中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
36期
4301-4306
,共6页
邹晖%方秋红%马迎民%王学艳
鄒暉%方鞦紅%馬迎民%王學豔
추휘%방추홍%마영민%왕학염
哮喘%表型%表皮生长因子%成纤维细胞生长因子%血管内皮生长因子A%血小板衍生生长因子
哮喘%錶型%錶皮生長因子%成纖維細胞生長因子%血管內皮生長因子A%血小闆衍生生長因子
효천%표형%표피생장인자%성섬유세포생장인자%혈관내피생장인자A%혈소판연생생장인자
Asthma%Phenotype%Epidermal growth factor%Fibroblast growth factors%Vascular endothelial growth factor A%Platelet-derived growth factor
目的：探讨支气管哮喘不同表型血清及诱导痰中表皮生长因子（ EGF）、碱性成纤维细胞生长因子（bFGF）、血小板衍生生长因子（PDGF）以及血管内皮生长因子（VEGF）之间的关系。方法选择2010年6月—2011年6月首都医科大学附属北京世纪坛医院呼吸内科门诊及住院的支气管哮喘急性发作患者62例，根据其诱导痰细胞不同分为嗜酸粒细胞表型组（48例）和中性粒细胞表型组（14例）；根据其肺功能分为第1秒用力呼气末容积占用力肺活量百分比（ FEV1/FVC）≥70%组（24例）和FEV1/FVC<70%组（38例）；根据其病情严重程度分为轻度组（38例）、中度组（10例）及重度组（14例）。采用酶联免疫吸附法（ ELISA）检测诱导痰上清液及血清中 EGF、bFGF、PDGF-AA、PDGF-BB以及VEGF水平。结果中性粒细胞表型组和嗜酸粒细胞表型组年龄、性别、病程、发病年龄<40岁、吸烟率、过敏性鼻炎发生率、支气管哮喘家族史、总免疫球蛋白E（ T-IgE）、第1秒用力呼气末容积（FEV1）、FEV1/FVC比较，差异均无统计学意义（P>0.05）；轻度组、中度组和重度组上述几项指标比较，差异均无统计学意义（P>0.05）；FEV1/FVC≥70%组和FEV1/FVC<70%组年龄、性别、病程、发病年龄<40岁、吸烟率、过敏性鼻炎发生率、支气管哮喘家族史、血清嗜酸粒细胞、T-IgE比较，差异均无统计学意义（ P>0.05），两组FEV1、FEV1/FVC比较，差异有统计学意义（ P<0.05）。患者血清EGF、PDGF-AA、VEGF水平均低于诱导痰中水平（ P<0.05）；血清bFGF、PDGF-BB水平均高于诱导痰中水平（ P <0.05）。血清及诱导痰中 EGF、bFGF、PDGF-AA及PDGF-BB在支气管哮喘不同临床表型组间比较，差异均无统计学意义（ P>0.05）。血清及诱导痰中嗜酸粒细胞表型组VEGF水平高于中性粒细胞表型组（ P<0.05）；血清及诱导痰中FEV1/FVC<70%组VEGF水平高于FEV1/FVC≥70%组（P<0.05）；血清及诱导痰中重度组VEGF水平均高于轻度组和中度组（P<0.05）。治疗前后患者血清及诱导痰中EGF、bFGF、PDGF-AA、PDGF-BB和VEGF水平比较，差异均无统计学意义（ P>0.05）。结论血清及诱导痰中VEGF水平与嗜酸粒细胞型支气管哮喘，气流受限以及支气管哮喘的严重程度有关。而EGF、bFGF、PDGF-AA及PDGF-BB在各表型中无明显差别。
目的：探討支氣管哮喘不同錶型血清及誘導痰中錶皮生長因子（ EGF）、堿性成纖維細胞生長因子（bFGF）、血小闆衍生生長因子（PDGF）以及血管內皮生長因子（VEGF）之間的關繫。方法選擇2010年6月—2011年6月首都醫科大學附屬北京世紀罈醫院呼吸內科門診及住院的支氣管哮喘急性髮作患者62例，根據其誘導痰細胞不同分為嗜痠粒細胞錶型組（48例）和中性粒細胞錶型組（14例）；根據其肺功能分為第1秒用力呼氣末容積佔用力肺活量百分比（ FEV1/FVC）≥70%組（24例）和FEV1/FVC<70%組（38例）；根據其病情嚴重程度分為輕度組（38例）、中度組（10例）及重度組（14例）。採用酶聯免疫吸附法（ ELISA）檢測誘導痰上清液及血清中 EGF、bFGF、PDGF-AA、PDGF-BB以及VEGF水平。結果中性粒細胞錶型組和嗜痠粒細胞錶型組年齡、性彆、病程、髮病年齡<40歲、吸煙率、過敏性鼻炎髮生率、支氣管哮喘傢族史、總免疫毬蛋白E（ T-IgE）、第1秒用力呼氣末容積（FEV1）、FEV1/FVC比較，差異均無統計學意義（P>0.05）；輕度組、中度組和重度組上述幾項指標比較，差異均無統計學意義（P>0.05）；FEV1/FVC≥70%組和FEV1/FVC<70%組年齡、性彆、病程、髮病年齡<40歲、吸煙率、過敏性鼻炎髮生率、支氣管哮喘傢族史、血清嗜痠粒細胞、T-IgE比較，差異均無統計學意義（ P>0.05），兩組FEV1、FEV1/FVC比較，差異有統計學意義（ P<0.05）。患者血清EGF、PDGF-AA、VEGF水平均低于誘導痰中水平（ P<0.05）；血清bFGF、PDGF-BB水平均高于誘導痰中水平（ P <0.05）。血清及誘導痰中 EGF、bFGF、PDGF-AA及PDGF-BB在支氣管哮喘不同臨床錶型組間比較，差異均無統計學意義（ P>0.05）。血清及誘導痰中嗜痠粒細胞錶型組VEGF水平高于中性粒細胞錶型組（ P<0.05）；血清及誘導痰中FEV1/FVC<70%組VEGF水平高于FEV1/FVC≥70%組（P<0.05）；血清及誘導痰中重度組VEGF水平均高于輕度組和中度組（P<0.05）。治療前後患者血清及誘導痰中EGF、bFGF、PDGF-AA、PDGF-BB和VEGF水平比較，差異均無統計學意義（ P>0.05）。結論血清及誘導痰中VEGF水平與嗜痠粒細胞型支氣管哮喘，氣流受限以及支氣管哮喘的嚴重程度有關。而EGF、bFGF、PDGF-AA及PDGF-BB在各錶型中無明顯差彆。
목적：탐토지기관효천불동표형혈청급유도담중표피생장인자（ EGF）、감성성섬유세포생장인자（bFGF）、혈소판연생생장인자（PDGF）이급혈관내피생장인자（VEGF）지간적관계。방법선택2010년6월—2011년6월수도의과대학부속북경세기단의원호흡내과문진급주원적지기관효천급성발작환자62례，근거기유도담세포불동분위기산립세포표형조（48례）화중성립세포표형조（14례）；근거기폐공능분위제1초용력호기말용적점용력폐활량백분비（ FEV1/FVC）≥70%조（24례）화FEV1/FVC<70%조（38례）；근거기병정엄중정도분위경도조（38례）、중도조（10례）급중도조（14례）。채용매련면역흡부법（ ELISA）검측유도담상청액급혈청중 EGF、bFGF、PDGF-AA、PDGF-BB이급VEGF수평。결과중성립세포표형조화기산립세포표형조년령、성별、병정、발병년령<40세、흡연솔、과민성비염발생솔、지기관효천가족사、총면역구단백E（ T-IgE）、제1초용력호기말용적（FEV1）、FEV1/FVC비교，차이균무통계학의의（P>0.05）；경도조、중도조화중도조상술궤항지표비교，차이균무통계학의의（P>0.05）；FEV1/FVC≥70%조화FEV1/FVC<70%조년령、성별、병정、발병년령<40세、흡연솔、과민성비염발생솔、지기관효천가족사、혈청기산립세포、T-IgE비교，차이균무통계학의의（ P>0.05），량조FEV1、FEV1/FVC비교，차이유통계학의의（ P<0.05）。환자혈청EGF、PDGF-AA、VEGF수평균저우유도담중수평（ P<0.05）；혈청bFGF、PDGF-BB수평균고우유도담중수평（ P <0.05）。혈청급유도담중 EGF、bFGF、PDGF-AA급PDGF-BB재지기관효천불동림상표형조간비교，차이균무통계학의의（ P>0.05）。혈청급유도담중기산립세포표형조VEGF수평고우중성립세포표형조（ P<0.05）；혈청급유도담중FEV1/FVC<70%조VEGF수평고우FEV1/FVC≥70%조（P<0.05）；혈청급유도담중중도조VEGF수평균고우경도조화중도조（P<0.05）。치료전후환자혈청급유도담중EGF、bFGF、PDGF-AA、PDGF-BB화VEGF수평비교，차이균무통계학의의（ P>0.05）。결론혈청급유도담중VEGF수평여기산립세포형지기관효천，기류수한이급지기관효천적엄중정도유관。이EGF、bFGF、PDGF-AA급PDGF-BB재각표형중무명현차별。
Objective To investigate the relationship between different subtypes of asthma and epidermal growth factor (EGF),basic fibroblast growth factor(bFGF),platelet-derived growth factor(PDGF),vascular endothelial growth factor ( VEGF) in induced sputum and serum. Methods 62 patients with acute attacks of asthma who received inpatient or outpatient treatment in Department of Respiratory of Beijing Shijitan Hospital Affiliated to Capital Medical University from June 2010 to June 2011,were divided into eosinophilic granulocyte phenotype group(48 cases)and neutrophilic granulocyte phenotype group(14 cases) by cytological classification in induced sputum;patients were also divided into FEV1/FVC≥70% group(24 cases) and FEV1/FVC<70% group(38 cases) by lung function;and patients were divided into mild group(38 cases),moderate group (10 cases) and severe group(14 cases) by asthma severity. The concentrations of EGF,bFGF,PDGF-AA,PDGF-BB and VEGF in serum and induced sputum supernatant were measured using ELISA. Results There was no significant difference in age,gender,course of disease,age of onset( <40 years),smoking rate,allergic rhinitis incidence,family history of asth-ma,T-IgE level,FEV1 ,FEV1/FVC between eosinophilic granulocyte phenotype group and neutrophilic granulocyte phenotype group(P>0. 05). There was no significant difference in the above indicators among mild group,moderate group and severe group(P>0. 05). There was no significant difference in age,gender,course of disease,age of onset( <40 years),smok-ing rate, allergic rhinitis incidence, family history of asthma, eosinophilic granulocyte level and T - IgE level between FEV1/FVC≥70% group and FEV1/FVC<70% group(P>0. 05),there were significant differences in FEV1 and FEV1/FVC between FEV1/FVC≥70% group and FEV1/FVC<70% group(P<0. 05). The levels of EGF,PDGF-AA and VEGF in ser-um were significantly lower than those in induced sputum(P<0. 05),respectively,and the levels of bFGF and PDGF-BB in serum were significantly higher than those in induced sputum(P<0. 05),respectively. There was no significant difference in se-rum and induced sputum levels of EGF, bFGF, PDGF-AA and PDGF-BB among different asthma subtype groups ( P >0. 05). The serum and induced sputum VEGF levels among cases in eosinophilic granulocyte phenotype group were significantly higher than those in neutrophilic granulocyte phenotype group(P<0. 05). The serum and induced sputum VEGF levels among cases in FEV1/FVC<70% group were significantly higher than those in FEV1/FVC≥70% group(P<0. 05). The serum and induced sputum VEGF levels among cases in severe group were significantly higher than those in mild group and moderate group, respectively(P<0. 05). There was no significant difference in EGF,bFGF,PDGF-AA,PDGF-BB and VEGF levels in se-rum and induced sputum before and after treatment(P>0. 05). Conclusion The VEGF level in serum and induced sputum is related to eosinophilic asthma, eosinophilic airway inflammation, airflow limitation and asthma severity. The levels of EGF, bFGF,PDGF-AA and PDGF-BB is no significant difference in different subtypes.
