论文部分内容阅读
目的:探究支气管哮喘(哮喘)患者外周血及诱导痰中降钙素基因相关肽(CGRP)、受体活性修饰蛋白1(RAMP-1)表达水平的测定及其临床意义。方法:本研究为病例对照研究。采用单纯随机抽样法，选择2017年2月至2019年10月东莞松山湖中心医院呼吸内科收治的122例哮喘患者为研究对象，根据病情严重程度将其分为非重症哮喘组(85例)及重症哮喘组(37例)，另选择同期来东莞松山湖中心医院健康体检的50名志愿者作为对照组。测定3组治疗前及哮喘患者治疗后的外周血、诱导痰中CGRP、RAMP-1水平，并收集受试者肺功能及气道炎症指标，采用组胺支气管激发试验测定受试者第1秒用力呼气容积(FEVn 1)下降20%的累积吸入组胺剂量(PD20)。采用多因素logistic回归分析哮喘患者血清中CGRP及诱导痰中CGRP、RAMP-1与治疗效果的相关性。n 结果:(1)3组外周血及诱导痰中CGRP、RAMP-1水平差异均有统计学意义(n P值均<0.05)，且重症哮喘组高于非重症哮喘组和对照组，非重症哮喘组高于对照组(n P值均<0.05)。(2)外周血及诱导痰中CGRP、RAMP-1水平与诱导痰中白细胞介素4(IL-4)、IL-9均呈正相关(n P值均<0.05)，与肺功能指标、PD20均呈负相关(n P值均<0.05)。(3)重症哮喘组中治疗无效者的血清、诱导痰中CGRP、RAMP-1水平高于有效者；多因素logistic回归分析显示，血清中CGRP及诱导痰中CGRP、RAMP-1水平是重症哮喘患者治疗效果的独立危险因素(n OR值分别为1.07、1.25、1.01、1.02，n P值均<0.05)。n 结论:哮喘患者外周血及诱导痰中CGRP、RAMP-1水平异常升高，且重症哮喘患者的上述指标水平与病情严重程度及治疗效果相关。“,”Objective:To detect the levels of peripheral blood and induced sputum calcitonin gene-related peptide (CGRP) and receptor activity-modifying protein-1 (RAMP-1) in patients with bronchial asthma (asthma) and their clinical significance.Methods:This was a case-control study.A total of 122 asthma patients admitted to the Department of Respiratory Medicine of Dongguan Songshan Lake Central Hospital from February 2017 to October 2019 were selected as the study subjects by simple random sampling.They were divided into non-severe asthma group (85 cases) and severe asthma group (37 cases) according to the severity of their disease.Another 50 healthy volunteers who came to Dongguan Songshan Lake Central Hospital for physical examination during the same period were selected as the control group.Serum and induced sputum CGRP and RAMP-1 levels were measured.Besides, lung function and airway inflammation indexes were collected.The cumulative dose of histamine which caused a 20% fall in the first second forced expiratory volume (PD20-FEVn 1) was detected by histamine challenge test.Multifactor logistic analysis was used to explore the correlation between serum and induced sputum CGRP and RAMP-1 levels and their clinical effect in patients with severe asthma.n Results:(1) The levels of serum and induced sputum CGRP and RAMP-1 were significantly different in the three groups (all n P<0.05), with severe asthma group significantly higher than those of the non-severe asthma group and control group (alln P<0.05). (2)Serum CGRP, RAMP-1 levels and induced sputum CGRP, RAMP-1 levels were positively correlated with induced sputum interleukin-4 (IL-4) and IL-9 (alln P<0.05), but were negatively correlated with the percentage of peak expiratory flow in predicted value PD20 (alln P<0.05). (3)In the severe asthma group, serum and induced sputum CGRP and RAMP-1 levels were significantly higher, and multifactor Logistic analysis showed that the levels of serum CGRP, induced sputum CGRP and ramp-1 were independent risk factors for the treatment effect of patients with severe asthma (n OR values were 1.07, 1.25, 1.01, and 1.02, respectively, all n P<0.05).n Conclusions:Peripheral blood and induced sputum CGRP and RAMP-1 levels in patients with asthma were significantly increased, and the levels are closely related to the severity and clinical effect in severe asthma patients.