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目的 探讨内皮素 (ET)在哮喘发病过程中的作用及其与肺功能的相关性。方法 用高渗盐水诱痰法收集 2 5例轻、中度哮喘发作期患者 ,2 6例哮喘缓解期患者及 30名健康者的痰标本 ,用放射免疫法测定其中ET的浓度。结果 ⑴FEV1/FVC发作组最低 ,缓解组次之 ,正常组最高 ,各组比较差异均有显著性 (均P <0 0 1)。⑵发作组和缓解组诱导痰中炎症细胞数均明显高于正常组 (均P <0 0 1)。⑶发作组诱导痰中ET浓度明显高于缓解组和正常组 (均P <0 0 1)。⑷发作组诱导痰中ET浓度与FEV1/FVC和氧分压均呈负相关 (r分别为 - 0 76 2、- 0 878) ,而与巨噬细胞数呈正相关 (r =- 0 6 53)。结论 哮喘发作期和缓解期患者气道腔内均存在慢性非特异性炎症。ET可能参与了哮喘的病理进展过程 ,并在哮喘的气道炎症和气道重塑中起了重要作用 ;诱导痰中ET的浓度可较好地反映气道腔局部ET浓度的变化。
Objective To investigate the role of endothelin (ET) in the pathogenesis of asthma and its correlation with pulmonary function. Methods Twenty-five sputum specimens from mild and moderate asthmatic patients, 26 asthmatic patients with remission and 30 healthy controls were collected by hypertonic saline phlegm method. The concentrations of ET were measured by radioimmunoassay. Results (1) FEV1 / FVC was the lowest in the attack group, followed by the remission group, the highest in the normal group, and the difference was significant among the groups (all P <0.01). (2) The number of inflammatory cells in induced sputum in both attack group and remission group were significantly higher than those in normal group (all P <0.01). (3) ET concentration in induced sputum of the attack group was significantly higher than that of the remission group and normal group (all P <0.01). (4) There was a negative correlation between the concentration of ET in induced sputum and the FEV1 / FVC and partial pressure of oxygen (r = -0.762, -0.878, respectively) in the seizure group and positively correlated with the number of macrophages (r = -0.653) . Conclusion There are chronic nonspecific inflammation in the airway of patients with asthma attack and remission. ET may be involved in the pathological process of asthma and plays an important role in airway inflammation and airway remodeling in asthma. The concentration of ET in induced sputum can better reflect the change of local ET concentration in airway.