Zhao Yunwei, Xu Yiqin, Li Shuang, Wei Yu, Wang Chunling
Department of Respiration, the First Affiliated Hospital of Jiamusi University, Jiamusi 154002, Heilongjiang, China. Corresponding author: Wang Chunling, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017 Sep;29(9):794-798. doi: 10.3760/cma.j.issn.2095-4352.2017.09.006.
To observe the changes of serum sphingosine-1-phosphate (S1P) level in asthmatic patients with different severity of bronchial asthma, and to explore the evaluation value of S1P on the severity of asthma.
A prospective observational study was conducted. Fifty-two patients with asthma admitted to Department of Respiratory Medicine of the First Affiliated Hospital of Jiamusi University from November 2015 to January 2017 were enrolled. According to the severity of the disease, the patients were divided into mild, moderate and severe groups. In the same period, 25 healthy subjects were served as healthy control group. All the subjects got the peripheral venous blood collection in the morning fasting, the level of serum S1P was determined by enzyme linked immunosorbent assay (ELISA), the peripheral blood eosinophil (EOS) was counted, and the pulmonary function test was performed. The correlation among the parameters was analyzed by Pearson correlation analysis. Receiver operating characteristic curve (ROC) was plotted, and the value of serum S1P on evaluating the severity of asthma was analyzed.
Fifty-two asthma patients were enrolled, including 17 patients of the mild, 19 of the moderate, and 16 of the severe. Compared with the healthy control group, serum S1P level and peripheral blood EOS in different degree asthma groups were significantly increased, and forced expiratory volume in 1 second (FEV1) was decreased significantly; and with asthma exacerbations, serum S1P levels and peripheral blood EOS were gradually increased [mild, moderate and severe S1P (nmol/L) were 1 537.0±120.3, 1 980.7±149.5, 2 202.2±117.2 (F = 274.624, P = 0.001); EOS (×10/L) were 0.13±0.06, 0.20±0.07, 0.37±0.14 , respectively (F = 44.093, P = 0.001)], and FEV1 was decreased gradually [mild, moderate and severe were 0.89±0.05, 0.63±0.06, 0.42±0.10, respectively (F = 159.756, P = 0.001)]. Correlation analysis showed that there were significant positive correlations between serum S1P level and peripheral blood EOS in patients with mild, moderate and severe asthma (r value was 0.696, 0.746, 0.508, all P < 0.05), and negatively correlations with FEV1 were found (r value was -0.761, -0.655, -0.815, all P < 0.01). There was no significant correlation between serum S1P level and EOS, FEV1 in healthy control group (r value was 0.324 and -0.048, both P > 0.05). ROC curve analysis showed that the area under curve (AUC) of serum S1P for assessing mild, moderate and severe asthma was 0.948, 1.000, 1.000, respectively; when the cut-off of S1P was 1 181.8, 1 534.2, 1 708.6 nmol/L, the sensitivity was 88.2%, 100%, 100%, and the specificity was 88.0%, 100% and 100%, respectively.
During asthma attack, the serum S1P level was gradually increased with the exacerbation of the disease. Serum S1P level has significant evaluative effect on the severity of asthma.
观察不同严重程度支气管哮喘患者血清鞘氨醇-1-磷酸(S1P)水平的变化,探讨S1P对哮喘严重程度的评估价值。
进行一项前瞻性观察性研究。选取2015年11月至2017年1月佳木斯大学附属第一医院呼吸内科收治的52例哮喘患者。根据疾病严重程度将患者分为轻度、中度和重度组。同期选取25例健康受试者作为健康对照组。所有受试者均于清晨空腹采集外周静脉血,采用酶联免疫吸附测定法(ELISA)测定血清S1P水平,计数外周血嗜酸性粒细胞(EOS),并进行肺功能检测。采用Pearson相关分析对各参数间的相关性进行分析。绘制受试者工作特征曲线(ROC),分析血清S1P对哮喘严重程度的评估价值。
共纳入52例哮喘患者,其中轻度17例,中度19例,重度16例。与健康对照组相比,不同程度哮喘组血清S1P水平和外周血EOS均显著升高,第1秒用力呼气容积(FEV1)显著降低;且随着哮喘病情加重,血清S1P水平和外周血EOS逐渐升高[轻度、中度和重度S1P(nmol/L)分别为1 537.0±120.3、1 980.7±149.5、2 202.2±117.2(F = 274.624,P = 0.001);EOS(×10/L)分别为0.13±0.06、0.20±0.07、0.37±0.14,(F = 44.093,P = 0.001)],FEV1逐渐降低[轻度、中度和重度分别为0.89±0.05、0.63±0.06、0.42±0.10,(F = 159.756,P = 0.001)]。相关性分析显示,轻度、中度和重度哮喘患者血清S1P水平与外周血EOS均呈显著正相关(r值分别为0.696、0.746、0.508,均P < 0.05),与FEV1呈负相关(r值分别为-0.761、-0.655、-0.815,均P < 0.01)。健康对照组血清S1P水平与EOS、FEV1无显著相关性(r值分别为0.324和-0.048,均P > 0.05)。ROC曲线分析显示,血清S1P评估轻度中度和重度哮喘的曲线下面积(AUC)分别为0.948、1.000、1.000;当S1P的截断值分别为1 181.8、1 534.2、1 708.6 nmol/L时,敏感度分别为88.2%、100%、100%,特异度分别为88.0%、100%、100%。
哮喘发作时,血清S1P水平随病情加重而逐渐升高。血清S1P水平对哮喘严重程度具有显著评估作用。