咳嗽变异性哮喘患儿血清25(OH)D_(3)、IL-6水平变化与T淋巴细胞免疫平衡的关系及预测预后的价值分析  

The Relationship Between Serum 25(OH)D_(3)and Inflammatory Factor Levels and Immune Balance in Children with Cough Variant Asthma and Their Prognostic Values

作　　者：张洲慧[1] 张彤[1] 李燕茹 李红霞[1] 赵华昌[2] ZHANG Zhouhui;ZHANG Tong;LI Yanru;LI Hongxi;ZHAO Huachang(Department of Pediatrics,Chengdu Third People’s Hospital,Chengdu 610031,China;Department of Respiratory Medicine,Chengdu Fourth People’s Hospital,Chengdu 610036,China)

机构地区：[1]成都市第三人民医院儿科,四川成都610031 [2]成都市第四人民医院呼吸内科,四川成都610036

出　　处：《标记免疫分析与临床》2024年第4期670-674,762,共6页Labeled Immunoassays and Clinical Medicine

基　　金：四川省医学(青年创新)科研课题项目(编号:S20047)。

摘　　要：目的分析咳嗽变异性哮喘(CVA)患儿血清25-羟维生素D_(3)[25(OH)D_(3)]、白介素-6(IL-6)水平变化与T淋巴细胞免疫平衡的关系及预测预后的价值。方法选取98例CVA患儿作为研究组,49例健康儿童作为对照组。比较两组一般资料、血清25(OH)D_(3)、IL-6水平、T淋巴细胞免疫平衡指标,分析研究组血清25(OH)D_(3)、IL-6水平与免疫平衡指标的相关性,比较治疗4周后不同预后患儿治疗前后血清25(OH)D_(3)、IL-6水平及变化值(以△表示治疗前后变化值的绝对值),分析△25(OH)D_(3)、△IL-6与预后的相关性及治疗前血清25(OH)D_(3)、IL-6预测预后的价值。结果研究组血清25(OH)D_(3)水平、外周血CD4^(+)T淋巴细胞百分比低于对照组,血清IL-6水平高于对照组(P<0.05);研究组血清25(OH)D_(3)水平与外周血CD4^(+)T淋巴细胞百分比呈正相关,血清IL-6水平与外周血CD4^(+)T淋巴细胞百分比呈负相关(P<0.05);预后不良患儿治疗前、治疗后血清25(OH)D_(3)水平低于预后良好患儿,IL-6水平高于预后良好患儿,△IL-6小于预后良好患儿(P<0.05);研究组△IL-6与预后呈正相关(P<0.05);治疗前血清25(OH)D_(3)、IL-6单独预测CVA患儿预后不良的曲线下面积(AUC)分别为0.784、0.764,与单独预测比较,联合预测的AUC(0.926)明显增大,NRI、IDI均>0(P<0.05)。结论CVA患儿血清25(OH)D_(3)、IL-6水平变化与T淋巴细胞免疫平衡失调有关,且各指标联合在预测患儿预后方面具有良好应用价值。Objective To analyze the relationship between changes in serum 25-hydroxyvitamin D_(3)[25(OH)D_(3)]and interleukin-6(IL-6)levels and T-lymphocyte immune homeostasis in children with cough-variant asthma(CVA),and their values of predicting prognosis.Methods Ninety-eight children with CVA were selected as the study group,while 49 healthy children as the control group.We compared the general information,serum 25(OH)D_(3),IL-6 levels and T-lymphocyte immune balance indexes between the two groups,analyzed the correlation between serum 25(OH)D_(3)and IL-6 levels and immune balance indexes in the study group,and compared serum 25(OH)D_(3)and IL-6 levels and the changes in the levels before and after the treatment of children with different prognoses after 4 weeks of treatment(△denotes the absolute value of the changes in the values before and after the treatment),and further analyzed the correlation between△25(OH)D_(3),△IL-6 and prognosis,and the absolute value of the changes in values before and after the treatment.We evaluated the correlation between△25(OH)D_(3),△IL-6 and prognosis and the value of pretreatment serum 25(OH)D_(3)and IL-6 in predicting prognosis.Results In the study group,serum 25(OH)D_(3)level and percentage of peripheral blood CD4^(+)T lymphocytes were lower than those in the control group,while serum IL-6 level was higher than those in the control group(P<0.05);In the study group,there was a positive correlation between serum 25(OH)D_(3)level and percentage of peripheral blood CD4^(+)T lymphocytes,and negative correlation between serum IL-6 level and percentage of peripheral blood CD4^(+)T lymphocytes(P<0.05);Children with poor prognosis had lower serum 25(OH)D_(3)level than those with good prognosis before and after treatment,and higher IL-6 level than those with good prognosis,and△IL-6 level was higher than those with good prognosis;Pre-treatment and post-treatment serum 25(OH)D_(3)levels of children with poor prognosis were lower than those of children with good prognosis,while IL-6 le

关 键 词：咳嗽变异性哮喘 免疫平衡 预后 25-羟维生素D_(3) 炎性因子 

分 类 号：R562.25[医药卫生—呼吸系统]