血IL-1β、IL-18、Eos水平与支气管哮喘急性发作病情程度的关系及对近期转归的预测效能探讨-东南大学学报医学版

血IL-1β、IL-18、Eos水平与支气管哮喘急性发作病情程度的关系及对近期转归的预测效能探讨

单位：1. 锦州中心医院急诊科, 辽宁锦州 121000;
2. 锦州中心医院肿瘤科, 辽宁锦州 121000;
3. 锦州医科大学附属第一医院呼吸科, 辽宁锦州 121000

关键词：支气管哮喘急性发作白介素-1β 白介素-18 嗜酸粒细胞病情程度近期转归

分类号：R562.25

出版年·卷·期（页码）：2022·41·第四期（464-470）

摘要：

目的：探讨血白介素（IL）-1β、IL-18、嗜酸粒细胞（Eos）水平与支气管哮喘（BA）急性发作病情程度的关系及对近期转归的预测效能。方法：选取2018年4月至2021年4月锦州中心医院BA急性发作患者86例为观察组，同期43例BA稳定期患者为对照组。比较两组血IL-1β、IL-18、Eos水平，分析BA急性发作患者血IL-1β、IL-18、Eos水平与病情程度的相关性，采用Logistic回归分析BA急性发作患者近期转归的影响因素，采用受试者工作特征（ROC）曲线分析血IL-1β、IL-18、Eos水平对BA急性发作患者近期转归的预测价值。结果：观察组血IL-1β、IL-18、Eos水平高于对照组（P<0.05）；BA急性发作患者血IL-1β、IL-18、Eos水平与病情程度呈正相关（P<0.05）；Logistic回归分析显示，将病情程度、血氧分压（PaO₂）、血二氧化碳分压（PaCO₂）控制后，血IL-1β、IL-18、Eos高表达均为BA急性发作患者哮喘未有效控制的独立危险因素（P<0.05）；ROC曲线显示，血IL-1β、IL-18、Eos水平联合预测BA急性发作患者近期转归的AUC值为0.890，高于单独预测（P<0.05）。结论：BA急性发作患者血IL-1β、IL-18、Eos水平与病情程度呈正相关，且可有效预测近期转归情况，对临床诊断、评估、治疗具有指导价值。

Objective: To explore the relationship between the levels of blood interleukin-1β (IL-1β), IL-18, eosinophils (Eos) and the severity of the acute attack of bronchial asthma (BA) and the predictive ability of blood IL-1β, IL-18 and Eos levels on short-term outcomes. Methods: From April 2018 to April 2021, 86 patients with acute onset of BA in Jinzhou Central Hospital were selected as the observation group, and 43 patients with stable phase of BA were selected as the control group during the same period.The blood levels of IL-1β, IL-18 and Eos were compared between the two groups.The correlation between the blood IL-1β, IL-18, Eos levels and the severity of the disease in patients with acute attack of BA were analyzed. Logistic regression was used to analyze the influencing factors of the short-term outcomes of patients with acute BA. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of blood IL-1β, IL-18 and Eos on the outcome of acute BA patients. Results: The blood levels of IL-1β, IL-18 and Eos in the observation group were higher than those in the control group (P<0.05).The levels of IL-1β, IL-18 and Eos in patients with acute attack of BA were positively correlated with the severity of the disease (P<0.05).Logistic regression analysis showed that after controlling the severity of disease, partial pressure of blood oxygen (PaO₂), and partial pressure of blood carbon dioxide (PaCO₂), the high expression of IL-1β, IL-18 and Eos were independent risk factors for asthma not effectively controlled in patients with acute exacerbation of BA (P<0.05).ROC results showed that the AUC value of blood IL-1β, IL-18, and Eos combined to predict the short-term outcomes of acute BA patients was 0.890, which was higher than the single prediction (P<0.05).Conclusion: The blood levels of IL-1β, IL-18, Eos in patients with acute attack of BA are positively correlated with the severity of the disease.They can effectively predict the outcome of the disease, and they have guiding value for clinical diagnosis, evaluation, and treatment.

参考文献：

[1] LUO H, HAN H, LIU X, et al.Efficacy and safety of montelukast sodium combined with fluticasone in the treatment of adult bronchial asthma:a protocol for systematic review and meta-analysis[J].Medicine(Baltimore), 2020, 99(52):e23453.
[2] 林江涛, 王文巧, 周新, 等.我国十城市支气管哮喘控制和疾病管理及患者认知水平的变化[J].中华结核和呼吸杂志, 2018, 41(3):191-195.
[3] AVDEEV S N, VOLKOVA O A, DEMKO I V, et al.Severe bronchial asthma patient care organization in various regions of the Russian Federation. From endotypes and phenotypes of bronchial asthma to personalized choice of therapy[J].Ter Arkh, 2020, 92(2):119-123.
[4] 李东升, 李风森, 常文俊.支气管哮喘急性发作期患者外周血Bcl-6mRNA、Blimp-1mRNA、IL-21水平变化及意义[J].临床肺科杂志, 2018, 23(1):70-72, 78.
[5] 高阳, 杨帆.支气管哮喘患者外周血Th1、Th2与Th17细胞表达水平及临床意义[J].解放军医药杂志, 2017, 29(1):76-79.
[6] 孔霞, 吴升华, 张莉, 等.脂氧素A4受体激动剂及白介素-1β在Toll样受体2/髓样分化因子88/核因子-κB信号通路对哮喘小鼠气道炎症的调控作用[J].儿科药学杂志, 2018, 24(7):1-6.
[7] 中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(2016年版)[J].中华结核和呼吸杂志, 2016, 39(9):675-697.
[8] AI J, XIE Z, XIANG Q, et al.Clinical effect of endoscopic vidian neurectomy on bronchial asthma outcomes in patients with coexisting refractory allergic rhinitis and asthma[J].Am J Rhinol Allergy, 2018, 32(3):139-146.
[9] FUJII U, MIYAHARA N, TANIGUCHI A, et al.Effect of a retinoid X receptor partial agonist on airway inflammation and hyperresponsiveness in a murine model of asthma[J].Respir Res, 2017, 18(1):23.
[10] 刘敏, 许西琳, 刘冬, 等.呼出气一氧化氮和外周血嗜酸性粒细胞百分率对支气管哮喘诊断和病情评估价值[J].中华实用诊断与治疗杂志, 2017, 31(8):769-771.
[11] 吴思仿, 周丽芹, 吴峰.支气管哮喘患者ICAM-1、EOS水平与病情严重程度的相关性分析[J].临床肺科杂志, 2019, 24(5):803-806.
[12] ANDREA M, ALESSANDRA V, ENRICO M, et al.Is IgE or eosinophils the key player in allergic asthma pathogenesis? Are we asking the right question[J].Respir Res, 2018, 19(1):113.
[13] 兰芙蓉, 陈文燕, 王明章.儿童支气管哮喘患者血清骨桥蛋白和嗜酸细胞趋化因子表达及临床意义[J].临床肺科杂志, 2017, 22(5):877-879.
[14] KHAITOV M R, GAISINA A R, SHILOVSKIY I P, et al.The role of interleukin-33 in pathogenesis of bronchial asthma. New experimental data[J].Biochemistry(Mosc), 2018, 83(1):13-25.
[15] 蔡艳, 杨旭东, 雷莹.TNF-α和IL-1β通过MAPK通路上调人支气管平滑肌细胞的缓激肽受体和内皮素受体[J].西北药学杂志, 2018, 33(3):353-359.
[16] 朱智全, 时新慧, 刘红升, 等.Th17及Th1相关细胞因子与支气管哮喘的关系研究[J].现代生物医学进展, 2017, 17(20):3932-3935.
[17] 张丽娟, 李得堂, 周小军, 等.Thl/Th2细胞中特征因子在不同分类与分度的肺气虚寒型AR患者外周血中表达研究[J].辽宁中医药大学学报, 2018, 20(9):189-192.
[18] 彭丽花, 谭宇蓉.蛙皮素受体亚型-3与支气管哮喘Th1/Th2免疫失衡[J].生命的化学, 2017, 37(2):250-254.
[19] 董天津, 谭华清, 修青永.过敏性哮喘患儿外周血单个核细胞mir-29c与Th1/Th2细胞平衡的相关性分析[J].中国儿童保健杂志, 2020, 28(6):672-675.
[20] TAYEL S I, EL-HEFNWAY S M, GAYED E, et al.Association of stem cell factor gene expression with severity and atopic state in patients with bronchial asthma[J].Respir res, 2017, 18(1):21.
[21] 黄传君, 赵方正, 陈方方, 等.吸入性糖皮质激素能有效控制支气管哮喘气道炎症[J].中华结核和呼吸杂志, 2018, 41(11):912.
[22] HU C P, XUN Q F, LI X Z, et al.Effects of glucocorticoid-induced transcript 1 gene deficiency on glucocorticoid activation in asthmatic mice[J].Chin Med J(Engl), 2018, 131(23):2817-2826.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录