不同年龄组支气管哮喘患者胸腺基质淋巴生成素与其他指标、肺功能结果及疾病控制的相关性

A. V. Kamaev, S. A. Krivskaya, N. Lyashenko, I. Kamaeva, Y. Mizernitsky, N. Shaporova
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摘要

目的:探讨不同年龄组患者胸腺基质淋巴生成素与支气管哮喘病程及控制的相关性。材料与方法:104例患者纳入为期1年的开放性前瞻性研究。共有3个年龄组:儿童(6 -11岁,n=38)、青少年(14-17岁,n=35)和成人(25 -50岁,n=31)。我们以哮喘持续时间≥12个月、哮喘未控制和急性呼吸道感染不存在≥14天作为纳入标准。首次就诊时获得临床病史、有效问卷、肺活量测定、普通血细胞计数、血清和鼻腔物质以评估胸腺基质淋巴生成素。患者每隔6个月检查两次。统计学分析采用方差分析(Kruskal-wallis检验)和Pearson相关分析(r),差异以< 0.05为显著性。结果:哮喘控制丧失的主要危险因素(依从性差、肥胖、非特应性表型、固定气道阻塞)的患病率在各年龄组中存在差异。我们未在鼻腔材料中发现胸腺基质淋巴生成素。胸腺基质淋巴生成素浓度与前12个月未控制哮喘的持续时间显著相关(r= 0.74)。我们发现在就诊3时FEV1低于正常的患者血清胸腺基质淋巴生成素浓度较高。结论。血清胸腺基质淋巴生成素水平可作为哮喘未来加重和肺活量测定结果下降的危险因素。
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Thymic stromal lymphopoietin in bronchial asthma patients of different age groups: correlation with other markers, lung function results and disease control
Objective: to investigate correlation between thymic stromal lymphopoietin and bronchial asthma course and control in patients of different age groups. Materials and methods: one hundred and four patients were included in 1-year long open prospective study. There were three age groups: children (6 –11 y.o., n=38), adolescents (14–17 y.o., n=35) and adults (25 –50 y.o., n=31). we used asthma duration ≥12 months, uncontrolled asthma and acute respiratory infection absence for ≥14 days as inclusion criteria. Clinical history, validated questionnaires, spirometry, common blood count, serum and nasal material to evaluate thymic stromal lymphopoietin were obtained during first visit. Patient were consequently examined twice with 6 months intervals. Statistical analyses included ANOVA (Kruskal-wallis test) and Pearson’s correlation (r). Differences accepted significant with р<0,05. Resuts: prevalence of main risk factors of asthma control lost (poor compliance, obesity, non-atopic phenotype, fixed airway obstruction) was different in age groups. we didn’t find any thymic stromal lymphopoietin in nasal material. Thymic stromal lymphopoietin concentration correlate significantly with duration of uncontrolled asthma in previous 12 months (r=0,74). we have found greater serum thymic stromal lymphopoietin concentration in patients who demonstrated FEV1 below normal at Visit 3. Conclusion. Serum thymic stromal lymphopoietin level can be used as risk factor of asthma future exacerbation and spirometry results decline.
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