河北医科大学学报 ›› 2024, Vol. 44 ›› Issue (5): 530-536.doi: 10.3969/j.issn.1007-3205.2024.05.007

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不同病情程度的支气管哮喘患儿VEGF、ET-1水平与气道炎症、肺功能的相关性分析

  

  1. 1.河北省廊坊市第四人民医院儿科，河北 廊坊 065700；2.河北省廊坊市第四人民医院内科，河北 廊坊 065700；
    3.河北省廊坊市第四人民医院骨科，河北 廊坊 065700；4.河北省廊坊市第四人民医院手术室，河北 廊坊 065700

  • 出版日期:2024-05-25 发布日期:2024-05-22
  • 作者简介:王晶晶（1988-），女，河北霸州人，河北省廊坊市第四人民医院主治医师，医学学士，从事儿科疾病诊治研究。
  • 基金资助:
    廊坊市科学技术研究与发展计划自敌经费项目（2022013115）

Correlation of VEGF and ET-1 levels with airway inflammation and lung function in children with different degrees of bronchial asthma

  1. 1.Department of Pediatrics, the Fourth People′s Hospital of Langfang City, Hebei Province, 
    Langfang 065700, China；2.Department of Internal Medicine, the Fourth People′s Hospital of 
    Langfang City, Hebei Province, Langfang 065700, China；3.Department of Orthopedics, 
    the Fourth People′s Hospital of Langfang City, Hebei Province, Langfang 065700, China； 
    4.Operating Room, the Fourth People′s Hospital of Langfang City, 
    Hebei Province, Langfang 065700, China

  • Online:2024-05-25 Published:2024-05-22

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摘要： 目的 探讨不同病情程度支气管哮喘患儿血管内皮生长因子（vascular endothelial growth factor，VEGF）、内皮素1（endothelin-1，ET-1）水平与气道炎症、肺功能的相关性，以期为临床早期评估病情、制定干预方案提供参考。
方法 选取我院80例支气管哮喘患儿作为研究对象，其中轻度44例，中-重度36例，统计所有患儿临床资料、肺功能［呼气峰流速（peak expiratory flow rate，PEF）、1秒内用力呼气容积（forced expiratory volume within 1 second，FEV1）、FEV1占预计值百分比（FEV1 as a percentage of expected value，FEV1%）］、痰液气道炎症指标［白细胞介素6（interleukin-6，IL-6）、白细胞介素10（interleukin-10，IL-10）、肿瘤坏死因子α（tumor necrosis factor-α，TNF）-α］、VEGF、ET-1水平，分析VEGF、ET-1水平与气道炎症、肺功能相关性及对支气管哮喘患儿病情的影响及评估价值。
结果 不同病情程度患儿肺功能指标（FEV1、FEV1%、PEF）、气道炎症指标（痰液IL-6、IL-10、TNF-α）及血清VEGF、ET-1水平比较差异有统计学意义（P＜0.05）；支气管哮喘患儿血清VEGF、ET-1与肺功能指标FEV1、FEV1%、PEF及痰液气道炎症指标IL-10呈负相关（P＜0.05），与痰液气道炎症指标IL-6、TNF-α呈正相关（P＜0.05）；VEGF、ET-1水平联合评估支气管哮喘患儿病情程度的AUC值为0.912，大于单一指标评估；支气管哮喘患儿VEGF、ET-1高水平时，病情加重风险是低水平的2.922倍（95%CI：1.678~5.089）、2.641倍（95%CI：1.514~4.608）；经Logistic回归分析，结果显示VEGF、ET-1均为支气管哮喘患者病情程度加重的危险因素（P＜0.05）；VEGF、ET-1在支气管哮喘患儿病情加重风险中存在正相加交互作用，二者同时存在时效应增强。
结论 VEGF、ET-1与支气管哮喘患儿气道炎症及肺功能具有显著相关性，临床可通过其水平变化早期评估病情，以针对性展开后续治疗，改善预后。


关键词: 哮喘, 血管内皮生长因子, 内皮缩血管肽1

Abstract: Objective To investigate the correlation of the levels of vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) with airway inflammation and lung function in children with different degrees of bronchial asthma, in order to provide a reference for early clinical assessment and development of intervention plans. 
Methods A total of 80 children with bronchial asthma were selected for the study, including 44 with mild and 36 with moderate-to-severe bronchial asthma.  Clinical data, lung function ［peak expiratory flow rate (PEF), forced expiratory volume within 1 second (FEV1), FEV1 as a percentage of expected value (FEV1%)］, sputum airway inflammatory markers ［interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α)］, VEGF and ET-1 levels were recorded, to analyse the correlation of VEGF and ET-1 levels with airway inflammation and lung function, their impact on the condition of children with bronchial asthma and their value in disease evaluation. 
Results There were significant differences in pulmonary function indexes (FEV1, FEV1%, PEF), airway inflammation indexes (sputum IL-6, IL-10, TNF-α) and serum levels of VEGF and ET-1 in children with different disease severity (P＜0.05). In children with bronchial asthma, serum VEGF and ET-1 were negatively correlated with lung function indexes FEV1, FEV1%, PEF and sputum airway inflammation index IL-10 (P＜0.05), but positively correlated with sputum airway inflammation indexes IL-6 and TNF-α (P＜0.05). The area under the receiver operating characteristic (ROC) curve (AUC) value of the combined assessment of VEGF and ET-1 was 0.912, which was higher than that of single index detection. When VEGF and ET-1 levels were high in children with bronchial asthma, the risk of disease exacerbation was 2.922 times (95%CI: 1.678-5.089) and 2.641 times (95%CI: 1.514-4.608) of those with low levels respectively. Results of Logistic regression analysis showed that VEGF and ET-1 were risk factors for exacerbation of the severity of bronchial asthma (P＜0.05). VEGF and ET-1 have positive additive interaction in the risk of exacerbation in children with bronchial asthma, and the effect was enhanced when both are present simultaneously. 
Conclusion VEGF and ET-1 are significantly correlated with airway inflammation and lung function in children with bronchial asthma. The changes in their levels can be used for early assessment of the disease, so as to carry out targeted follow-up treatment and improve the prognosis. 


Key words: asthma, vascular endothelial growth factor, endothelin-1

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