生物标志物、CT评价咳嗽变异性哮喘气道重塑研究.docVIP

生物标志物、CT评价咳嗽变异性哮喘气道重塑研究 　　[摘要] 目的 探讨诱导痰神经生长因子（NGF）、基质金属蛋白酶-9（MMP-9）及高分辨CT在评价咳嗽变异性哮喘（CVA）患者气道重塑中的作用。 方法 将50例确诊为CVA的患者设为CVA组，20例健康体检者设为正常对照组（N组），受试者行肺通气功能、诱导痰及胸部高分辨CT（HRCT）检查，应用酶联免疫吸附法（ELISA）检测诱导痰中NGF、MMP-9浓度，计算气道壁的厚度（T）、气道壁面积（WA）、气道壁面积占气道总截面积的百分比（WA%），并应用体表面积（BSA）对T、WA进行校正。 结果 与N组比较，CVA组诱导痰NGF、MMP-9浓度升高，差异有统计学意义（P 0.05）。CVA组T/BSA、WA/BSA、WA%测定值与N组相比，差异有统计学意（P 　　[关键词] 咳嗽变异性哮喘；气道重塑；神经生长因子；基质金属蛋白酶-9；高分辨CT 　　[中图分类号] R562.2+5 [文献标识码] A [文章编号] 1674-4721（2013）06（c）-0015-03 　　Research on the assessment of airway remodeling in cough variant asthma by use of biological markers and CT 　　ZHONG Xueying HUANG Yanming WEN Yuting 　　Department of Respiratory Medicine，Jiangmen Central Hospital of Guangdong Province，Jiangmen 529030， China 　　[Abstract] Objective To explore the roles of biological markers of nerve growth factor （NGF）， matrix metalloproteinase-9（MMP-9） in induced sputum and high-resolution CT （HRCT） in assessing airway remodelillg in cough variant asthma（CVA）. Methods Fifty cases of CVA patients were recruited as CVA group， and control group （N group） included 20 healthy persons in this study. Lung function test， induced sputum and HRCT check were performed on these subjects. The concentrations of NGF， MMP-9 in induced sputum were measured by ELISA. The wall thickness（T）， the airway wall area （WA） and the percentage of airway wall area to total airway cross sectional area（WA%） were calculated on HRCT. T and WA were adjusted by body surface area（BSA）. Results The concentration of NGF， MMP-9 in induced sputum of CVA group were higher than those of N group （P 0.05）. WA/BSA， WA% and T/√BSA of CVA group were higher than N group （P 　　[Key words] Cough variant asthma； Airway remodeling； Nerve growth factor； Matrix metalloproteinase-9； High resolution computed tomography 　　咳嗽变异性哮喘（cough variant asthma，CVA）是一种特殊类型的支气管哮喘，咳嗽是其唯一或主要临床表现，无明显气促、喘息。研究表明CVA也具有典型哮喘的病理生理过程，包括气道嗜酸粒细胞炎症、气道高反应性，甚至气道重塑[1]。因气道重塑最终可导致气道壁结构和功能的改变，因此，有效监测CVA患者的气道重塑情况，对评价、指导治疗及判断预后均有重要意义。本研究拟探讨生物标志物神经生长