支气管哮喘患儿的血清NAMPT、HIF-2α水平及其与急性发作期疾病严重程度的关系、诊断重度急性发作的价值  

Levels of serum NAMPT and HIF-2αin children with bronchial asthma and their relation with severity of acute exacerbation and the diagnostic values of severe acute exacerbation

作　　者：黄运丽 刘冠彬 杜茹 王顺兰 王雅玲 HUANG Yun-li;LIU Guan-bin;DU Ru;WANG Shun-lan;WANG Ya-ling(Department of Pediatrics,Honghu People′s Hospital,Honghu 433200,Hubei,China)

机构地区：[1]洪湖市人民医院儿科,湖北省洪湖市433200

出　　处：《广西医学》2022年第24期2837-2840,2846,共5页Guangxi Medical Journal

基　　金：湖北省卫生健康委员会科研项目(WJ2019M197)。

摘　　要：目的探讨支气管哮喘患儿的血清烟酰胺磷酸核糖转移酶(NAMPT)、缺氧诱导因子2α(HIF-2α)水平,分析二者与急性发作期疾病严重程度的关系,以及二者诊断重度急性发作的价值。方法将236例支气管哮喘患儿按是否处于急性发作期分为急性期组141例与缓解期组95例,急性期组再根据哮喘急性发作严重程度分级分为轻度组58例、中度组50例、重度组33例。另选取100例健康儿童作为对照组。收集所有儿童的一般临床资料,并检测血清NAMPT、HIF-2α水平。检测急性期组患儿肺功能指标[第1秒用力呼气容积占预计值百分比(FEV_(1)%)、第1秒用力呼气容积占用力肺活量百分比(FEV_(1)/FVC)、最大呼气峰流速(PEF)]。分析急性期组患儿血清NAMPT、HIF-2α水平与肺功能指标的相关性;采用受试者工作特征(ROC)曲线分析血清NAMPT、HIF-2α水平对支气管哮喘患儿重度急性发作的诊断价值。结果对照组、缓解期组、急性期组的血清NAMPT、HIF-2α水平均依次升高(均P<0.05)。轻度组、中度组、重度组的血清NAMPT、HIF-2α水平均依次升高,FEV_(1)%、FEV_(1)/FVC、PEF均依次降低(均P<0.05)。急性期组的血清NAMPT、HIF-2α水平与FEV_(1)%、FEV_(1)/FVC、PEF均呈负相关(均P<0.05)。血清NAMPT、HIF-2α水平单独及二者联合诊断支气管哮喘患儿重度急性发作的曲线下面积分别为0.810、0.851、0.902,灵敏度分别为84.85%、78.79%、85.11%,特异度分别为81.48、83.33%、87.04%。结论支气管哮喘患儿血清NAMPT、HIF-2α水平升高,在急性发作期升高更明显,且二者均与患儿急性发作时的严重程度有关,均可用于支气管哮喘患儿重度急性发作的辅助诊断,且二者联合应用时的诊断效能更高。Objective To explore the levels of serum niacinamide phosphoribose transferase(NAMPT)and hypoxia inducible factor 2α(HIF-2α)in children with bronchial asthma,and to analyze their relation with severity of acute exacerbation,as well as the values of the two indicators for diagnosing severe acute exacerbation.Methods A total of 236 children with bronchial asthma were assigned to acute exacerbation group(141 cases)or remission group(95 cases)whether the children were in an acute exacerbation or not,and the acute exacerbation group was further assigned to mild group(58 cases),moderate group(50 cases),or severe group(33 cases)according to the severity of asthma acute exacerbation;in addition,100 healthy children were selected as control group.The general clinical data of all children were collected,and the levels of serum NAMPT and HIF-2αwere detected.The pulmonary function indices in terms of the percentage of forced expiratory volume in the first second to predicted value(FEV_(1)%),the percentage of FEV_(1)to forced vital capacity(FEV_(1)/FVC),and peak expiratory flow(PEF)of children in the acute exacerbation group were detected.The correlation of serum NAMPT and HIF-2αlevels with pulmonary function indices of children in the acute exacerbation group was analyzed,and the diagnostic values of serum NAMPT and HIF-2αlevels on severe acute exacerbation in children with bronchial asthma were analyzed by the receiver operating characteristic(ROC)curve.Results The levels of serum NAMPT and HIF-2αin the control group,the remission group and the acute exacerbation group were elevated successively(all P<0.05).The levels of serum NAMPT and HIF-2αin the mild,moderate,and severe groups were elevated successively,and FEV_(1)%,FEV_(1)/FVC and PEF were decreased successively(all P<0.05).Serum NAMPT and HIF-2αlevels negatively correlated with FEV_(1)%,FEV_(1)/FVC and PEF of children in the acute exacerbation group(all P<0.05).The areas under the curve of serum NAMPT and HIF-2αlevels alone and jointly for diagnosing severe a

关 键 词：支气管哮喘 急性发作期 烟酰胺磷酸核糖转移酶 缺氧诱导因子2α 肺功能 严重程度 诊断 儿童 

分 类 号：R725.6[医药卫生—儿科]