血清骨桥蛋白、维生素D、白三烯B4对支气管哮喘病儿诊断及预后的应用价值  

The value of serum osteopontin,vitamin D and leukotriene B4 in the diagnosis and prognosis of children with bronchial asthma

作　　者：郑华月[1] 张云涵[2] 郑春阳[3] ZHENG Huayue;ZHANG Yunhan;ZHENG Chunyang(Department of Pediatrics,The First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan 473000,China;Department of Women and Children,Nanyang Medical College,Nan-yang,Henan 473000,China;Electrocardiogram Room,The Second Affiliated Hospital of Nan-yang Medical College,Nanyang,Henan 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院儿二科,河南南阳473000 [2]南阳医学高等专科学校妇儿教研室,河南南阳473000 [3]南阳医学高等专科学校第二附属医院心电图室,河南南阳473000

出　　处：《安徽医药》2022年第1期126-131,共6页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探究血清骨桥蛋白(OPN)、维生素D[25(OH)D]、白三烯B4(LTB4)对支气管哮喘(BA)病儿诊断及预后的应用价值。方法选取南阳医学高等专科学校第一附属医院2017年9月至2019年9月收治的BA病儿104例作为观察组,另选取同期健康体检儿童98例作为对照组。检测对比两组及不同预后病儿血清OPN、25(OH)D、LTB4水平,分析血清各指标对儿童BA的诊断价值及与预后的关系。结果观察组治疗前血清OPN(583.46±120.55)ng/L、LTB4(20.53±4.22)ng/L高于对照组(212.77±65.31)ng/L(8.06±2.18)ng/L,血清25(OH)D(25.10±6.19)ng/L低于对照组(40.05±7.27)ng/L(P<0.05);有过敏史、有呼吸道反复感染史、父母有哮喘史以及治疗前血清OPN、LTB4,25(OH)D均是儿童BA的独立影响因素(P<0.05);血清OPN、25(OH)D、LTB4及其联合诊断评估BA的曲线下面积AUC(95%CI)分别为0.790(0.728~0.844)、0.771(0.706~0.827)、0.809(0.748~0.861)及0.892(0.841~0.931)。治疗第7天、第14天控制者、部分控制者血清OPN、LTB4低于治疗前,25(OH)D高于治疗前(P<0.05);控制者治疗第7天、第14天血清OPN、LTB4(391.29±73.20)ng/L、(300.47±68.81)ng/L、LTB4(15.42±2.63)ng/L、(11.90±2.81)ng/L低于部分控制者(452.26±92.45)ng/L、(378.14±74.35)ng/L、(17.79±3.02)ng/L、(14.14±3.17)ng/L、未控制者(557.82±117.28)ng/L、(557.82±117.28)ng/L、(25.12±2.93)ng/L、(25.55±3.12)ng/L,25(OH)D(31.06±3.17)ng/L、(34.77±4.10)ng/L高于部分控制者(28.21±3.02)ng/L、(30.64±3.76)ng/L、控制者(25.12±2.93)ng/L、(25.12±2.93)ng/L(P<0.05)。logistic回归分析显示,治疗第14天血清OPN、LTB4,25(OH)D均是预后不良的独立影响因素(P<0.05)。结论血清OPN、25(OH)D、LTB4水平在BA病儿中呈异常表达,三者联合应用有望成为BA的更有效诊断手段,为临床选择针对性治疗方案及预后评估提供参考。Objective To investigate the application value of serum osteopontin(OPN),vitamin D(25(OH)D),leukotriene B4(LTB4)in the diagnosis and prognosis of children with bronchial asthma(BA).Methods A total of 104 children with BA who were treated in The First Affiliated Hospital of Nanyang Medical College from September 2017 to September 2019 were selected as the observation group,and 98 children with healthy physical examination during the same period were selected as the control group.The serum levels of OPN,25(OH)D,LTB4 in the two groups and children with different prognosis were detected and compared,and the diagnostic value of serum indicators and the relationship with the prognosis were analyzed.Results Serum OPN(583.46±120.55)ng/L and LTB4(20.53±4.22)ng/L of the observation group before treatment were higher than those of the control group(212.77±65.31)ng/L(8.06±2.18)ng/L,and serum 25(OH)D(25.10±6.19)ng/L was lower than the control group(40.05±7.27)ng/L(P<0.05);a history of allergies,a history of repeated respiratory tract infections,a history of parental asthma,and serum OPN and LTB4,25 before treatment(OH)D were all independent influencing factors of BA in children(P<0.05);serum OPN,25(OH)D,LTB4 and their combined diagnosis and assessment of BA area under the curve AUC(95%CI)were 0.790(0.728-0.844),0.771(0.706-0.827),0.809(0.748-0.861)and 0.892(0.841-0.931).Serum OPN and LTB4 of the totally controlled and partially controlled were lower than those before treatment on the 7th and 14th day of treatment,and 25(OH)D was higher than that before treatment(P<0.05);the serum OPN of the controllers on the 7th and 14th day of treatment,LTB4(391.29±73.20)ng/L,(300.47±68.81)ng/L,LTB4(15.42±2.63)ng/L,(11.90±2.81)ng/L are lower than some controls(452.26±92.45)pg/mL,(378.14±74.35)ng/L,(17.79±3.02)ng/L,(14.14±3.17)ng/L,uncontrolled(557.82±117.28)ng/L,(557.82±117.28)ng/L,(25.12±2.93)ng/L,(25.55±3.12)ng/L,25(OH)D(31.06±3.17)ng/L,(34.77±4.10)ng/L higher than some controls(28.21±3.02)ng/L,(30.64±3.76)ng/L,contr

关 键 词：支气管哮喘 骨桥蛋白 维生素D 白三烯B4 受试者工作特征曲线 儿童 

分 类 号：R725.6[医药卫生—儿科]