支气管哮喘患儿血清类胰蛋白酶诊断价值及其与疾病严重程度的关系  

Diagnostic value of serum tryptase in children with bronchial asthma and its relationship with disease severity

作　　者：宋令瑄[1] 韩增菊[1] 廉建丽 SONG Ling-xuan;HAN Zeng-ju;LIAN Jian-li(Department of Pediatrics,the Second People＇s Hospital of Zhengzhou,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州市第二人民医院儿科,河南郑州450000

出　　处：《临床肺科杂志》2018年第10期1833-1837,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨支气管哮喘(简称"哮喘")患儿血清类胰蛋白酶诊断价值及其与疾病严重程度的关系。方法选取本院2016年1月-2017年9月收治的哮喘患儿116例为研究组,根据疾病严重程度分间歇组(n=37)、轻度组(n=32)、中度组(n=29)和重度组(n=18),以同期进行体格检查的35例健康儿童为对照组。检测各组血清类胰蛋白酶水平,统计研究组儿童哮喘控制测试(C-ACT)评分、肺功能及血清免疫球蛋白(Ig E)、白细胞介素-4(IL-4)、白细胞介素-13(IL-13)水平,分析血清类胰蛋白酶对哮喘的诊断价值及与临床指标的相关性。结果研究组血清类胰蛋白酶水平高于对照组(P<0.05),且各亚组间差异有统计学意义(P<0.05)。ROC曲线显示,血清类胰蛋白酶诊断哮喘的阈值为3.08μg/L,敏感性为74.86%,特异性为86.75%。研究组各亚组C-ACT评分、FEV_1/预估值、PEF/预估值、FEV_1/FVC值及血清Ig E、IL-4、IL-13水平比较差异有统计学意义(P<0.05)。研究组血清类胰蛋白酶水平与C-ACT评分、FEV_1/预估值、PEF/预估值、FEV_1/FVC值呈负相关(P<0.05),与血清Ig E、IL-4、IL-13水平呈正相关(P<0.05)。结论哮喘患儿血清类胰蛋白酶水平与疾病严重程度呈正相关,可作为病情诊断的有效指标。Objective To investigate the diagnostic value of serum tryptase in children with bronchial asthma and its relationship with the severity of disease.Methods 116 children with asthma from January 2016 to September 2017 were selected as the research group.According to the severity of disease,they were divided into the intermittent group（ n = 37）,the mild group（ n = 32）,the moderate group（ n = 29） and the severe group（ n = 18）.35 healthy children who underwent physical examination at the same time were selected as the control group.Serum tryptase levels in each group were measured,and their asthma control test（ C-ACT） score,pulmonary function,and serum immunoglobulin（ Ig E）,interleukin-4（ IL-4）,interleukin-13（ IL-13） levels in the study group were measured.The value of serum tryptase in the diagnosis of asthma and its correlation with clinical indicators were analyzed.Results The level of serum tryptase in the study group was significantly higher than that in the control group（ P〈0.05）,and the differences between the subgroups were statistically significant（ P〈0.05）.The ROC curve showed that the threshold value of serum tryptase in diagnosis of asthma was 3.08 μg/L,with a sensitivity of 74.86% and a specificity of 86.75%.The C-ACT score,FEV_1/predictive value,PEF/predictive value,FEV_1/FVC value and serum Ig E,IL-4 and IL-13 levels in each subgroup of the study group were significantly different（ P〈0.05）.The serum tryptase level in the study group was negatively correlated with C-ACT score,FEV_1/predictive value,PEF/predictive value,and FEV_1/FVC value（ P〈0.05）,and was positively correlated with serum Ig E,IL-4 and IL-13 levels（ P〈0.05）.Conclusion The serum tryptase level is positively correlated with the severity of disease in children with asthma,and can be used as an effective indicator for the diagnosis of asthma.

关 键 词：支气管哮喘 类胰蛋白酶 肺功能 免疫球蛋白E 白细胞介素-4 白细胞介素-13 诊断 

分 类 号：R725.6[医药卫生—儿科]