中性粒细胞哮喘可溶性MPO、IL-8水平及肺功能特征分析

Analysis on soluble MPO, IL-8 levels and lung function characteristics in neutrophil asthma

  • 摘要: 目的:观察中性粒细胞哮喘(NA)患者诱导痰、外周血中性粒细胞(NEU)髓过氧化物酶(MPO)、白介素8(IL-8)水平、肺功能的特征及其规范治疗后的变化。方法:选取2018年1月至2022年12月本院收治的47例未经规范治疗的慢性持续期哮喘患者,分为NA 组(18 例)和非NA 组(NNA 组,29 例)。分别于治疗前和治疗1 个月后行哮喘控制测试(ACT)评分、肺功能检测,肺功能指标包括第1 秒用力呼气容积占预计值百分比(FEV1%)、第1 秒用力呼气容积占用力肺活量百分比(FEV1/FVC%)、75%和50%的最大呼气中期流速(MMEF75%/25%)。采用酶联免疫吸附试验(ELISA)法检测外周血和诱导痰MPO、IL-8 水平。采用Pearson 相关分析法分析各指标的相关性。结果:治疗前,NA 组FEV1%、FEV1/FVC%、MMEF75%/25%均低于NNA 组(P<0.05),ACT 无明显差异(P> 0.05),治疗后两组上述指标均较治疗前升高(P<0.05)。治疗前、后NA 组诱导痰MPO、IL-8 水平和NE%均高于NNA 组(P<0.05),治疗后NA 组诱导痰IL-8 水平、NE%下降(P<0.05),MPO 无变化(P> 0.05)。治疗前NA 组外周血IL-8水平高于NNA 组(P<0.05),治疗后外周血IL-8水平显著降低(P<0.05),而MPO、NE%无变化(P> 0.05)。两组治疗前痰NE%与FEV1%、MMEF75%/25%呈正相关关系,外周血MPO 水平与IL-8 呈正相关关系,与ACT评分呈负相关关系(均P<0.05);治疗后,外周血MPO 水平与IL-8呈正相关关系(P<0.05)。结论:NA 患者痰和外周血MPO、IL-8水平高于NNA患者,肺功能较差;MPO、IL-8与NA肺功能、哮喘控制水平相关,监测MPO、IL-8可指导NA治疗。

     

    Abstract: Objective: To observe the characteristics of induced sputum, peripheral blood neutrophil (NEU) myeloperoxidase (MPO), interleukin 8 (IL-8) levels, lung function and their changes after standardized treatment in patients with neutrophil asthma(NA).Methods: 47 patients with chronic persistent asthma admitted to our hospital from January 2018 to December 2022 without standard treatment were selected and divided into NA group(n=18) and non-NA(NNA) group (n=29).Asthma control test (ACT) and lung function test were performed before and one month after treatment, respectively, including percentage of forced expiratory volume in one second to the predicted value (FEV1%), percentage of forced vital capacity in one second to forced vital capacity (FEV1/FVC%), maximum mid expiratory flow rate (MMEF75%/25%).Enzyme-linked immunosorbent assay (ELISA)was used to detect the levels of MPO and IL-8 in fasting venous blood and induced sputum and Pearson correlation analysis was used to analyze the correlation of each index.Results: Before treatment, the FEV1%、FEV1/FVC%、MMEF75%/25% in NA group were lower than those in NNA group (P<0.05), there was no significant difference in ACT score (P> 0.05), and the above indexes in both groups were higher after treatment (P<0.05).The levels of MPO, IL-8 and the percentage of NEU(NE%) in induced sputum in NA group were significantly higher than those in NNA group before and after treatment (P<0.05), the levels of IL-8 and NE% in induced sputum in NA group decreased After treatment (P<0.05), while MPO remained unchanged (P> 0.05).Before treatment, the level of IL-8 in peripheral blood of NA group was higher than that of NNA group(P<0.05), peripheral blood IL-8 levels decreased significantly after treatment (P<0.05), while MPO and NE%remained unchanged (P> 0.05).Sputum NE% was positively correlated with FEV1% and MMEF75%/25% before treatment, and peripheral blood MPO level was positively correlated with IL-8, and negatively correlated with ACT score (all P<0.05).After treatment, peripheral blood MPO level was positively correlated with IL-8(P<0.05).Conclusion: Sputum and peripheral blood MPO and IL-8 levels in NA patients are higher than those in NNA patients, and lung function is worse; MPO and IL-8 levels correlate with NA lung function and asthma control levels, and monitoring MPO and IL-8 levels can guide NA treatment.

     

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