The Controlled Clinical Research Of Leptin Levels And Clinical Severity And Pulmonary Function In Patients With Bronchial Asthma

Objective:Bronchial asthma(Bronchial asthma,BA)is a serious threat to human health of chronic respiratory diseases,which is very common in clinical practice,the majority of patients can relieve itself or remission after treatment, and after remission it dose not influence the daily life.According to the Global and our country Asthma Prevention Guide provides the information,that through long-term standardized treatment and management, of which more than 80% of patients can achieve the clinical control of asthma,but actually, the minority of patients in the world can receive good control.In recent years our living standard rises gradually, and the deterioration of the environment pollution,in recent years the prevalence of bronchial asthma is the trend of gradually increased each year,and gradually tend to be younger.Most patients with asthma has not been well controlled,seriously damage to human health,influence the quality of people’s lives.The pathogenesis of asthma is very complicated,is not definite so far.Acquaintance the factors involved in bronchial asthma development and progression,and to control them effectively,is of great help to treatment and prevention of asthma.Leptin means "thin",is a cytokinelike protein polypeptide that secreted by fat cells,which is widely involved in the pathogenesis of asthma,and have a close relation with asthma airway inflammation and airway hyperresponsiveness.The research of relationship between leptin and asthma is more and more mature,and become a research hotspot in recent years. The research has shown that serum leptin concentrations can affect or aggravate the occurrence of asthma,through the study of the correlation analysis of leptin and asthma in our experiment,acquaintance the relationship between the serum leptin concentrations and asthma severity of asthma patients,analyze the change of leptin levels in asthma patients of acue phase and non acute phase,and the relationship between serum leptin concentrations and lung function、body mass index,discuss the role of leptin in pathogenesis of asthma,provide a reference for clinical prevention and treatment of bronchial asthma.Methods:All the 70 subjects were recruited from department of Affiliated Hospital of Cheng De Medical College from October 2014 to March 2015 which in the stage of acute phase of bronchial asthma,including 35 men,35 women,including 23 patients in mild acute phase,31 patients in moderate acute phase,16 patients in severe acute phase,meanwhile selected 20 healthy adult volunteers as control group.1.October 2014 to March 2015 after entering group,according to the asthma clinical illness severity,bronchial asthma patients in acute phase can be divided into three groups of mild group、moderate group and severe group,respectively collections fasting venous blood in the early morning within 24 h after admission and stay in stable condition of one month after treatment of non acute phase, using ELISA method to detect serum leptin level,compared the leptin levels of asthma patients group with normal control group,and comparison the change of leptin levels in asthma patients of acue phase and non acute phase.2.All the patients with lung function after entering the group, comparisons of the function indicators(FVC%pred 、 FEV1%pred and FEV1/FVC%), analysis the correlation of lung function index and serum leptin level at the same time.3.October 2014 to March 2015 after entering group,measure the height, weight, calculate body mess index,analysis the correlation of serum leptin level with BMI and age of asthma patients.4.After patients entering the group,detection the indicators of blood routine CRP, blood gas and so on,analysis CRP and inflammatory factors.5.All the bronchial asthma patients in non acute phase unified fill in asthma control test,25 was divided into totally control group,20 to 24 was divided into control group,less than twenty divided into non control group,comparison of leptin levels between each group.Results:1.The comparison of serum leptin lever in each group and at different period of asthma patientsIn acute phase,the serum leptin levels at each asthma group compared with control group,mild group(5.10±2.68vs2.96±1.93)、moderate group(6.9 3±2.77vs2.96±1.93)、severe group(11.31±4.32vs2.96±1.93) that were higher,the difference was statistically significant(P<0.05);the serum leptin lever gradually increased as the deterioration of the illness severity,severe group is the highest,moderate is second,mild group is the lowest,the difference have statistically significant between the three groups(P<0.05).In non acute phase,comparison of control group,the difference of leptin at moderate group(4.25±2.04vs2.96±1.93) 、 severe group(7.66±2.88vs2.96±1.93) was statistically significant(P<0.05); the serum leptin lever at mild group and moderate group were lower than the severe group,the difference was statistically significant(P<0.05).The serum leptin lever in acute phase were higher than in non acute phase of three groups,the difference was statistically significant in moderate group and sever group(P<0.05).2.The comparison of FVC%pred、FEV1%Pred、FEV1/FVC% at each asthma patients groupAccording to the results through single factor analysis of variance between the three groups show that the inter-group difference of FVC%Pred、FEV1%Pred、FEV1/FVC% was statistically significant(P<0.05).Mild group compared with moderate group FVC%Pred(101.13±13.94vs78. 94±17.07)、FEV1%Pred(83.61±16.97vs54.35±17.69)、FEV1/FVC%(67.74 ±8.89vs52.90±10.79),with severe group FVC%Pred(101.13±13.94vs77.88±16.05)、FEV1%Pred(83.61±16.97vs54.75±19.28)、FEV1/FVC%(67.74±8.89vs5 9.13±15.03)were significantly higher, the difference was statistically significant(P<0.05).The serum leptin concentrations has negative correlation with FEV1%Pred of bronchial asthma patients(r=-0.251,P=0.036).3.The comparison of leptin concentration in different control groupLeptin concentration in patients with asthma was higher in non control group,leptin concentration decreases gradually as the condition control,the difference was statistically significant at three groups(P<0.05).Of which, leptin concentration at the totally control group and well control group is significantly lower than non control group(P<0.05),the difference has no statistically significant between the totally control group and well control group(P>0.05).4.The comparison of CRP、neutrophils and eosinophils ratio of three groups asthma patientsAccording to the results through single factor analysis of variance between the three groups show that CRP of the inter-group difference was statistically significant(P<0.05),and comparison between any two groups show that,comparison of the C-Reactive Protein lever between the mild group and moderate group(10.00±8.64 vs 17.25±16.11),the mild group and severe group(10.00±8.64vs24.00±24.99) were significantly decreased,the difference was statistically significant(P<0.05).The difference of neuter granulocyte ratio and eosinophils ratio did not show statistical significance(P>0.05).5.Correlation analysis of serum leptin leverThe serum leptin lever has negative correlation with FEV1%Pred(r=-0.251,P=0.036);has no significant correlation with BMI(r=0.035,P=0.74 3);has no significant correlation with CRP(r=0.112,P=0.356),has no significant correlation with age(r=0.086,P=0.423).Conclusion:1.The serum leptin lever of bronchial asthma patients was higher than the healthy normal person,leptin may ply a role in the occurrence and development of asthma disease.2.The serum leptin lever was higher with the deterioration of the asthma, the more heavier asthma condition the much higher leptin concentration.In different period of asthma,leptin concentration is different,the leptin lever was higher in acute phase than that in non acute phase.3.The serum leptin concentrations has negative correlation with FEV1%Pred of bronchial asthma patients,the much higher leptin levels,the much lower lung function,the more serious asthma symptoms.4.The worse of asthma control the much higher leptin lever.5.CRP has a role in asthma patients,the CRP is higher at severe group.The leptin lever has no correlation with body mess index and C reactive protein。...