目的 分析细胞间黏附因子(ICAM-1)与儿童哮喘严重程度及气道炎症反应相关性,为儿童哮喘的早期诊断和病情评估提供科学依据。方法 回顾性分析2018年8月—2020年7月南阳市中心医院收治80例哮喘患儿的临床资料,根据哮喘严重程度将患儿分为轻度、中度及重度哮喘组,并选取同期在医院进行体检的健康儿童80例作为对照组,讨论各组儿童痰液ICAM-1水平的变化,分析ICAM-1与哮喘严重程度及气道炎症反应相关性。结果 哮喘组痰液ICAM-1、白细胞介素(IL)-6、IL-13、肿瘤坏死因子(TNF-α)水平均高于正常组(t=40.251、27.532、48.392、23.096,P＜0.05)。不同哮喘严重程度患儿的痰液ICAM-1、IL-6、IL-13、TNF-α水平以及肺功能指标中肺活量(VC)、第1秒用力呼气量(FEV1)、呼气峰值流速(PEF)比较,差异均有统计学意义(F=16.410、38.726、12.167、46.661、29.540、10.419、24.676,P＜0.05);其中,重度哮喘患儿痰液ICAM-1、IL-6、IL-13、TNF-α水平均高于轻度组、中度组;重度、中度哮喘患儿FEV1、VC、PEF均低于轻度组(P＜0.05)。Spearman相关性分析结果显示,哮喘患儿痰液ICAM-1水平与IL-6、IL-13、TNF-α水平、哮喘严重程度均呈正相关(r=0.745、0.684、0.786、0、692,P＜0.05);哮喘患儿痰液ICAM-1水平与FEV1、VC、PEF呈负相关(r=-0.457、-0.378、-0.692,P＜0.05)。结论 哮喘患儿痰液ICAM-1水平高于健康儿童,其水平与哮喘严重程度分级、IL-6、IL-13、TNF-α水平呈正相关,与肺功能指标呈负相关。检测哮喘患儿痰液ICAM-1水平,在评估其疾病严重程度、气道炎症反应中有一定实用价值。
Abstract
Objective To explore the correlation between intercellular adhesion factor-1 (ICAM-1) and asthma severity,airway inflammation response in children,in order to provide scientific reference for early diagnosis and assessment of asthma. Methods The clinical data of 80 children with asthma admitted to Nanyang Central Hospital from August 2018 to July 2020 were retrospectively analyzed. According to different severity levels,children were divided into mild,moderate and severe asthma groups. And 80 healthy children who underwent physical examination in the hospital during the same period were enrolled as control group. The changes of ICAM-1 level in sputum of all groups were explored. The correlation between ICAM-1 and asthma severity,airway inflammation response was analyzed. Results The levels of sputum ICAM-1,interleukin-6 (IL-6),IL-13 and tumor necrosis factor (TNF-α) in asthma group were significantly higher than those in normal group (t＝40.251,27.532,48.393,23.096,P<0.05). The differences in levels of sputum ICAM-1,IL-6,IL-13 and TNF-α,as well as lung function indexes [vital capacity (VC),forced expiratory volume in the first second (FEV1),peak expiratory flow (PEF)] were statistically significant among children with different asthma severity levels (F=16.410,38.726,12.167,46.661,29.540,10.419,24.676,P<0.05). The levels of sputum ICAM-1,IL-6,IL-13 and TNF-α in severe asthma group were higher than those in mild and moderate asthma groups. FEV1,VC and PEF in severe and moderate asthma groups were lower than those in mild asthma group (P<0.05). Spearman correlation analysis showed that the level of sputum ICAM-1 was positively correlated with IL-6,IL-13,TNF-α and asthma severity (r=0.745,0.684,0.786,0.692,P<0.05),while negatively correlated with FEV1,VC and PEF (r=-0.457,-0.378,-0.692,P<0.05). Conclusions The level of sputum ICAM-1 in asthma children is higher than that in healthy children. Detecting the level of sputum ICAM-1 is of certain practical value in assessing disease severity and airway inflammation response.
关键词
细胞间黏附因子 /
哮喘 /
炎症反应 /
儿童
Key words
intercellular adhesion factor-1 /
asthma /
inflammatory response /
children
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参考文献
[1] Huang WC,Liu CY,Shen SC,et al.Protective effects of licochalcone a improve airway hyper-responsiveness and oxidative stress in a mouse model of asthma[J].Cells,2019,8(6):617.
[2] Sun X,Hou T,Cheung E,et al.Anti-inflammatory mechanisms of the novel cytokine interleukin-38 in allergic asthma[J].Cell Mol Immunol,2020,17(6):631-646.
[3] 陈昌达,杨培文,李就文,等.支气管哮喘患者支气管肺泡灌洗液中IL-17、TGF-β1水平变化[J].国际检验医学杂志,2020,41(13):1632-1635.
[4] 及立立,曹丽洁,牛波,等.过敏性支气管哮喘患儿呼出气一氧化氮与免疫功能的相关性及其影响因素研究[J].现代中西医结合杂志,2020,29(20):2174-2178,2183.
[5] Soveyd N,Abdolahi M,Djalali M,et al.The combined effects of ω -3 fatty acids and nano-curcumin supplementation on intercellular adhesion molecule-1 (ICAM-1) gene expression and serum levels in migraine patients[J].CNS Neurol Disord Drug Targets,2018,16(10):1120-1126.
[6] Bessa AS,Ragab AM,Nassra RA,et al.Expression levels of aldose reductase enzyme,vascular endothelial growth factor,and intercellular adhesion molecule-1 in the anterior lens capsule of diabetic cataract patients[J]. J Cataract Refract Surg,2018;44(12):1431-1435.
[7] 中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[8] Butov D,Makieieva N,Vasylchenko Y,et al.Interrelationship of endothelial function parameters in children with bronchial asthma in exacerbation and remission[J].Adv Respir Med,2019,87(1):7-13.
[9] 周璇,葛灿侠,陈羽,等.小儿消积止咳口服液联合西药治疗儿童支气管哮喘临床效果的远期观察[J].世界中医药,2020,15(11):1611-1614.
[10] Janelidze S,Mattsson N,Stomrud E,et al.CSF biomarkers of neuroinflammation and cerebrovascular dysfunction in early Alzheimer disease[J].Neurology,2018,91(9):e867-e877.
[11] Liu YF,Zhang SY,Chen YY,et al.ICAM-1 Deficiency in the bone marrow niche impairs quiescence and repopulation of hematopoietic stem cells[J].Stem Cell Reports,2018,11(1):258-273.
[12] 赵小鹏,乔树斌.定喘汤联合布地奈德福莫特罗治疗咳嗽变异性哮喘疗效及对外周血细胞间黏附分子-1、嗜酸细胞活化趋化因子的影响[J].世界中西医结合杂志,2020,15(1):107-110.
[13] 张长生,张海涛.支气管哮喘患者细胞间黏附因子-1、嗜酸粒细胞的水平变化及临床意义[J].中国医药导报,2020,17(1):94-97.
[14] Busse WW. Biological treatments for severe asthma:A major advance in asthma care[J].Allergol Int,2019,68(2):158-166.
[15] Li H,Wang K,Huang H,et al.A meta-analysis of anti-interleukin-13 monoclonal antibodies for uncontrolled asthma[J].PLoS One,2019,14(1):884-887.
[16] 王红娟,郭红荣,张恩景,等.止咳定喘汤联合孟鲁司特在咳嗽变异性哮喘中的临床疗效[J].医药导报,2020,39(4):568-572.
[17] 吴青兰,成俊芬.VEGF、ICAM-1和NO与支气管哮喘的相关性研究进展[J].现代医学,2019,47(9):1169-1172.
[18] 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.
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