毛细支气管炎患儿血清IL-35、Th2类细胞因子水平变化及其意义  

Changes and significance of serum IL-35 and Th2 cytokines in children with bronchiolitis

作　　者：汪廉 孙明月 彭万胜[1] WANG Lian;SUN Mingyue;PENG Wansheng(Department of Pediatrics,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院第一附属医院儿科,安徽蚌埠233004

出　　处：《山东医药》2022年第3期20-24,共5页Shandong Medical Journal

基　　金：安徽省高校自然科学研究重点项目(KJ2019A0365)。

摘　　要：目的 观察毛细支气管炎患儿血清IL-35及Th2类细胞因子的水平变化,并探讨其意义。方法 选取毛细支气管炎住院患儿68例(观察组),按照疾病严重程度将患儿分为轻度组及中重度组,选取同时期非感染患儿20例(对照组)。采用ELISA法检测患儿血清IL-35及Th2类细胞因子IL-4、IL-10、IL-13、IL-33;比较观察组与对照组及轻度组与中重度组上述血清细胞因子的水平;采用Spearman相关分析血清细胞因子之间的相关性;采用多元线性回归分析毛细支气管炎疾病严重程度的影响因素;采用ROC分析上述血清细胞因子对中重度毛细支气管炎的诊断效能。结果 与对照组比较,观察组血清IL-35、IL-10、IL-33水平低,IL-4、IL-13水平高(P均<0.05);与轻度组比较,中重度组血清IL-35、IL-10、IL-33水平低,IL-4、IL-13水平高(P均<0.05)。观察组血清IL-35水平与IL-10呈正相关(P<0.05),与IL-4呈负相关(P<0.05)。观察组血清IL-4、IL-10、IL-13、IL-33是毛细支气管炎疾病严重程度的影响因素(P均<0.05)。当血清IL-35取10.53 pg/mL时,诊断中重度毛细支气管炎的ROC下面积(AUC)为0.760,灵敏度为70.6%,特异度为70.6%;当血清IL-4取7.3 pg/mL时,诊断中重度毛细支气管炎的AUC为0.827,灵敏度为82.4%,特异度为73.5%;当血清IL-10取115.38 pg/mL时,诊断中重度毛细支气管炎的AUC为0.712,灵敏度为44.1%,特异度为97.1%;当血清IL-13取643 pg/mL时,诊断中重度毛细支气管炎的AUC为0.739,灵敏度为97.1%,特异度为41.2%;当血清IL-33取22.61 pg/mL时,诊断中重度毛细支气管炎的AUC为0.635,灵敏度为26.5%,特异度为100.0%。结论 毛细支气管炎患儿血清IL-35、IL-10、IL-33水平降低,IL-4、IL-13水平升高,且中重度患儿较轻度患儿更明显。血清IL-35水平与IL-10水平呈正相关,与IL-4水平呈负相关。Th2类细胞因子是毛细支气管炎严重程度的影响因素。IL-35及Th2类细胞因子可用于辅助判断毛细支气管炎的严重程度。ObjectiveTo observe the changes of serum IL-35 and Th2 cytokines in children with bronchiolitis and to explore their significance.MethodsSixty-eight hospitalized children with bronchiolitis(observation group)and 20 non-infected children in the same period(control group)were selected. According to the severity of the disease,children with bronchiolitis were divided into the mild group and moderate-severe group. Serum IL-35,IL-4,IL-10,IL-13 and IL-33 were detected by ELISA. The levels of serum cytokines were compared between the observation group and the control group,the mild group and the moderate-severe group. Spearman correlation was used to analyze the correlation between serum cytokines. Multiple linear regression was used to analyze the influencing factors for the severity of bronchiolitis.ROC was used to analyze the diagnostic efficacy of the above serum cytokines in the moderate-severe bronchiolitis.ResultsCompared with the control group,the levels of serum IL-35,IL-10 and IL-33 in the observation group were lower,and the levels of IL-4 and IL-13 were higher(all P<0. 05). Compared with the mild group,the levels of serum IL-35,IL-10 and IL-33 in the moderate-severe group were lower,and the levels of IL-4 and IL-13 were higher(all P<0. 05). The level of serum IL-35 in the observation group was positively correlated with IL-10(P<0. 05),and was negatively correlated with IL-4(P<0. 05). Serum IL-4,IL-10,IL-13 and IL-33 in the observation group were the influencing factors for the severity of bronchiolitis(all P<0. 05). When the cut-off value was 10. 53 pg/mL,the area under the curve of serum IL-35 level in diagnosing moderate-severe bronchiolitis was 0. 760,and the sensitivity and specificity were 70. 6% and 70. 6%,respectively. When the cut-off value was 7. 3 pg/mL,the area under the curve of serum IL-4 level in diagnosing moderatesevere bronchiolitis was 0. 827,and the sensitivity and specificity were 82. 4% and 73. 5%,respectively. When the cutoff value was 115. 38 pg/mL,the area under the curve of serum IL-

关 键 词：白细胞介素-35 辅助性T细胞 辅助性T2类细胞因子 呼吸系统疾病 毛细支气管炎 

分 类 号：R725.6[医药卫生—儿科]