肺泡灌洗液中CCL20和CD200R对儿童迁延性细菌性支气管炎的诊断价值  

Diagnostic value of CCL20 and CD200R in bronchoalveolar lavage fluid for protracted bacterial bronchitis in children

作　　者：陈淑华 何秀 张碧清[1] 曾艳芳 欧书腾 CHEN Shuhua;HE Xiu;ZHANG Biqing;ZENG Yanfang;OU Shuteng(Department of Pediatrics,the First People′s Hospital of Chenzhou,Chenzhou,Hunan 423000,China)

机构地区：[1]湖南省郴州市第一人民医院儿科,湖南郴州423000

出　　处：《检验医学与临床》2024年第13期1905-1909,共5页Laboratory Medicine and Clinic

基　　金：湖南省自然科学基金项目(2021JJ40005)。

摘　　要：目的研究肺泡灌洗液(BALF)中CC趋化因子配体20(CCL20)、细胞表面分子CD200受体(CD200R)对迁延性细菌性支气管炎(PBB)的诊断价值。方法选取2019年1月至2021年2月该院收治的136例PBB患儿作为PBB组。另选取同期在该院因支气管异物进行支气管镜检查的60例儿童作为对照组。采用酶联免疫吸附试验检测BALF及血清中CCL20、CD200R水平。比较两组BALF及血清中CCL20、CD200R水平。根据PBB患儿是否存在复发难治性PBB,将PBB组患儿分为普通性组和复发难治性组,分析两组患儿的临床特征及BALF中CCL20、CD200R的水平。采用多因素Logistic回归分析复发难治性PBB发生的危险因素。绘制受试者工作特征(ROC)曲线分析BALF中CCL20、CD200R对复发难治性PBB的诊断价值。结果PBB组BALF中CCL20水平明显高于对照组BALF中CCL20水平,BALF中CD200R水平明显低于对照组BALF中CD200R水平,差异均有统计学意义(P<0.05)。两组血清中CCL20、CD200R水平比较,差异均无统计学意义(P>0.05)。82例患儿纳入普通性组,54例患儿纳入复发难治性组。复发难治性组PBB患儿咳嗽持续时间、白细胞计数、C反应蛋白水平及BALF中CCL20、CD200R水平明显高于普通性组,差异均有统计学意义(P<0.05),而两组性别、年龄、喘息、潜在病因、病原菌构成、淋巴细胞百分比及乳酸脱氢酶水平比较,差异均无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,咳嗽持续时间长、BALF中CCL20水平升高、CD200R水平降低是复发难治性PBB发生的独立危险因素(P<0.05)。ROC曲线分析结果显示,CCL20、CD200R二者联合检测诊断复发难治性PBB的曲线下面积为0.925,明显高于CCL20、CD200R单独检测的0.866、0.875(Z=3.724、3.418,P<0.05)。结论PBB患儿BALF中CCL20水平升高、CD200R水平降低是复发难治性PBB发生的独立危险因素,二者联合检测有助于诊断复发难治性PBB。Objective To study the diagnostic value of CC chemokine ligand 20(CCL20)and cell surface molecule CD200 receptor(CD200R)in bronchoalveolar lavage fluid(BALF)for protracted bacterial bronchitis(PBB).Methods A total of 136 children with PBB admitted to this hospital from January 2019 to February 2021 were selected as the PBB group.Another 60 children who underwent bronchoscopy due to bronchial foreign bodies in the same hospital during the same period were selected as the control group.The levels of CCL20 and CD200R in BALF and serum were detected by enzyme-linked immunosorbent assay.The levels of CCL20 and CD200R in BALF and serum were compared between the two groups.According to the presence or absence of relapsed and refractory PBB,the PBB group was divided into general group and relapse-refractory group,the clinical features and levels of CCL20 and CD200R in the BALF between the two groups were analyzed.Multivariate Logistic regression was used to analyze the risk factors of relapsed and refractory PBB.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of CCL20 and CD200R in BALF for relapsed and refractory PBB.Results The level of CCL20 in BALF of the PBB group was significantly higher than that in the control group,and the level of CD200R in BALF was significantly lower than that in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in serum CCL20 and CD200R levels between the two groups(P>0.05).Eighty-two children were enrolled in the general group and 54 children were enrolled in the relapse-refractory group.The duration of cough,the levels of WBC and CRP,and the levels of CCL20 and CD200R in BALF in children in relapse-refractory group were significantly higher than those in the general group(P<0.05),but there was no significant difference in gender,age,wheezing,potential etiology,pathogen composition,lymphocyte percentage and LDH level between the two groups(P>0.05).Multivariate Logistic regression analy

关 键 词：儿童迁延性细菌性支气管炎 肺泡灌洗液 CC趋化因子配体20 细胞表面分子CD200受体 诊断 

分 类 号：R562.2[医药卫生—呼吸系统]