血清抗中性粒细胞胞浆抗体与儿童闭塞性细支气管炎诊治的相关性研究  

The Correlation Between Serum Anti-neutrophil Cytoplasmic Antibodies and Diagnosis and Treatment of Bronchiolitis Obliterative in Children

作　　者：郑应莲 毛国其 ZHENG Yinglian;MAO Guoqi(Pediatrics,Chongqing Dazu People′s Hospital,Chongqing 402360,China)

机构地区：[1]重庆医科大学附属第一医院大足医院,重庆市大足区人民医院儿科,重庆402360

出　　处：《标记免疫分析与临床》2020年第1期70-73,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨血清抗中性粒细胞胞浆抗体(ANCA)与儿童闭塞性细支气管炎(BO)诊治的相关性。方法将80例感染后BO患儿作为研究对象,给予布地奈德混悬液+异丙托溴铵溶液雾化吸入,孟鲁司特+阿奇霉素口服等规范化治疗。选取同期门诊体检的60例健康儿童作为对照组。比较治疗前后患儿血清白介素-6(IL-6)、白介素-8(IL-8)、血C-反应蛋白(CRP)和ANCA表达水平,分析ANCA表达水平与血清炎症指标以及患儿转归的相关性。结果观察组患儿治疗有效6例(7.50%),好转71例(88.75%),无效3例(3.75%),治疗有效率为96.25%(77/80);观察组患儿的血清IL-6、IL-8、CRP和ANCA表达水平明显高于对照组,观察组患儿治疗后血清IL-6、IL-8、CRP和ANCA表达水平明显低于治疗前,差异均有统计学意义(均P<0.01);经Pearson相关性分析显示,观察组患儿血清ANCA表达水平与IL-6表达水平呈正相关(r=0.53,P=0.006),与IL-8表达水平呈正相关(r=0.46,P=0.001),与CRP表达水平呈正相关(r=0.61,P=0.012);出院1年再入院组(n=15)、门诊组(n=21)、缓解组(n=41)三组患儿出院时的血清IL-6、IL-8和ANCA表达水平呈明显递减趋势,差异均有统计学意义(均P<0.01),三组患儿的CRP表达水平无明显差异(P>0.05)。结论血清ANCA是一种BO患儿病情严重程度和转归的较好观测指标,值得临床推广应用。Objective To investigate the relationship between serum anti-neutrophil cytoplasmic antibody(ANCA)and childhood bronchiolitis obliterative(BO).Methods Eighty children with post-infection BO were enrolled in this study.They were given budesonide suspension+ipratropium bromide solution for nebulization,and montelukast+azithromycin was orally administered.Sixty healthy children from physical examination at the same time were selected as the control group.The levels of serum interleukin-6(IL-6),interleukin-8(IL-8),C-reactive protein(CRP)and ANCA were compared before and after treatment between groups.The relevance of the expression level of ANCA with serum inflammation index and the outcome of children was analyzed.Results In the observation group,6 patients(7.50%)were effective,71 patients(88.75%)were improved,3 patients(3.75%)were ineffective,and the effective rate was 96.25%(77/80).The expression levels of IL-6,IL-8,CRP and ANCA in the observation group were significantly higher than those of the control group.The levels of serum IL-6,IL-8,CRP and ANCA in the observation group after treatment were significantly lower than those of before treatment(all P<0.01).Pearson correlation analysis showed that the serum ANCA expression level was positively correlated with IL-6 expression level in the observation group(r=0.53,P=0.006),and positively correlated with IL-8 expression level(r=0.46,P=0.001),also positively correlated with CRP expression level(r=0.61,P=0.012).The levels of serum IL-6,IL-8 and ANCA in these three groups which contained the one-year re-admission group(n=15),outpatient group(n=21),and remission group(n=41)were gradually decreased,and the differences were statistically significant(P<0.01).There was no significant difference in CRP expression among these three groups(P>0.05).Conclusion Serum ANCA is a good observation index for the severity and outcome of children with BO,which is worthy of clinical application.

关 键 词：闭塞性细支气管炎 抗中性粒细胞胞浆抗体 白介素-6 白介素-8 

分 类 号：R563[医药卫生—呼吸系统]