支气管哮喘急性发作时血清1-磷酸鞘氨醇水平及其临床意义

摘要

目的 观察成人支气管哮喘(简称哮喘)急性发作时血清1-磷酸鞘氨醇(S1P)水平变化,探讨其在哮喘发病中的临床意义.方法 选择2015年11月至2016年7月佳木斯大学附属第一医院呼吸内科门诊及住院患者45例为哮喘组,以同期本院健康体检者25例为健康对照组.采用酶联免疫吸附试验检测受试者血清S1P水平,比较其肺功能指标1秒用力呼气容积(FEV1)占预计值的百分比(FEV1％)、FEV1/用力肺活量(FVC)比值的差异,采用Pearson法分析FEV1％、FEV1/FVC与S1P水平的相关性.结果 哮喘组血清S1P水平明显高于健康对照组(μmol/L:1.90±0.32比0.89±0.17,P＜0.01),FEV1％、FEV1/FVC水平明显低于健康对照组[FEV1％:(68.26±22.83)％比(97.46±10.44)％,FEV1/FVC:0.69±0.13比0.82±0.05,均P＜0.01].哮喘组患者FEV1％、FEV1/FVC与血清S1P水平呈负相关(r值分别为-0.801和-0.648,均P＜0.01).健康对照组患者FEV1％、FEV1/FVC与血清S1P水平均无相关性(r值分别为-0.048和0.183,均P＞0.05).结论 哮喘患者血清S1P明显升高,其作为一种重要的炎性介质在哮喘发病中可能发挥了重要作用.%Objective To observe the changes of serum sphingosine-1-phosphate (S1P) level in acute attack of adult bronchial asthma (simplified as asthma) and explore its clinical significance in the pathogenesis of the disease.Methods Forty-five patients of outpatient and hospitalized admitted to the Department of Respiratory Medicine in First Affiliated Hospital of Jiamusi University from November 2015 to July 2016 were arranged to an asthma group;in thc samc period,25 healthy peoples in our hospital having passed physical examination were chosen and assigned in a healthy control group.Serum S1P levels were determined by enzyme-linked immunosorbent assay (ELISA) in the subjects,the differences of pulmonary function indexes,the percentage of 1 second forced expiratory volume (FEV1)in predicted FEV1 value,FEV1/forced vital capacity (FVC) ratio were compared between the two groups,and the correlations between FEV1％,FEV1/FVC and S1P level were analyzed by Pearson analysis.Results The level of S1P in serum of asthma group was significantly higher than that of the healthy control group (μmol/L:1.90 ± 0.32 vs.0.89 ± 0.17,P ＜ 0.01),the levels of FEV1％,FEV1/FVC were significantly lower in the asthma group than those in healthy control group [FEV1％:(68.26 ±22.83)％ vs.(97.46 ± 10.44)％,FEV1/FVC:0.69 ±0.13 vs.0.82 ±0.05,both P ＜ 0.01].In the asthma group,the levels of FEV1％,FEV1/FVC were negatively correlated to the serum S1P level (r =-0.801 and -0.648,both P ＜ 0.01).While the levels of FEV1％,FEV1/FVC were not correlated to the serum S1P level in the healthy control group (r =-0.048 and 0.183,P ＞ 0.05).Conclusion The serum S1P is increased significantly in patients with asthma,and it being an important inflammatory mediator may play a crucial role in the pathogenesis of asthma.