学龄前期支气管哮喘患儿哮喘发作情况及与肺表面活性蛋白水平的关系分析  

Correlation between Asthma Attack Frequency and Pulmonary Surfactant Protein Level in Preschool Children with Bronchial Asthma

作　　者：毛华[1] 赵晓媛 孙欢欣 马杜婷 王慧渊 王莉[1] MAO Hua;ZHAO Xiaoyuan;SUN Huanxin(The Second Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710000,China)

机构地区：[1]西安交通大学第二附属医院,陕西西安710000

出　　处：《河北医学》2024年第12期2043-2048,共6页Hebei Medicine

基　　金：陕西省重点研发计划项目,(编号:2023-YBSF-087)。

摘　　要：目的:探讨学龄前期支气管哮喘患儿哮喘发作情况及与肺表面活性蛋白(SP)水平的关系。方法:选取2020年2月至2023年10月在本院确诊的112例支气管哮喘患儿(疾病组),根据哮喘发作频率分为高频组(n=52)和低频组(n=60)。纳入同期在本院体检正常的60例同龄儿童为对照组。比较疾病组与对照组、高频组与低频组患儿肺表面活性蛋白A(SP-A)、肺表面活性蛋白D(SP-D)水平,记录哮喘控制测试(ACT)评分、肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)]。采用Spearman等级相关分析评估哮喘发作情况与SP水平及肺功能之间的关系,并绘制ROC曲线分析SP对哮喘发作情况的预测能力。结果:疾病组SP-A、SP-D水平高于对照组,ACT评分低于对照组,肺功能指标低于对照组(均P<0.05)。与低频组相比,高频组SP-A、SP-D水平明显升高(P<0.05),FEV1、FVC及FEV1/FVC比值降低(P<0.05),ACT评分明显降低(P<0.05)。单因素分析显示,SP-A、SP-D、FEV1、FVC及FEV1/FVC与哮喘发作频率相关(P<0.05)。多因素Logistic回归分析显示,SP-A、SP-D是哮喘发作频率的独立危险因素(P<0.05)。ROC曲线分析显示,SP-A、SP-D单独预测哮喘发作情况的AUC为0.784、0.816(P<0.05)。而SP水平联合预测的AUC为0.984,灵敏度为0.942,特异度为0.950(P<0.05)。结论:学龄前期支气管哮喘患儿的哮喘发作频率与SP水平密切相关,SP水平可作为哮喘发作频率的预测指标,肺功能指标可用于评估患儿的呼吸功能状态,有助于临床早期干预和治疗。Objective:To investigate the correlation between asthma attack frequency and pulmonary surfactant protein(SP)level in preschool children with bronchial asthma(BA).Methods:A total of 112 preschool children with BA(disease group)diagnosed in the hospital from February 2020 to October 2023 were enrolled,and children of disease group were divided into high-frequency subgroup(n=52)and low-frequency subgroup(n=60)based on the asthma attack frequency.At the same time,60 healthy children of the same age with normal physical examination in our hospital were regarded as the control group.The pulmonary surfactant protein A(SP-A),pulmonary surfactant protein D(SP-D),Asthma Control Test(ACT)scores,pulmonary function indexes(forced expiratory volume in one second[FEV1],forced vital capacity[FVC],FEV1/FVC)were included as comparators between groups.Spearman rank correlation analysis was used to evaluate the correlation between asthma attack frequency with SP level and pulmonary function,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive ability of SP for asthma attack.Results:The disease group had significantly higher SP-A and SP-D levels,and lower ACT score and pulmonary function indexes relative to the control group(all P<0.05).The high-frequency subgroup presented significantly increased SP-A and SP-D levels,decreased ACT score and levels of FEV1,FVC and FEV1/FVC compared to the low-frequency subgroup(all P<0.05).Univariate analysis showed that SP-A,SP-D,FEV1,FVC and FEV1/FVC were correlated with the asthma attack frequency(P<0.05).Multivariate logistic regression analysis indicated that SP-A and SP-D were independent risk factors for the asthma attack frequency(P<0.05).ROC curve analysis indicated that the area under the curve(AUC)of SP-A and SP-D alone in predicting asthma attack frequency was 0.784 and 0.816,respectively(P<0.05).The AUC combined prediction were 0.984,with the sensitivity of 0.942 and the specificity of 0.950.Conclusion:The asthma attack frequency is closely related to SP l

关 键 词：支气管哮喘 学龄前期 肺表面活性蛋白 哮喘发作 生物标志物 

分 类 号：R725.6[医药卫生—儿科]