血清Leptin、CCL26在反复喘息患儿中的变化及与哮喘预测指数的相关性  

Changes of serum Leptin and CCL26 in children with recurrent wheezing and their correlation with asthma predictive index

作　　者：李佳[1] 何霞[1] LI Jia;HE Xia(Department of Clinical Laboratory,Ya′an People′s Hospital,Sichuan Province,Ya′an 625000,China)

机构地区：[1]四川省雅安市人民医院检验科,四川雅安625000

出　　处：《河北医科大学学报》2023年第8期934-940,共7页Journal of Hebei Medical University

基　　金：四川省卫生健康委员会科研课题(19PJ155)。

摘　　要：目的分析血清瘦素(Leptin)、趋化因子配体26(chemokine ligand 26,CCL26)在反复喘息患儿中的变化,并探讨二者与哮喘预测指数(asthma predictive index,API)的相关性。方法选取反复喘息患儿178例作为观察组,并根据API分为API阳性组(n=92例)、API阴性组(n=86例),均进行规范管理。选取同期健康体检儿童89例为对照组。API阳性组、API阴性组在急性期、缓解期、对照组在入组时均检测血清Leptin、CCL26水平。分析血清Leptin、CCL26水平与API相关性及反复喘息患儿API阳性的影响因素。反复喘息患儿出院后均随访1年,对比随访期间是否再次发生喘息患儿血清Leptin、CCL26水平。结果观察组急性期、缓解期血清Leptin、CCL26水平均高于对照组(P<0.05);急性期、缓解期API阳性组血清Leptin、CCL26水平高于API阴性组(P<0.05);API阳性组、API阴性组急性期血清Leptin、CCL26水平高于缓解期(P<0.05);急性期、缓解期血清Leptin(r=0.480/0.401,P<0.001)、CCL26(r=0.481/0.512,P<0.001)水平与API均呈正相关;二元Logistic回归模型校正早产儿、变应性皮炎、烟草暴露史、母亲孕期主动或被动吸烟后,特应质、急性期血清Leptin及CCL26水平高表达仍会增加API阳性风险(P<0.05);建立Logistic回归模型:logit(P)=-7.005+1.020×特应质+1.098×急性期血清Leptin水平+1.058×急性期血清CCL26水平,经Hosmer-Lemeshow拟合优度检验显示,χ^(2)=4.249,DF=6,P=0.452,拟合度较好;178例反复喘息患儿随访1年,18例患儿再次发生喘息(10.11%),160例未发生喘息(89.89%),喘息患儿API阳性率高于未发生喘息患儿,急性期、缓解期血清Leptin、CCL26水平高于未发生喘息患儿(P<0.05)。结论反复喘息患儿血清Leptin、CCL26升高显著,且与API关系密切,是API阳性的独立危险因素。Objective To analyze the changes of serum leptin(Leptin)and chemokine ligand 26(CCL26)in children with recurrent wheezing,and to explore their correlation with asthma predictive index(API).Methods A total of 178 children with recurrent wheezing were selected as the observation group,and they were divided into API positive group(n=92)and API negative group(n=86)according to API,and they all received standardized management.Another 89 healthy children undergoing physical examination during the same period were selected as the control group.Serum Leptin and CCL26 levels were detected in the API positive group and API negative group at the acute stage,remission stage,and in control group at the time of enrollment.The correlation between serum Leptin,CCL26 levels and API and the influencing factors of API positivity in children with recurrent wheezing were analyzed.The children with recurrent wheezing were followed up for 1 year after discharge,and the serum levels of Leptin and CCL26 in the children with recurrent wheezing were compared during the follow-up period.Results Serum Leptin and CCL26 levels in the observation group were higher than those in the control group at acute stage and remission stage(P<0.05).Serum Leptin and CCL26 levels of API positive group were higher than those of API negative group at acute stage and remission stage(P<0.05).Serum Leptin and CCL26 levels in API positive and API negative groups were higher at acute stage than at remission stage(P<0.05).The levels of serum Leptin(r=0.480/0.401,P<0.001)and CCL26(r=0.481/0.512,P<0.001)at acute stage and remission stage were positively correlated with API.After the binary logistic regression model was adjusted for premature infants,allergic dermatitis,tobacco exposure history,and maternal active or passive smoking during pregnancy,atopy,high expression of serum Leptin and CCL26 at acute stage still increased the risk of API positivity(P<0.05).Logistic regression model was established:logit(P)=-7.005+1.020×atopic+1.098×serum Leptin level in acute

关 键 词：哮喘 瘦素 趋化因子配体26 

分 类 号：R256.12[医药卫生—中医内科学]