血清CC16和骨膜蛋白在哮喘患儿急性期和缓解期的表达水平差异及意义  

The expression levels of CC16 and periosteum protein in children with asthma in the acute stage and remission stage and their significance

作　　者：李小丽 李文静 白建强 金晶晶 丁亚 LI Xiaoli;LI Wenjing;BAI Jianqiang;JIN Jingjing;DING Ya(Department of Pediatrics,Shijiazhuang Maternal and Child Health Hospital,Shijiazhuang,Hebei050000,China;Department of Pediatrics,Cangzhou Maternal and Child Health Hospital,Cangzhou,Hebei061000,China;Department of Pediatrics,Zhangjiakou Maternal and Child Health Hospital,Zhangjiakou,Hebei075000,China;Department of Pediatrics,Luanzhou Hospital of Traditional Chinese Medicine,Tangshan063700,China;Newborns of Xinji First Hospital,Shijiazhuang,Hebei052360,China)

机构地区：[1]石家庄市妇幼保健院儿一科,河北石家庄050000 [2]沧州市妇幼保健院儿内科,河北沧州061000 [3]张家口市妇幼保健院儿三科,河北张家口075000 [4]滦州市中医医院儿科,河北唐山063700 [5]辛集市第一医院新生儿科,河北石家庄052360

出　　处：《临床肺科杂志》2024年第11期1674-1681,共8页Journal of Clinical Pulmonary Medicine

基　　金：河北省医学科学研究课题计划(No.20242144)。

摘　　要：目的分析急性期、缓解期哮喘患儿血清Clara细胞分泌蛋白(CC16)、骨膜蛋白表达水平变化,并探究其与肺功能、小气道功能、气道炎症相关性及其对哮喘急性发作的评估价值。方法选取2021年9月~2023年1月本院收治的87例哮喘急性期患儿(急性期组),且经治疗后病情转为缓解期(缓解期组),另选同期50例健康儿童作为对照组。观察三组血清CC16、骨膜蛋白水平。对比分析急性期组不同程度者血清CC16、骨膜蛋白、肺功能[一秒用力呼气容积占预计值的百分比(FEV_(1))、FEV_(1)/用力肺活量(FVC)]、小气道功能[最大呼气中期流量(MMEF)、用力呼气25%肺活量的瞬间流量(FEF_(25%))、用力呼气75%肺活量的瞬间流量(FEF_(75%))]与气道炎症[嗜酸性粒细胞(EOS)、呼出气一氧化氮(FeNO)]。分析CC16、骨膜蛋白与肺功能、小气道功能、气道炎症、急性发作严重程度相关性。交互作用分析血清CC16、骨膜蛋白对哮喘急性发作的影响。采用受试者工作特征曲线(ROC)分析血清CC16、骨膜蛋白对哮喘急性发作的评估效能。结果急性期组血清CC16水平低于缓解期组、对照组,骨膜蛋白水平高于缓解期组、对照组(P<0.05);重度及危重组血清CC16、FEV_(1)、FEV_(1)/FVC、MMEF、FEF 25%、FEF_(75%)低于中度、轻度组,骨膜蛋白、EOS、FeNO高于中度、轻度组(P<0.05);CC16与哮喘急性发作程度呈负相关(r=-0.706,P<0.001),骨膜蛋白与哮喘急性发作程度呈正相关(r=0.779,P<0.001);CC16与急性期患者FEV_(1)、FEV_(1)/FVC、MMEF、FEF 25%、FEF_(75%)呈正相关,EOS、FeNO呈负相关,而骨膜蛋白与之相反(P<0.001);CC16降低对骨膜蛋白升高的效应具有正向交互作用;CC16、骨膜蛋白及联合检测评估哮喘急性发作的AUC分别为0.813(95%CI:0.732~0.879)、0.812(95%CI:0.731~0.878)、0.931(95%CI:0.869~0.969),且联合评估的AUC大于单项指标评估(Z=3.057、3.058;P=0.018、0.017,P均<0.05)。结论急性期哮喘患儿血Objective To analyze the expression levels of serum Clara cell secreted protein(CC16)and periosteum protein in children with acute and palliative asthma,and to explore the correlation between CC16 and lung function,small airway function,and airway inflammation,as well as its evaluation value in an acute asthma attack.Methods 87 children with acute asthma(acute phase group)who were admitted to our hospital from September 2021 to January 2023 were selected,and after treatment,their condition turned to remission(remission group).In addition,50 healthy children were selected as a control group.We observed the levels of serum CC16 and periostein in the three groups.The levels of serum CC16,periostein,lung function[percentage of forced expiratory volume in one second to predicted value(FEV_(1)),FEV_(1)/forced vital capacity(FVC)],small airway function[maximum mid-expiratory flow(MMEF),instantaneous flow at 25%forced expiratory volume(FEF_(25%)),instantaneous flow at 75%forced expiratory volume(FEF_(75%))]and airway inflammation[eosinophil(EOS),exhaled nitric oxide(FeNO)]were compared and analyzed in the acute phase group with different degrees.Results The serum CC16 level in the acute phase group was lower than that in the remission phase group and the control group,while the periosteal protein level was higher than that in the remission phase group and the control group(P<0.05).The serum CC16,FEV_(1),FEV_(1)/FVC,MMEF,FEF 25%,and FEF 75%levels in severe and critical patients were lower than those in moderate and mild patients,while the periosteal protein,EOS,and FeNO levels were higher than those in moderate and mild patients(P<0.05).CC16 was negatively correlated with the severity of asthma exacerbation(r=-0.706,P<0.001),while periosteal protein was positively correlated with the severity of asthma exacerbation(r=0.779,P<0.001).CC16 was positively correlated with FEV_(1),FEV_(1)/FVC,MMEF,FEF_(25%),and FEF_(75%)in acute phase patients,while EOS and FeNO were negatively correlated with them,and periosteal protein was th

关 键 词：哮喘 急性期 缓解期 CLARA细胞分泌蛋白 骨膜蛋白 炎症 评估价值 

分 类 号：R725.6[医药卫生—儿科]