哮喘患者血清中巨噬细胞炎症蛋白-1的表达及其临床意义

摘要

目的:探讨哮喘患者血清中巨噬细胞炎症蛋白-1(MIP-1)的表达以及与病情的关系.方法:选取哮喘患者114例,其中,哮喘急性发作期患者76例(急性发作期组),慢性持续性患者38例(慢性组),同时选取健康志愿者100例作为对照组,检测3组血清及诱导痰中MIP-1、血清IL-13水平以及第1秒用力呼气容积(FEV1)占预计值百分比.结果:急性发作期组血清及痰液MIP-1和血清IL-13分别为(1981.5 ±98.8) pg/L、(52.3 ±7.8) ng/L和(32.5±5.6) pg/mL,明显高于慢性组和对照组(均P＜0.05),而FEV1占预计值为(53.8±16.6)％,明显低于慢性组和对照组(均P＜0.05);慢性组血清及痰液MIP-1和血清IL-13分别为(1422.5±101.2)pg/L、(24.3±6.1) ng/L和(17.4±7.2) pg/mL,明显高于对照组(均P＜0.05),而FEV1占预计值为(71.2±15.5)％,明显低于对照组(P＜0.05);重度急性发作期患者血清及痰液MIP-1和血清IL-13分别为(2340.8±114.8) pg/L、(62.8±8.0) ng/L和(40.8±8.2) pg/mL,明显高于轻度和中度急性发作期患者(均P＜0.05),而FEV1占预计值为(45.2±11.4)％,明显低于轻度和中度急性发作期患者(均P ＜0.05);急性发作期组患者血清和痰液MIP-1水平与患者病情、血清IL-13呈正相关(均P＜ 0.05),与FEV1占预计值呈负相关(P＜0.05),血清MIP-1与痰液MIP-1呈正相关(P＜0.05);急性发作期患者治疗后血清及痰液MIP-1和血清IL-13明显低于治疗前(均P＜0.05),而FEV1占预计值明显高于治疗前(P＜0.05).结论:哮喘患者血清及诱导痰中MIP-1水平升高,尤其急性发作期患者显著升高,其表达水平与患者病情、血清IL-13水平及肺功能有一定关系.%Objective:To investigate the expression of macrophage inflammatory protein-1 (MIP-1) in serum of patients with asthma and its relationship with the disease conditions.Methods:114 patients with asthma were selected in our hospital from February 2015 to June 2016,including 76 patients with acute exacerbation of asthma (acute exacerbation group) and 38 patients with asthma chronic persistence (chronic group).100 healthy volunteers served as controls.MIP-1 in sputum and serum,serum IL-13 and forced expiratory volume in 1 second (FEV1) accounting for the predicted values were detected in each group.Results:In acute exacerbation group,serum and sputum MIP-1 levels were (1981.46 ± 98.84) pg/L and (52.31 ± 7.81) ng/L,and serum IL-13 level was (32.54 ± 5.60) pg/mL,significantly higher than in the chronic group and the control group (P ＜ 0.05),while the FEV1 accounting for the predicted value in acute exacerbation group was (53.82-± 16.61) ％,significantly lower than that in the chronic group and the control group (P ＜ 0.05).The serum and sputum MIP-1 levels and serum IL-13 level in the chronic group were (1422.50± 101.22) pg/L,(24.27 ± 6.10) ng/L and (17.41 ± 7.22) pg/mL respectively,significantly higher than those in the control group (P ＜ 0.05),but the FEV1 accounting for the predicted value was (71.22 ± 15.54)％ in the chronic group,significantly lower than in the control group (P ＜0.05).In severe acute exacerbation patients,the serum and sputum MIP-1 and serum IL-13 levels were (2340.76-114.76) pg/L,(62.82 ± 8.03) ng/L and (40.76 ± 8.22) pg/mL respectively,significantly higher than those in the mild and moderate acute exacerbation patients (P ＜ 0.05),while the FEV1 accounting for the predicted value was (45.23 ± 11.42) ％,significantly lower than that in the mild and moderate acute exacerbation patients (P ＜ 0.05).The serum MIP-1 level in patients with acute exacerbation was positively correlated with the disease condition and IL-13 (rs =0.322,r =0.412,P ＜ 0.05),but negatively correlated with the FEV1 accounting for the predicted value (r =-0.401,P ＜ 0.05).The sputum MIP-1 content was positively correlated with the disease condition and IL-13 (rs =0.301,r =0.344,P ＜ 0.05),but negatively correlated with the FEV1 accounting for the predicted value (r =-0.351,P ＜ 0.05).Serum MIP-1 level was positively correlated with sputum MIP-1 content (r =0.327,P ＜ 0.05).In acute exacerbation patients,serum and sputum MIP-1 levels and serun IL-13 level after treatment were significantly lower than those before treatment (P ＜0.05),and the FEV1 accounting for the predicted value after treatment was significantly higher than that before treatment (P ＜ 0.05).Conclusion:Serum MIP-1 expression is increased in patients with asthma,especially in those with acute exacerbation.The expression level of MIP-1 is significantly correlated to the disease condition,serum IL-13 level and lung function.