老年支气管哮喘患者血清 MC-CP、S1P水平与 T细胞免疫分子及气道基底膜厚度的关系

摘要 目的：探讨老年支气管哮喘患者血清肥大细胞羧肽酶（MC-CP）、1-磷酸鞘氨醇（S1P）水平，并分析与 T细胞免疫分子及气道基底膜厚度的关系。方法：选择 2016年 8月至 2018年 12月我院收治的老年支气管哮喘患者 86例，根据哮喘控制情况分为急性发作期组 48例和缓解期组 38例，选择同期医院体检的健康老年人 40例作为对照组，检测并比较各组血清 MC-CP、S1P水平、肺功能、T细胞免疫分子、支气管黏膜网状基底膜厚度（BMT），并分析血清 MC-CP、S1P水平与肺功能指标、T细胞免疫分子及BMT的相关性。结果：急性发作组、缓解组患者血清 MC-CP、S1P水平及 BMT、CD8⁺均高于对照组，且急性发作组患者血清MC-CP、S1P、CD8+水平高于缓解期组（P＜0.05）。急性发作期组和缓解期组 FEV1%pred、CD4⁺、CD4⁺/ CD8⁺，血清免疫球蛋白 A（IgA）、免疫球蛋白 M（IgM）、免疫球蛋白 G（IgG）水平低于对照组，且急性发作期组上述指标低于缓解期组（P＜0.05）。老年支气管哮喘患者血清 MC-CP、S1P与 CD8⁺、BMT呈正相关（P＜0.05），与 FEV1%pred、CD4⁺、CD4⁺/CD8⁺、IgA、IgM、IgG呈负相关（P＜0.05）。结论：老年支气管哮喘患者的血清 MC-CP、S1P水平显著升高，其水平与与肺功能、免疫功能和气道重塑相关，且血清MC-CP与 S1P水平密切相关。

Relationship between Serum MC-CP, S1P Levels and T Cell Immune Molecules and Airway Basement Membrane Thickness in Elderly Patients with Bronchial Asthma

ABSTRACT Objective: To investigate serum mast cell carboxypeptidase (MC-CP) and 1- sphingosine (S1P) levels in elderly patients with bronchial asthma, the relationship between T cell immunologic molecules and airway basement membrane thickness was also analyzed. Methods: 86 elderly patients with bronchial asthma in our hospital from August 2016 to December 2018 were selected, according to the situation of asthma control, the patients were divided into acute attack group (48 cases) and remission group (38 cases). 40 healthy elderly patients in the same period were selected as control group. The levels of serum MC-CP, S1P, lung function, T cell immune molecules, the thickness of bronchial reticular basement membrane (BMT) were measured and compared. The correlation between the levels of serum mc-cp and S1P and the indexes of lung function, T cell immune molecules and BMT were analyzed. Results: The serum levels of MC-CP, S1P, BMT and CD8⁺ in the acute attack group and the remission group were higher than those in the control group, and the serum levels of MC-CP, S1P and CD8⁺ in the acute attack group were higher than those in the remission group (P<0.05). The FEV1% pred, levels of CD4⁺, CD4⁺/CD8⁺, serum levels of Immunoglobulin A (IgA), Immunoglobulin M (IgM) and Immunoglobulin G (IgG) in acute attack group and remission group was lower than that of control group, and all above indexes in acute attack group was lower than those in remission group (P<0.05). Serum MC-CP and S1P were positively correlated with CD8⁺ and BMT in elderly patients with bronchial asthma (P<0.05), and which were negatively correlated with FEV1%pred, CD4⁺, CD4⁺/CD8⁺, IgA, IgM and IgG (P<0.05). Conclusion: The levels of serum MC-CP and S1P in elderly patients with bronchial asthma increased significantly, and their levels were correlated with lung function, immune function and airway remodeling. Serum MC-CP levels in asthma patients were closely related to S1P levels.