儿童支气管哮喘外周血中CST1表达及临床意义  

Expression changes and clinical significance of CST1 in children with asthma

作　　者：李玲 杨敏 刘文春 LI Ling;YANG Min;LIU Wenchun(Department of Pediatric Neurorespiratory Rehabilitation,Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi,Hubei 445000,China)

机构地区：[1]恩施土家族苗族自治州中心医院儿童神经呼吸康复科,湖北恩施445000

出　　处：《中华全科医学》2025年第2期261-264,共4页Chinese Journal of General Practice

基　　金：湖北恩施州科技计划研究与开发项目(E20200013)。

摘　　要：目的 探讨儿童支气管哮喘外周血中半胱氨酸蛋白酶抑制物SN(CST1)的表达变化及其临床意义。方法 选取2021年5月—2022年9月恩施土家族苗族自治州中心医院收治的儿童哮喘患者52例(观察组)和同期健康体检者(对照组)52例,分别采集2组外周静脉血,采用ELISA法检测血清CST1、IFN-γ、IL-33、IL-4和IL-13的表达。采用Spearman相关分析法分析血清CST1蛋白表达与儿童-哮喘控制测试(C-ACT)评分、IL-33、IL-14和IL-13水平的相关性;采用ROC曲线评估CST1蛋白表达对儿童哮喘的诊断效能。结果 与对照组相比,观察组血清中CST1蛋白表达显著增高(P<0.01)。Spearman相关分析显示,在观察组中,CST1的表达与C-ACT评分呈负相关关系(r=-0.601,P<0.001);与血清IL-33蛋白表达呈正相关关系(r=0.416,P=0.002);与血清IFN-γ表达呈负相关关系(r=-0.413,P=0.002);与血清IL-4、IL-13水平呈正相关关系(r=0.542,P<0.001;r=0.425,P=0.002)。ROC曲线分析显示,血清中CST1蛋白表达水平诊断儿童哮喘的AUC为0.876(95%CI:0.807~0.945),截断值为944 pg/mL,此时灵敏度为90.4%,特异度为61.5%;血清中CST1蛋白表达预测病情严重程度的AUC为0.711(95%CI:0.568~0.854),截断值为1 404 pg/mL,此时灵敏度为70.4%,特异度为68.0%。结论 儿童哮喘患者血清中CST1蛋白表达升高,并与患者C-ACT评分、血清IL-33蛋白表达、Th1/Th2失衡有一定的相关性;血清中CST1蛋白表达可作为儿童哮喘诊断和评估的生物学指标。Objective To investigate the expression of cysteine protease inhibitor SN(CST1)in peripheral blood of childhood asthma and its clinical significance.Methods Fifty-two asthma children(observation group)and 52 health were selected in Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi from May 2021 to September 2022.Peripheral venous blood was taken in the observation group and control group on the day after admission,and the expression of serum CST1,IFN-γ,IL-33,IL-4,and IL-13 was detected by ELISA.Spearman correlation analysis was used to analyze the correlation between serum CST1 expression and children-asthma control test(C-ACT)score,IL-33,IL-4,and IL-13 levels.The ROC curve was used to evaluate the diagnostic efficacy of CST1 expression in asthma children.Results Compared with the control group,the expression of CST1 protein in the serum of the observation group was significantly increased(P<0.01).Spearman correlation analysis showed that CST1 expression was negatively correlated with C-ACT score in the observation group(r=-0.601,P<0.001)and was negatively correlated with IFN-γexpression(r=-0.413,P=0.002).The expression of CST1 was positively correlated with the levels of serum IL-33(r=0.416,P=0.002),IL-4 and IL-13(r=0.542,P<0.001;r=0.425,P=0.002).ROC curve analysis showed that the AUC of serum CST1 expression in the diagnosis of childhood asthma was 0.876(95%CI:0.807-0.945),and its cut-off value was 944 pg/mL,with a sensitivity of 90.4%and specificity of 61.5%.The AUC of predicting the severity of the disease by CST1 expression in serum was 0.711(95%CI:0.568-0.854),and the cutoff value was 1404 pg/mL,with a sensitivity of 70.4%and a specificity of 68.0%.Conclusion The expression of CST1 protein in the serum of asthma children is increased,and it is correlated with C-ACT score,serum IL-33,IL-4,and IL-13.Serum CST1 expression can be used as a biological indicator for the diagnosis and severity of childhood asthma.

关 键 词：儿童哮喘 半胱氨酸蛋白酶抑制物SN TH1 TH2 IL-33 IL-13 

分 类 号：R562.25[医药卫生—呼吸系统] R725.6[医药卫生—内科学]