胆碱脂酶、触珠蛋白在反复呼吸道感染儿童血清中的表达水平及其对预后的评估价值

郭娜; 索瑞; 郭杰; 李大龙; 贾浩; 商晓丽; 刘冬青

doi:10.7619/jcmp.20240512

胆碱脂酶、触珠蛋白在反复呼吸道感染儿童血清中的表达水平及其对预后的评估价值

Expression levels of cholinesterase and haptoglobin in serum of children with recurrent respiratory tract infections and their value in evaluation of prognosis

摘要

摘要:
目的探讨胆碱脂酶(CHE)、触珠蛋白(HPT)在反复呼吸道感染(RRTI)儿童血清中的表达水平及其对预后的评估价值。
方法选取112例RRTI患儿纳入RRTI组，随机选取同期健康体检儿童95例纳入对照组。根据疾病的严重程度，将RRTI组患儿分为轻度组38例、中度组40例和重度组34例。检测血清CHE、HPT、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)水平以及CD3⁺、CD3⁺CD4⁺水平。分析RRTI患儿的CHE与HPT的相关性。分析血清CHE、HPT的表达水平对RRTI患儿预后的预测价值。
结果 RRTI组患儿的CHE表达水平低于对照组, HPT水平高于对照组，差异有统计学意义(P < 0.05)。重度组RRTI患儿的CHE水平低于中度组和轻度组，中度组低于轻度组; 重度组RRTI患儿的HPT水平高于中度组和轻度组，中度组高于轻度组，差异有统计学意义(P < 0.05)。RRTI患儿的CHE表达水平与HPT表达水平呈负相关(r=-0.637, P < 0.001)。RRTI组的IL-1、IgA、IgM水平和CD3⁺、CD3⁺CD4⁺低于对照组, IL-6水平高于对照组，差异有统计学意义(P < 0.05)。RRTI患儿CHE表达水平与IL-1、IgA、IgM、CD3⁺、CD3⁺CD4⁺呈正相关，与IL-6呈负相关; HPT表达水平与IL-1、IgA、IgM、CD3⁺、CD3⁺CD4⁺呈负相关，与IL-6呈正相关(P < 0.05)。预后良好RRTI患儿的血清CHE表达水平高于预后不良RRTI患儿, HPT水平低于预后不良RRTI患儿，差异有统计学意义(P < 0.05)。CHE、HPT联合预测RRTI患儿预后的曲线下面积(AUC)大于其单独预测的AUC, 差异有统计学意义(P < 0.05)。
结论在RRTI患儿血清中, CHE呈低表达, HPT呈高表达。CHE、HPT联合评估RRTI患儿预后的价值较高。

Abstract:
Objective To explore the expression levels of cholinesterase (CHE) and haptoglobin (HPT) in serum of children with recurrent respiratory tract infections (RRTI) and their value in evaluation of prognosis.
Methods A total of 112 children with RRTI were selected and included in the RRTI group, and 95 normal children who underwent physical examination during the same period were randomly selected and included in control group. According to the severity of the disease, patients in the RRTI group were divided into mild group of 38 cases, moderate group of 40 cases, and severe group of 34 cases. The levels of serum CHE, HPT, interleukin-1 (IL-1), interleukin-6 (IL-6), immunoglobulin A (IgA), immunoglobulin M (IgM), as well as CD3⁺ and CD3⁺CD4⁺ were detected. The correlation between CHE and HPT in RRTI children was analyzed. The predictive value of serum CHE and HPT expression levels on the prognosis of RRTI children was analyzed.
Results The CHE expression level in the RRTI group was significantly lower than that in the control group, while the HPT level was significantly higher (P < 0.05). The CHE level in severe RRTI patients was significantly lower than that in the moderate and mild groups, and the moderate group was significantly lower than the mild group; the HPT level in severe RRTI children was significantly higher than that in the moderate and mild groups, and the moderate group was significantly higher than the mild group (P < 0.05). The CHE expression level in RRTI children was negatively correlated with the HPT expression level (r=-0.637, P < 0.001). The levels of IL-1, IgA, IgM, CD3⁺ and CD3⁺CD4⁺, in the RRTI group were significantly lower than those in the control group, while the IL-6 level was significantly higher (P < 0.05). The CHE expression level in RRTI children was positively correlated with IL-1, IgA, IgM, CD3⁺and CD3⁺CD4⁺, and negatively correlated with IL-6; the HPT expression level was negatively correlated with IL-1, IgA, IgM, CD3⁺ and CD3⁺CD4⁺, and positively correlated with IL-6 (P < 0.05). The serum CHE expression level in RRTI children with good prognosis was significantly higher than that in RRTI children with poor prognosis, while the HPT level was significantly lower (P < 0.05). The area under the curve (AUC) of the combined prediction of CHE and HPT for the prognosis of RRTI children was higher than that of their individual predictions, and the difference was statistically significant (P < 0.05).
Conclusion In the serum of RRTI children, CHE is lowly expressed, while HPT is highly expressed. The combined evaluation of CHE and HPT has high prognostic value for RRTI patients.

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