IL-17、IL-27和FeNO与支气管哮喘儿童肺功能的相关性及其对哮喘诊断的临床价值  

Correlation of IL-17, IL-27, and FeNO with lung function in children with bronchial asthma and its clinical value in the diagnosis of asthma

作　　者：吴丹丹 李晓玲[1] 赵晓红[1] WU Dan-dan;LI Xiao-ling;ZHAO Xiao-hong(Department of Pediatrics,Luohe Central Hospital,Luohe 462000,China)

机构地区：[1]漯河市中心医院儿科,河南漯河462000

出　　处：《现代药物与临床》2021年第1期39-44,共6页Drugs & Clinic

摘　　要：目的检测哮喘患儿白细胞介素-17(IL-17)、白细胞介素-27(IL-27)和呼出气一氧化氮(FeNO)水平的变化,探讨这些指标与肺功能指标的相关性、诊断哮喘的临床价值。方法收集2019年5月—2020年5月在漯河市中心医院儿科接受治疗的64例哮喘患儿作为哮喘组,同期体检的30例健康儿童作为对照组。记录患者入院时的一般资料、外周血清中白细胞介素-17(IL-17)、白细胞介素-27(IL-27)、FeNO水平和肺功能检测结果。比较治疗前后哮喘患者IL-17、IL-27、FeNO和肺功能指标的变化,分析IL-17、IL-27、FeNO与肺功能指标的相关性。绘制ROC曲线,估测IL-17、IL-27、FeNO单独及联合检测对哮喘的诊断价值。结果入院时,哮喘组用力肺活量(FVC)、1秒用力呼气量(FEV1)、75%呼气中期流量(MEF75%)、50%呼气中期流量(MEF50%)、25%呼气中期流量(MEF25%)和最大呼气峰值流速(PEF)水平均明显低于对照组(P<0.05)。治疗后哮喘组FVC、FEV1、MEF75%、MEF50%、MEF25%和PEF均有所增加,差异具有统计学意义(P<0.05)。入院时哮喘组IL-17和FeNO水平高于对照组,IL-27低于对照组(P<0.05)。治疗后哮喘组IL-17和FeNO水平降低,IL-27水平增加,差异有统计学意义(P<0.05)。IL-17与肺功能指标FVC、FEV1和PEF均呈负相关(r=-0.660、-0.742、-0.889,P<0.05),IL-27与肺功能指标FVC、FEV1和PEF均呈正相关(r=0.664、0.712、0.726,P<0.05),FeNO与肺功能指标FVC、FEV1和PEF均呈负相关(r=-0.874、-0.817、-0.696,P<0.05)。IL-17、IL-27和FeNO单独检测均可诊断哮喘,但灵敏度和特异度均较低,三者联合检测后诊断哮喘的灵敏度和特异度均有所提高。结论哮喘患儿中IL-17、FeNO水平升高,IL-27水平降低,联合检测可提高诊断哮喘的灵敏度和特异度。Objective To detect the level changes of interleukin-17(IL-17), interleukin-27(IL-27) and exhaled nitric oxide(FeNO) levels in children with asthma and their correlation with pulmonary function indexes and the clinical value of diagnosis of asthma. Methods Children(64 cases) with asthma in the Department of Paediatrics of Luohe Central Hospital from May 2019 to May 2020 were selected as the asthma group, and 30 healthy children for physical examination during the same period were selected as the control group. Children’s general information at the time of admission and the levels of IL-17 and IL-27 in the peripheral serum, the level of FeNO and the results of lung function tests were Recorded. Changes of IL-17, IL-27, FeNO, and lung function indexes in children with asthma before and after treatment were compare, and the correlations between IL-17, IL-27, FeNO, and lung function indexes were analyze. ROC curve was drawn to estimate the diagnostic value of IL-17, IL-27, FeNO alone and combined detection for asthma. Results On admission. pulmonary function test indicators forced vital capacity(FVC), forced expiratory volume in 1 second(FEV1), 75% mid-expiratory flow(MEF75%), 50% mid-expiratory flow(MEF50%), 25% mid-expiratory flow(MEF25%) and maximum peak expiratory flow rate(PEF) in the asthma group were lower than those in the control group(P < 0.05). After treatment, the levels of FVC, FEV1, MEF75%, MEF50%, MEF25%, and PEF in the asthma group was increased, and the difference was statistically significant in the same group(P < 0.05). On admission, the levels of IL-17 and Fe NO in the asthma group were higher than those in the control group, but the levels of IL-27 were lower than those in the control group(P < 0.05). After treatment, the levels of IL-17 and FeNO in the asthma group were decreased, but the levels of IL-27 were increased, and the difference was statistically significant(P < 0.05). There was negative correlation between IL-17 levels and lung function indexes FVC, FEV1, and PEF(r=-0.660,-0.742, an

关 键 词：哮喘 儿童 白细胞介素-17 白细胞介素-27 呼出气一氧化氮 肺功能 

分 类 号：R979.1[医药卫生—药品]