative correlation between serum TNF-α and FEV1% （r=-0.83, P〈0.01 ） and FEV1/FVC （ r =-0.69,P〈0.01） in asthma, but serum TNF-α showed no sig nificant correlation with Vmax25（r=-0.27,P〉0.05 ） and Vmax50=-0.31,P〉0.05 ）. Conclusion：Proinflammatory cytokine TNF-α plays important roles in the formation of airway inflammation and descent of pulmonary ventilation function in acute phase in asthma, and it takes part in the maintenance of airway inflammation and damage of small airway function in stable phase.