动态监测血清嗜酸性粒细胞趋化蛋白、LTE4、SP-D水平对喘息性支气管炎患儿疗效的预测价值  

Predictive Value of Dynamic Monitoring of Serum Eotaxin,LTE4 and SP-D Levels in Children with A sthmatic B ronchitis

作　　者：张艳华 李微 张嘉雯 刘静炎 ZHANG Yanhua;LI Wei;ZHANG Jiawen;LIU Jingyan(Department of Pediatrics,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450003,,China)

机构地区：[1]郑州大学附属郑州中心医院儿科,河南郑州450003

出　　处：《河南医学研究》2024年第2期256-260,共5页Henan Medical Research

摘　　要：目的探讨血清嗜酸性粒细胞趋化蛋白、白三烯E4(LTE4)、表面活性蛋白D(SP-D)水平对喘息性支气管炎患儿疗效的预测价值。方法回顾性2020年3月至2023年3月医院收治的268例喘息性支气管炎患儿,根据治疗7 d后疗效分为有效组(217例)和无效组(51例)。比较两组治疗前及治疗3、5 d后血清嗜酸性粒细胞趋化蛋白、LTE4、SP-D水平、肺功能指标[呼吸频率(RR)、达峰容积比(VPEF/VE)、达峰时间比(TPTEF/TE)]。分析血清嗜酸性粒细胞趋化蛋白、LTE4、SP-D水平与肺功能指标及疗效相关性,分析血清嗜酸性粒细胞趋化蛋白、LTE4、SP-D水平联合检测对喘息性支气管炎患儿疗效的预测价值,各指标不同水平对喘息性支气管炎患儿治疗无效的影响。结果治疗3、5 d后,与有效组相比,无效组血清嗜酸性粒细胞趋化蛋白、LTE4、SP-D、RR高(P<0.05),VPEF/VE、TPTEF/TE低(P<0.05)。治疗3、5 d后,血清嗜酸性粒细胞趋化蛋白、LTE4、SP-D与疗效、VPEF/VE、TPTEF/TE呈负相关(P<0.05);治疗3、5 d后血清嗜酸性粒细胞趋化蛋白、LTE4、SP-D与RR呈正相关(P<0.05);血清嗜酸性粒细胞趋化蛋白、LTE4、SP-D水平联合预测喘息性支气管炎患儿治疗无效的AUC均大于各单一指标预测(P<0.05)。血清嗜酸性粒细胞趋化蛋白、LTE4、SP-D高水平患儿治疗无效危险度高于低水平(P<0.05)。结论血清嗜酸性粒细胞趋化蛋白、LTE4、SP-D水平能反映喘息性支气管炎患儿肺损伤及病情严重程度,联合检测可作为早期预测治疗结局的重要辅助途径。Objective To investigate the predictive value of serum eotaxin,leukotriene E4(LTE4),and surfactant associated protein D(SP-D)levels for the efficacy of treatment in children with asthmatic bronchitis.Methods Retrospectively,268 children with asthmatic bronchitis admitted to hospital from March 2020 to March 2023 were divided into effective group(217 cases)and ineffective group(51 cases)according to their efficacy after 7 d of treatment.Serum eotaxin,LTE4 and SP-D levels were compared between the two groups before treatment and 3 and 5 days after treatment,and lung function indexes[respiratory rate(RR),peak-to-volume ratio(VPEF/VE),peak-to-time ratio(TPTEF/TE)]were compared between the two groups before treatment and 3 and 5 days after treatment.To analyze the correlation between serum eotaxin,LTE4 and SP-D levels and lung function indexes and therapeutic efficacy,and analyze the predictive value of combined detection of serum eotaxin,LTE4 and SP-D levels for therapeutic efficacy in children with asthmatic bronchitis,and the effects of different levels of each index on therapeutic efficacy in children with asthmatic bronchitis.Results Compared with the effective group,the levels of eotaxin,LTE4 and SP-D in the ineffective group were higher after 3 and 5 days of treatment(P<0.05).After 3 and 5 days of treatment,RR in ineffective group was higher than that in effective group,while VPEF/VE and TPTEF/TE were lower than that in effective group(P<0.05).Serum eotaxin,LTE4 and SP-D were negatively correlated with efficacy,VPEF/VE and TPTEF/TE after 3 and 5 days of treatment(P<0.05).Serum eotaxin,LTE4 and SP-D were positively correlated with RR after 3 and 5 days of treatment(P<0.05).Serum eotaxin,LTE4 and SP-D combined predicted that area under curve of treatment failure in asthmatic bronchitis children was higher than that predicted by each single index(P<0.05).The risk of treatment failure in children with high levels of serum eotaxin,LTE4 and SP-D was higher than that with low levels(P<0.05).Conclusion Serum eotaxin,LT

关 键 词：喘息性支气管炎 疗效 嗜酸性粒细胞趋化蛋白 肺表面活性蛋白D 

分 类 号：R725.6[医药卫生—儿科]