| Objective:To explore the clinical features and the function of interleukin 4(IL-4) and serum interferon gamma(IFN-γ) in bronchiectasis accompany asthma patients, we can have a further understanding about the pathogenesis of bronchiectasis merger asthma, and provide the early diagnosis. Methods:According the expert consensus about diagnosing and treatmenting of adult bronchiectasis disease in 2012 and China asthma control guidelines in 2008,I collected 29 cases of patients with bronchiectasis and 12 cases of asthma patients in the ward of Department of Respiratory Medicine in the Second Clinical Hospital of Jilin University between October 2014 and October 2015. Group A is 14 patients with pure bronchiectasis;group B is 12 patients with simple asthma;group C is 15 patients with bronchiectasis accompany asthma, group D is 7 healthy people. The four groups were compared with regard to baseline data, Fe NO and the expression of IL-4 and IFN –γ level in serum of patients. Results:1. Each baseline determination results(1) Each natural data determination results There was no statistically significant difference between the age, sex(P > 0.05) of the patients in bronchiectasis, asthma, bronchiectasis accompany asthma and control group; The allergies difference was statistically significant in bronchiectasis group and bronchiectasis accompany asthma group(P < 0.05), the allergy difference has no statistical significance in asthma group and bronchiectasis accompany asthma group(P > 0.05).(2) Groups of lung function index determination results(1) The FEV1(%), FEV1 / FVC(%),MMEF75/25 and MMEF75/25(%) are statistically significant in front of the bronchi relaxation test in bronchiectasis group and bronchiectasis accompany asthma group(P< 0.05).(2) The period of FVC, FEV1 and MMEF75/25 are statistically significant after bronchial diastolic test in bronchiectasis group and bronchiectasis accompany asthma group(P < 0.01), and FEV1 / FVC(%)was statistically significant(P < 0.05).(3) There was no difference in lung function index between asthma group and bronchiectasis accompany asthma group(P > 0.05).(3) Each illness yearsThe average illness years of patients in bronchiectasis group was 9.15, asthma group was 14.68. The average illness years of bronchiectasis and asthma were 14.35/4.28.There were 14 patients with bronchiectasis as the primary diagnosis in bronchiectasis accompany asthma group, the average illness years of bronchitis was 10.07 years before asthma appearing.2. FENO level(1) The expression of FENO level in bronchiectasis group and bronchiectasis accompany asthma group(37.95±13.03ppb;58.96±15.17ppb) were higher than the control group(16.95±4.97ppb),the difference was statistically significant(P < 0.01).(2) The expression of FENO level in bronchiectasis group(11.05±5.35ppb)was lower than the control group, the difference is statistically significant(P < 0.05); The expression of FENO level in group bronchiectasis accompany asthma group was higher than bronchiectasis group, the difference was statistically significant(P < 0.01).(3) The expression of FENO level in bronchiectasis accompany asthma group was lower than asthma group, the difference was statistically significant(P < 0.01).(4) There were 5 patients with pseudomonas aeruginosa(PA) infection in bronchiectasis accompany asthma group,the expression of FENO level(26.78±5.69ppb)was lower than the patients who had no PA infection(43.54±12.03ppb), the difference was statistically significant(P < 0.05); There were 3 patients with PA infection in bronchiectasis group, the expression of FENO level(6.77±1.88ppb)was lower than the patients who had no PA infection(12.13±5.67ppb), the difference was not statistically significant(P >0.05).3.serum interleukin 4(IL- 4) expression levelSerum interleukin 4(IL- 4) : The expression of IL- 4 level in bronchiectasis, asthma, bronchiectasis accompany asthma and control group(317.02±53.53ng/L; 279.02 ±44.24) ng/L;367.60±45.10ng/L) were higher than the control group(215.33±46.33 ng/L), the difference was statistically significant(P < 0.01); The expression of IL- 4 level in bronchiectasis accompany asthma group was higher than bronchiectasis group, the difference was statistically significant(P < 0.05); The expression of IL- 4 level in bronchiectasis accompany asthma group was lower than asthma group, the difference was statistically significant(P < 0.05).4.Interferon- gamma(IFN- γ) expression levelGamma interferon(IFN-γ) : The expression of IFN –γ level in bronchiectasis accompany asthma group(241.68 ±50.33ng/L) was higher than the control group(192.14-25.99 ng/L), the difference was statistically significant(P < 0.05); the bronchiectasis group(295.65 ±77.10 ng/L) was higher than the control group, the difference was statistically significant( P< 0.01); The expression of IFN –γ level in asthma group(153.76±26.69ng/L) was lower than the control group, the difference was statistically significant(P < 0.05); The expression of IFN –γ level in bronchiectasis accompany asthma group was lower than bronchiectasis group, the difference was statistically significant(P < 0.05); The expression of IFN –γ level in bronchiectasis accompany asthma group was higher than asthma group, the difference was statistically significant(P < 0.01). Conclusion:1.The risk of asthma will increase after about 10.07 years with bronchiectasis as the primary diagnosis.2.The expression of breath of nitric oxide in patients with bronchiectasis significantly below the bronchiectasis accompany asthma group and asthma group, the pathogenesis of bronchiectasis has no relationship with airway eosinophilic infiltrates.3.The expression levels of IL-4, IFN–γ may provide the reference for the early diagnosis of bronchiectasis merger asthma. |
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