| 李媛媛,常 炜,阿丽亚·哈力克,古丽茹·阿热斯兰,娜迪热·阿不都萨拉木.机体微生态变化及炎症因子表达在支气管扩张症中的预警作用初步分析[J].,2023,(6):1110-1115 |
| 机体微生态变化及炎症因子表达在支气管扩张症中的预警作用初步分析 |
| Preliminary Analysis of The Early Warning Effect of Body Microecological Changes and Inflammatory Factor Expression in Bronchiectasis |
| 投稿时间：2022-07-05 修订日期：2022-07-30 |
| DOI：10.13241/j.cnki.pmb.2023.06.022 |
| 中文关键词: 支气管扩张 肺功能 微生态 |
| 英文关键词: Bronchiectasis Pulmonary function Microecology |
| 基金项目:新疆维吾尔自治区自然科学基金项目（2020D01A108） |
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| 中文摘要: |
| 摘要 目的：初步探讨与分析机体微生态变化及炎症因子表达在支气管扩张症中的预警作用。方法：2020年6月1日-2022年3月31日选择在本院诊治的支气管扩张患者100例作为支气管扩张组，同期选择本院体检中心招募50例体检人员作为对照组。测定支气管扩张组及对照组的第一秒用力呼气容积（FEV1），用力肺活量（FVC），血清炎性细胞因子IL-1β、IL-6、IL-8、IL-17、TNF-α含量以及外周血炎性标记物中性粒细胞（NEU），C-反应蛋白（CRP）。将完成电子气管镜检查的患者分为急性加重期组（A组）及稳定期组（B组），同时测定A组B组肺泡灌洗液的细菌丰度并进行相关性分析。结果：支气管扩张组的FEV1、FVC都明显低于对照组（P<0.05）。支气管扩张组中急性加重期支气管扩张患者43例，稳定期支气管患者扩张例57例。支气管扩张组的血IL-1β、IL-6、IL-8、IL-17、TNF-α、NEU、CRP明显高于对照组（P<0.05），且在急性加重时增高更明显。100例支气管扩张患者中完成电子气管镜检查的患者61例，分为急性加重期组（A组）30例及稳定期组（B组）31例，A组流感嗜血杆菌丰度明显高于B组（P<0.05），A组铜绿假单胞菌丰度与B组无显著差异（P＞0.05）。在支气管扩张组及对照组150例入选者中，Spearsman分析显示血IL-1β、IL-6、IL-8、IL-17、TNF-α、NEU、CRP与支气管扩张存在相关性（P<0.05），在61例支气管扩张患者中，流感嗜血杆菌丰度与支气管扩张急性加重存在相关性（P<0.05）。COX比例风险回归模型分析显示血IL-1β、IL-6、IL-8、IL-17、TNF-α、NEU、CRP都可能为导致支气管扩张发生的重要预警因子（P<0.05）。流感嗜血杆菌丰度可能为导致支气管扩张急性加重的重要预警因子（P<0.05）。结论：支气管扩张可导致患者肺功能下降，多伴随有血清炎性细胞因子IL-1β、IL-6、IL-8、IL-17、TNF-α含量的高表达以及外周血炎症标记物NEU、CRP的增高，且在急性加重时的表达和增高更明显，该因子都可能为导致支气管扩张发生的重要预警因子。支气管扩张患者肺泡灌洗液中可含有大量铜绿假单胞菌、流感嗜血杆菌，流感嗜血杆菌丰度可能为导致支气管扩张急性加重的重要预警因子，铜绿假单胞菌丰度却与支气管扩张急性加重无显著相关。 |
| 英文摘要: |
| ABSTRACT Objective: To explore and analyze the early warning role of microecological changes and expression of inflammatory factors in bronchiectasis. Methods: From June 1st, 2020 to March 31st, 2022, 100 patients with bronchiectasis diagnosed and treated in our hospital were selected as the bronchiectasis group, and 50 physical examiners were recruited from the physical examination center of our hospital as the control group. The first second forced expiratory volume (FEV1), forced vital capacity (FVC), Blood inflammatory markers IL-1β, IL-6, IL-8, IL-17, TNF-α, Contents of neutrophils (NEU) and C-reactive protein (CRP) were measured in the bronchiectasis group and the control group. Patients in the bronchiectasis group who completed electronic bronchoscopy were divided into stable group (group A) and acute exacerbation group (group B). At the same time, the bacterial abundance of alveolar lavage fluid in group A and group B was measured and analyzed. Results: FEV1 and FVC in bronchiectasis group were lower than those in control group (P<0.05). In the bronchiectasis group, there were 43 cases of acute bronchiectasis and 57 cases of chronic bronchiectasis. Blood IL-1β, IL-6, IL-8, IL-17, TNF-α, NEU and CRP in bronchiectasis group were higher than those in the control group (P<0.05), and increased more in the acute exacerbation period. Among 100 patients with bronchiectasis, 61 patients who completed electronic tracheoscopy were divided into 30 cases in acute exacerbation group (group A) and 31 cases in stable group (group B). The abundance of Haemophilus influenzae in group A was higher than that in group B (P<0.05), and there was no difference in the abundance of Pseudomonas aeruginosa between group A and group B (P>0.05). Spearsman analysis showed that the levels of blood IL-1β, IL-6, IL-8, IL-17, TNF-α, NEU and CRP in 150 patients in the bronchiectasis group and the control group were correlated with bronchiectasis (P<0.05). Among 61 patients with bronchiectasis, Haemophilus influenzae abundance was correlated with acute exacerbation of bronchiectasis (P<0.05). Cox proportional hazards regression model analysis showed that IL-1β, IL-6, IL-8, IL-17,TNF-α, NEU and CRP may be important early warning factors leading to bronchiectasis (P<0.05). The abundance of Haemophilus influenzae may be an important early warning factor for the acute exacerbation of bronchiectasis (P<0.05). Conclusion: Bronchiectasis can lead to the decline of lung function in patients, which is often accompanied by the high expression of serum inflammatory cytokines IL-1β, IL-6, IL-8, IL-17, and TNF-α and the expression of peripheral blood inflammatory markers NEU and CRP. The expression and increase are more obvious in acute exacerbation, and this factor may be an important early warning factor for the occurrence of bronchiectasis. The bronchoalveolar lavage fluid of patients with bronchiectasis may contain a large amount of Pseudomonas aeruginosa and Haemophilus influenzae, and the abundance of Haemophilus influenzae may be an important early warning factor leading to acute exacerbation of bronchiectasis. No association with dilated exacerbations. |
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