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支气管哮喘患儿血清白细胞介素-25、白细胞介素-33、趋化因子-2和趋化因子-17联合检测的价值

Value of combined detection of serum interleukin-25, interleukin-33, chemokine-2 and chemokine-17 in children with bronchial asthma

    摘要
  • 摘要:
    目的 探讨支气管哮喘患儿血清白细胞介素-25(IL-25)、白细胞介素-33(IL-33)、趋化因子-2(CCL-2)和趋化因子-17(CCL-17)联合检测的价值。
    方法 将91例支气管哮喘患儿纳入哮喘组, 46例同期健康体检儿童纳入健康组。比较2组的一般资料、气道炎症标志物呼出气一氧化氮(FeNO)、免疫球蛋白E(IgE)、肺功能指标用力肺活量(FVC)、第1秒用力呼气量(FEV1)、最大呼气峰流速(PEF)、每分钟静息通气量(VE)和特定气道阻力(Raw)。比较2组血清IL-25、IL-33、CCL-2和CCL-17水平。根据支气管哮喘患儿病情严重程度, 将其分为重度组(n=31)与非重度组(n=60)。采用Spearman相关分析法分析哮喘患儿血清IL-25、IL-33、CCL-2、CCL-17水平与哮喘严重程度的相关性。采用多因素Logistic回归分析法筛选支气管哮喘患儿重度发作的影响因素。采用受试者工作特征(ROC)曲线分析血清IL-25、IL-33、CCL-2、CCL-17对支气管哮喘重度发作的预测价值。
    结果 哮喘组患儿的FeNO、IgE、IL-25、IL-33、CCL-2、CCL-17、VE水平高于健康组, FVC、FEV1、PEF以及Raw水平低于健康组，差异有统计学意义(P < 0.05)。重度组患儿的FeNO、IgE、IL-25、IL-33、CCL-2、CCL-17、VE水平高于非重度组, FVC、FEV1、PEF以及Raw水平低于非重度组，差异有统计学意义(P < 0.05)。哮喘组患儿血清IL-25、IL-33、CCL-2、CCL-17水平与哮喘严重程度呈正相关(r=0.382、0.416、0.475、0.501, P < 0.05)。血清IL-25、IL-33、CCL-2和CCL-17水平为重度哮喘的独立影响因素。IL-25、IL-33、CCL-2、CCL-17联合诊断的曲线下面积大于上述指标单独诊断的曲线下面积。
    结论 血清IL-25、IL-33、CCL-2及CCL-17联合预测支气管哮喘患儿病情发展为重度哮喘的价值较高。

     

    Abstract:
    Objective To investigate the value of combined detection of serum interleukin-25 (IL-25), interleukin-33 (IL-33), C-C motif chemokine ligand 2 (CCL-2) and C-C motif chemokine ligand 17 (CCL-17) in children with bronchial asthma.
    Methods A total of 91 children diagnosed with bronchial asthma were enrolled into asthma group, and 46 healthy children undergoing routine physical examinations during the same period were included in control group. General clinical data, airway inflammatory markers fractional exhaled nitric oxide (FeNO) and immunoglobulin E (IgE)and pulmonary function parameters forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), minute resting ventilation (VE) and specific airway resistance (Raw)were comparedbetween the two groups. The levels of serum IL-25, IL-33, CCL-2 and CCL-17 were compared between the two groups. According to the severity of asthma, the patients were further divided into severe asthma subgroup (n=31) and non-severe asthma subgroup (n=60). Spearman correlation analysis was performed to evaluate the association between serum levels of IL-25, IL-33, CCL-2 as well as CCL-17 and the severity of asthma. Multivariate logistic regression analysis was used to identify independent risk factors for severe exacerbation in children with bronchial asthma. The predictive value of serum IL-25, IL-33, CCL-2 and CCL-17 for severe attacks of bronchial asthma was analyzed by using the receiver operating characteristic (ROC) curve.
    Results The levels of FeNO, IgE, IL-25, IL-33, CCL-2 CCL-17 and VE in the asthma group were significantly higher than those in the healthy group, while the levels of FVC, FEV1, PEF and Raw were significantly lower than those in the healthy group (P < 0.05). The levels of FeNO, IgE, IL-25, IL-33, CCL-2, CCL-17 and VE in the severe group were significantly higher than those in the non-severe group, while the levels of FVC, FEV1, PEF and Raw were significantly lower than those in the non-severe group (P < 0.05). The levels of serum IL-25, IL-33, CCL-2 and CCL-17 in children of the asthma group were positively correlated with the severity of asthma (r=0.382, 0.416, 0.475, 0.501, P < 0.05). The levels of serum IL-25, IL-33, CCL-2 and CCL-17 were independent influencing factors for severe asthma. The area under the receiver operating characteristic curve for the combined detection of IL-25, IL-33, CCL-2 and CCL-17 was greater than that obtained from each individual biomarker.
    Conclusion The combined prediction of serum IL-25, IL-33, CCL-2 and CCL-17 has relatively high value in predicting the development of severe asthma in children with bronchial asthma.

     

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