摘要
目的 分析支气管哮喘患者血清细胞趋化因子受体5(CCR5)、脂氧素A4(LXA4)表达水平及其与免疫功能失调、气道重塑的相关性.方法 采用回顾性研究,根据疾病严重程度将2021年1月至2023年5月北京市大兴区人民医院收治的80例支气管哮喘患者分为轻中度组(n=60)和重度组(n=20),另选取同期入院体检的50名健康体检者作为对照组.检测各组血清CCR5、LXA4和免疫功能指标(CD3+、CD4+、CD8+、CD4+/CD8+),并采用CT仪检查其右肺上叶尖段的气道重塑指标[气道管腔面积(LA)、气道管壁面积(WA)和气道总面积(TA)].根据双变量Spearman相关性检验分析血清CCR5、LX4A与免疫功能失调和气道重塑的相关性,并建立多因素Logistic模型分析影响支气管哮喘患者血清CCR5、LX4A的独立危险因素.结果 轻中度组、重度组患者血清CCR5、LX4A水平均高于对照组,重度组患者血清CCR5高于轻中度组患者,LXA4水平低于轻中度组患者,差异均有统计学意义(P＜0.05).轻中度组、重度组患者血清CD3+、CD4+、CD4+/CD8+水平均低于对照组,CD8+水平高于对照组患者,且重度组患者CD3+、CD4+、CD4+/CD8+水平均低于轻中度组患者,CD8+水平高于轻中度组患者,差异均有统计学意义(P＜0.05).轻中度组、重度组患者右肺上叶尖段LA、WA、TA水平均低于对照组,且重度组患者右肺上叶尖段LA、WA、TA水平均低于轻中度组,差异均有统计学意义(P＜0.05).血清CCR5、LX4A与CD3+、CD4+、CD4+/CD8+呈负相关性(P＜0.05),与CD8+、LA、WA、TA呈正相关性(P＜0.05).多因素Logistic回归分析结果显示,疾病严重程度、CD3+、CD4+、CD8+、CD4+/CD8+、LA、WA、TA均是导致支气管哮喘患者血清CCR5、LX4A升高的独立危险因素(P＜0.05).结论 血清CCR5、LX4A与支气管哮喘疾病严重程度、免疫功能失调和气道重塑密切相关.
Abstract
Objective To analyze the expression levels of serum chemokine receptor 5(CCR5)and lipoxin A4(LXA4)in patients with bronchial asthma and their correlation with immune dysfunction and airway remodeling.Methods According to the severity of the disease,80 patients with bronchial asthma admitted to Beijing Daxing District Peoples Hospital from January 2021 to May 2023 were divided into mild to moderate group(n=60)and severe group(n=20)retraspectively,and 50 healthy subjects admitted for physical examination during the same period were selected as the control group.Serum CCR5,LXA4 and immune function indicators(CD3+,CD4+,CD8+,CD4+/CD8+)were detected in all patients,and airway remodeling indicators(airway lumen area(LA),airway wall area(WA),and airway total area(TA))in up-per tip segment of the right lung were examined by CT.The correlation of serum CCR5 and LX4A with immune dysfunction and airway remodeling was tested according to bivariate Spearman correlation,and multivariate Logistic model was established to analyze the independent risk factors af-fecting serum CCR5 and LX4A in patients with bronchial asthma.Results The levels of serum CCR5 and LX4A in the mild to moderate group and severe groups were higher than those in the control group,the level of serum CCR5 in the severe group was higher than that in the mild to mod-erate group,and the level of LXA4 was lower than that in the mild to moderate group,the differences were statistically significant(P＜0.05).The levels of serum CD3+,CD4+,CD4+/CD8+in mild to moderate groups and severe groups were lower than those in the control group,and the levels of CD8+were higher than those in the control group,and the levels of CD3+,CD4+,and CD4+/CD8+in the severe group were lower than those in the mild to moderate group,and the level of CD8+was higher than that in the mild to moderate group,the differences were statisti-cally significant(P＜0.05).The levels of LA,WA and TA in the right upper lobe tip segment of the lung in the mild to moderate group and the severe group were lower than those in the control group,and the levels of LA,WA and TA in the right upper lobe tip segment of the lung in the severe group were lower than those in the mild to moderate group,the differences were statistically significant(P＜0.05).Serum CCR5 and LX4A were negatively correlated with CD3+,CD4+,CD4+/CD8+(P＜0.05),and positively correlated with CD8+,LA,WA,TA(P＜0.05).Multivariate Logistic regression analysis showed that disease severity,CD3+,CD4+,CD8+,CD4+/CD8+,LA,WA and TA were in-dependent risk factors for the increase of serum CCR5 and LX4A in patients with bronchial asthma(P＜0.05).Conclusion Serum CCR5 and LX4A are closely related to the severity of bronchial asthma,immune dysfunction and airway remodeling.
基金项目
北京白求恩公益基金会项目(BJ-RW2020023J)
维普
万方数据