咳嗽变异性哮喘患者外周血细胞计数及基质金属蛋白酶9变化分析.docVIP

咳嗽变异性哮喘患者外周血细胞计数及基质金属蛋白酶9变化分析 　　【摘要】 目的 探讨咳嗽变异性哮喘(CVA)患者血清中基质金属蛋白酶-9(MMP-9)的表达情况。方法 选择典型哮喘30例，咳嗽变异性哮喘40例，正常对照组20例，用ELISA法分别测定各组病例血清中MMP-9水平并测定各病例外周血嗜酸性粒细胞计数(Eos)、淋巴细胞计数(Lym)。结果 CVA组与典型哮喘组血清中MMP-9水平显著高于健康对照组(P0．05)。嗜酸性粒细胞计数CVA组与典型支气管哮喘组显著高于健康对照组(P0．05)；淋巴细胞计数CVA组显著高于典型哮喘组与健康对照组(P0．05)；CVA组MMP-9水平与外周血嗜酸细胞计数、淋巴细胞计数皆呈显著正相关关系(r=0．581,P0．05；r=0．627,P0．05)。结论 CVA是以嗜酸性粒细胞、淋巴细胞浸润为主的慢性气道炎症，MMP-9参与了CVA的气道炎症及气道重塑。? 　　【关键词】咳嗽变异性哮喘；基质金属蛋白酶；外周血细胞计数 　　 　　【Abstract】 Objective This study is to investigate the level of matrix metalloproteinase-9(MMP-9)in blood of the patients with cough variant asthma(CVA).Methods To select 30 patients with typical asthma,40 patients with CVA and 20 healthy controls.We detected MMP-9 by enzyme linked immunoabsorbent assay(ELSIA)and detected eosinophil count and lymphocyte count in peripheral blood in the three groups.Results The levels of MMP-9 in plasma of CVA group and typical asthma group were higher than that in healthy group(P0．05);The number of eosinophil in blood of CVA group or typical asthma group was higher than that in healthy group(P0．05);The number of lymphocyte in blood of CVA group was higher than that in typical asthma group and healthy group(P0．05);The relationship between the level of MMP-9 and the eosinophil count or lymphocyte count were both positive correlation.Conclusion CVA is a kind of chronic airway inflammation with eosinophil andlymphocyte,and MMP-9 participates the airway inflammation and airway remodeling in CVA. 　　 　　典型的支气管哮喘常有喘息、胸闷、咳嗽三大症状，而咳嗽变异性哮喘(cough variant asthma,CVA)，又称咳嗽型哮喘(cough type asthma)，是指以慢性干咳为主要或唯一临床表现的一种特殊类型哮喘。随着病情发展，约30%在几年内可发展成典型的支气管哮喘[1]。早期诊断CVA患者并加以正确的治疗，可望减少CVA发展成典型的支气管哮喘的几率。基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)是MMPs家族的一员，MMP-9参与典型哮喘的气道重塑及气道炎症国内外已有相关报道，但MMP-9是否也参与CVA这种特殊类型哮喘的发病，目前国内外未见相关报道。本研究拟通过观察CVA患者血清中MMP-9的表达情况及其与外周血中淋巴细胞计数、嗜酸粒细胞计数相关情况，来探讨MMP-9在CVA中的作用，为CVA的早期诊断提供依据。 　　 　　1 对象及方法 　　 　　1．1 对象 全部病例均为2005年12月至2007年5月在潍坊医学院附属医院门诊就诊和住院治疗的患者，按就诊顺序将患者分为CVA组和典型哮喘组。CVA组，男19例，女21例，平均(32．