闭塞性细支气管炎患儿病情进展程度与肺功能、VEGF及炎性因子的关系研究

摘要

目的 研究闭塞性细支气管炎(BO)患儿病情进展程度与肺功能、血管内皮生长因子(VEGF)以及炎性因子IL-4、IL-10、IFN-γ的相关性.方法 整理本院2006年1月-2016年1月间收治的108例闭塞性细支气管炎(BO)患儿病例资料作为研究对象,将全部患儿根据病情进展程度分为轻度组与重度组,对比不同病情患儿的HRCT(肺部高分辨率CT)表现、肺功能、VEGF表达、IL-4、IL-10、IFN-γ三项炎性因子表达的差异性,并分析肺功能与VEGF、IL-4、IL-10、IFN-γ的相关性.结果 重度组支气管扩张率为71.88%,轻度组支气管扩张率为47.37%,两组比较具有统计学差异性,P<0.05;两组吸气呼气时间比(Ti/Te)、达峰值容积比(VPTEF/VE)、呼吸阻力(Rrs)具有统计学明显性差异,P<0.05;两组达峰时间比(tPTEF/tE)、中期流速比(TEF50/TIF50)具有统计学显著性差异,P<0.01;重度组VEGF表达水平、IL-4表达水平以及IFN-γ表达水平与轻度组均具有统计学显著差异性,P<0.01;VEGF与肺功能指标Rrs呈负相关r<0,但不具有显著性,P>0.05;VEGF与肺功能指标Ti/Te、VPTEF/VE、tPTEF/tE、TEF50/TIF50具有正相关性00.05;IL-4与肺功能指标Ti/Te、VPTEF/VE、tPTEF/tE、TEF50/TIF50呈负相关性r<0,其中Ti/Te无负相关显著性P>0.05;炎性因子IFN-γ与肺功能指标Ti/Te、VPTEF/VE、tPTEF/tE、TEF50/TIF50呈显著正相关性,00.05.结论 轻度BO患儿肺功能明显优于重度BO患儿,BO患儿的肺功能随病情进展而变化,并与VEGF及炎性因子的表达水平密切相关.%Objective To study the relationship of the degree of disease progression with pulmonary function, VEGF and inflammatory factors (IL-4, IL-10 and IFN-γ) in patients with obliterating bronchiolitis (OB).Methods The clinical data of 108 children with BO were selected in our hospital from January 2006 to January 2016, and they were divided into the mild group and the severe group according to their degree of disease progression.The difference of HRCT (lung high resolution CT), pulmonary function, and the expression of VEGF, IL-4, IL-10, IFN-γ were compared, and the correlation of the degree of disease progression with pulmonary function, VEGF and inflammatory factors was analyzed.Results The bronchiectasis rate was 71.88% in the severe group and 47.37% in the mild group (P<0.05).There were significant differences in inspiratory expiratory time ratio (Ti/Te), peak volume ratio (VPTEF/VE), respiratory resistance (Rrs), peak time ratio (tPTEF/tE), and middle velocity ratio (TEF50/TIF50) between the two groups (P<0.05).The expression of VEGF, IL-4 and IFN-γ showed significant difference between the two groups (P<0.01).VEGF was negatively correlated with lung function index Rrs (r<0) without significance (P>0.05), and positively correlated with pulmonary function indexes of Ti/Te, VPTEF/VE, tPTEF/tE, and TEF50/TIF50 (00.05).The IFN-γ and lung function indexes of Ti/Te, VPTEF/VE, tPTEF/tE, TEF50/TIF50 showed a significant positive correlation (00.05).Conclusion The pulmonary function of children with mild BO is significantly better than those with severe BO.With the disease progression, their lung function is closely correlated with the expression levels of VEGF and inflammatory factors.