摘要
目的研究血清1-磷酸鞘氨醇(S1P)、脂氧素A4(LXA4)联合检测对成人支气管哮喘的诊断价值。方法选取哮喘发作期患者120例,按疾病严重程度分为轻度哮喘组(n=43)、中度哮喘组(n=43)和重度哮喘组(n=34);同时选取40例健康受试者为健康对照组。比较4组肺功能指标[1秒钟用力肺呼气容积(FEV1)与预计值比值(FEV1%)、用力肺活量与预计值比值(FVC%)、FEV1/FVC]及血清S1P、LXA4水平;采用Pearson相关性分析方法对血清S1P、LXA4水平与肺功能指标的相关性进行分析;采用ROC曲线研究血清S1P、LXA4水平单项检测及两者联合检测对诊断成人支气管哮喘的临床价值。结果4组FEV1%、FVC%、FEV1/FVC值及血清S1P、LXA4水平比较差异有统计学意义(F=16.255、209.605、26.220、571.290、284.822,均P<0.01),且随着哮喘严重程度的增加,FEV1%、FVC%、FEV1/FVC值及血清LXA4水平逐渐降低,血清S1P水平逐渐升高。Pearson相关性分析显示,血清S1P水平与FEV1%、FVC%、FEV1/FVC值均呈负相关(r=-0.807、-0.860、-0.766,均P<0.01),血清LXA4水平与FEV1%、FVC%、FEV1/FVC值均呈正相关(r=0.655、0.707、0.819,均P<0.01)。ROC曲线结果显示,血清S1P、LXA4水平检测及两者联合检测诊断成年哮喘的AUC曲线下面积分别为0.864(95%CI 0.801~0.913)、0.807(95%CI 0.737~0.865)、0.981(95%CI 0.946~0.996),敏感度分别为88.33%、86.67%、99.17%,特异度分别为77.5%、80.00%、92.5%。结论血清S1P、LXA4水平能反映成人支气管哮喘患者肺功能情况及疾病严重程度;两指标联合检测对成人支气管哮喘的临床诊断有较高价值。
Objective To explore the diagnostic value of combined detection of serum sphingosine 1-phosphate(S1P)and lipoxin A4(LXA4)in adult patients with asthma.Methods According to the severity of the disease,120 adult patients with asthma were divided into three groups:mild group(n=43),moderate group(n=43)and severe group(n=34).In addition,40 healthy subjects were selected as the healthy control group.The percentage of the forced expiratory volume in 1 second(FEV1)predicted(FEV1%),percentage of the forced vital capacity(FVC)predicted(FVC%),FEV1/FVC ratio and serum S1P and LXA4 levels were compared among the four groups.The correlations between pulmonary function indexes and serum S1P and LXA4 levels were analyzed by Pearson correlation analysis.The diagnostic values of S1P,LXA4 and their combination were analyzed by receiver operating curve(ROC).Results There were significant differences in FEV1%,FVC%,FEV1/FVC,S1P level and LXA4 concertation among the four groups(F=16.255,209.605,26.220,571.290 and 284.822,respectively;P<0.01).Pulmonary function indexes and LXA4 concertation decreased but S1P level increased with the severity of disease(P<0.01).Pearson correlation analysis revealed that serum S1P levels were negatively correlated with FEV1%,FVC%and FEV1/FVC(r=-0.807,-0.860 and-0.766,respectively;P<0.01).However,serum LXA4 levels were positively related to FEV1%,FVC%and FEV1/FVC(r=0.655,0.707 and 0.819,respectively;P<0.01).The areas under the ROC curve were 0.864(95%CI 0.801-0.913),0.807(95%CI 0.737-0.865)and 0.981(95%CI 0.946-0.996)for S1P,LXA4 and their combined detection,respectively.In addition,the sensitivity and specificity were respectively 88.33%and 77.5%for S1P determination,86.67%and 80.00%for LXA4 measurement,and 99.17%and 92.5%for their combination.Conclusion Serum levels of S1P and LXA4 can reflect pulmonary function and disease severity in adult patients with bronchial asthma.Combined detection of S1P and LXA4 has a high value for clinical diagnosis of bronchial asthma.
作者
许枫
张艳萍
刘晓娜
代先慧
XU Feng;ZHANG Yan-ping;LIU Xiao-na;DAI Xian-hui(Department of Respiratory Medicine,Qingdao Chengyang District People’s Hospital,Qingdao 266000,China)
出处
《南昌大学学报（医学版）》
CAS
2020年第1期52-56,共5页
Journal of Nanchang University：Medical Sciences
关键词
支气管哮喘
1-磷酸鞘氨醇
脂氧素A4
联合诊断
肺功能
bronchial asthma
sphingosine 1-phosphate
lipoxin A4
combined diagnosis
pulmonary function
