血清YKL⁃40与气道炎性因子在婴幼儿喘息中的表达及临床意义  

Expression and Significance of Serum YKL-40 and Inflammatory Factors in Infants and Young Children withWheezing

作　　者：王淑玉[1] 郑一博[1] 杨蕾 李矢云 马晓琳 刘凡 张伟[1] WANG Shuyu;ZHENG Yibo;YANG Lei;LI Shiyun;MA Xiaolin;LIU Fan;ZHANG Wei(Department of Pediatrics,the 980th Hospital of Joint Logistics Support Force of the PLA/the Bethune International Peace Hospital,Shijiazhuang 050082,China)

机构地区：[1]解放军联勤保障部队第九八〇(白求恩国际和平)医院儿科,石家庄050082

出　　处：《临床误诊误治》2024年第4期52-56,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫生健康委员会重点科技研究计划课题(20211386)。

摘　　要：目的探讨血清YKL-40及气道炎性因子白细胞介素(IL)-5和IL-8在婴幼儿喘息中的表达情况及临床意义。方法选择2021年6月—2023年5月收治的喘息急性发作(急性期)患儿70例,其中初次喘息发作32例,反复喘息38例。经治疗恢复期34例。另选取同期体检健康婴幼儿22例为健康对照组。反复喘息患儿依据哮喘预测指数(API)分为阳性组23例和阴性组15例。检测上述各组血清YKL-40、IL-5和IL-8水平,分析YKL-40与IL-5、IL-8、外周血中性粒细胞及嗜酸粒细胞的相关性。结果喘息急性期患儿血清YKL-40、IL-5、IL-8水平均高于喘息恢复期和健康对照组(P<0.01)。反复喘息组血清YKL-40和IL-8水平均高于初次喘息组(P<0.01)。API阳性组与API阴性组血清YKL-40、IL-5和IL-8水平比较差异无统计学意义(P>0.05)。血清YKL-40与IL-8呈显著正相关(r=0.926,P<0.001),但与IL-5、外周血嗜酸粒细胞绝对值、中性粒细胞绝对值均无相关性(P>0.05)。结论血清YKL-40、IL-5和IL-8参与婴幼儿喘息急性气道炎症过程,YKL-40可能与中性粒细胞炎症有关。YKL-40水平增高可能是婴幼儿喘息发作和反复喘息的危险因素,但与API无关。Objective To investigate the expression and clinical significance of serum YKL-40 and airway inflammatory factors interleukin-5(IL-5)and interleukin-8(IL-8)in infants and young children with wheezing.Methods A total of 70 children with acute onset of wheezing(acute stage)admitted from June 2021 to May 2023 were selected,including 32 with the first onset of wheezing,and 38 with repeated wheezing.Of them,34 patients were in the recovery stage after treatment.In addition,22 healthy infants and young children undergoing physical examination during the same period were selected as healthy control group.Children with repeated wheezing were divided into positive group(n=23)and negative group(n=15)according to asthma predictive index(API).Serum YKL-40,IL-5 and IL-8 levels in the above groups were detected,and the correlation of YKL-40 with IL-5,IL-8,peripheral blood neutrophils and eosinophils was analyzed.Results The serum levels of YKL-40,IL-5 and IL-8 in children with asthma in acute stage were higher than those in patients with asthma in convalescent stage and healthy control group(P<0.01).The serum levels of YKL-40 and IL-8 in the repeated wheezing group were higher than those in the first wheezing group(P<0.01).There were no significant differences in serum YKL-40,IL-5 and IL-8 levels between API positive group and API negative group(P>0.05).Serum YKL-40 was positively correlated with IL-8(r=0.926,P<0.001),but was not correlated with IL-5,absolute value of peripheral blood eosinophils and absolute value of neutrophils(P>0.05).Conclusion Serum YKL-40,IL-5 and IL-8 may be involved in the process of acute airway inflammation in infants and young children with wheezing,and YKL-40 may be associated with neutrophil inflammation.The elevated level of serum YKL-40 may be a risk factor of acute onset and recurrent wheezing,but it is not associated with the API.

关 键 词：喘息 哮喘 YKL-40 白细胞介素-5 白细胞介素-8 嗜酸粒细胞 中性粒细胞 婴幼儿 

分 类 号：R725.62[医药卫生—儿科]