肺炎支原体感染复发喘息患儿血清EDN、IL-13、TGF-β1水平及危险因素分析  

Analysis of serum levels of EDN,IL-13,TGF-β1 and risk factors in children with recurrent wheezing of mycoplasma pneumoniae infection

作　　者：刘文洁 武帆 赵娜娜 申营 齐海燕 LIU Wenjie;WU Fan;ZHAO Nana;SHEN Ying;QI Haiyan(Affiliated Hospital of Shandong Second Medical University,School of Clinical Medicine,Shandong Second Medical University,Weifang 261031,China;Department of Pediatrics,Affiliated Hospital of Shandong Second Medical University;Department of Laboratory,Affiliated Hospital of Shandong Second Medical University)

机构地区：[1]山东第二医科大学附属医院(临床医学院),山东第二医科大学,261031 [2]山东第二医科大学附属医院儿科 [3]山东第二医科大学附属医院检验科

出　　处：《天津医药》2025年第2期151-155,共5页Tianjin Medical Journal

基　　金：山东省儿童青少年生长发育与健康管理重点课题(JKZX2023138);潍坊市卫生健康科研项目(WFWSJK-2023-039)。

摘　　要：目的 探讨肺炎支原体(MP)感染复发喘息患儿血清嗜酸性粒细胞来源神经毒素(EDN)、白细胞介素(IL)-13、转化生长因子(TGF)-β1水平并分析MP感染复发喘息的危险因素。方法 80例MP感染的患儿根据既往有无MP感染伴喘息病史分为MP感染复发喘息组(复发喘息组)45例和MP感染无喘息组(无喘息组)35例,选取同期支气管哮喘急性发作的患儿35例为哮喘组。采用酶联免疫吸附试验测定EDN、IL-13、TGF-β1水平。多因素Logistic回归分析影响MP感染复发喘息的危险因素,受试者工作特征(ROC)曲线评估EDN、IL-13、TGF-β1对MP感染复发喘息的预测价值。结果 与无喘息组比较,复发喘息组、哮喘组EDN、IL-13、TGF-β1水平均较高(P<0.05),哮喘组与复发喘息组比较差异无统计学意义。单因素分析显示,复发喘息组的出生体质量低于无喘息组,特应性体质、一二级亲属过敏史、烟雾接触、住院时间≥7 d比例高于无喘息组(P<0.05)。多因素Logistic回归分析显示,EDN、IL-13、TGF-β1水平升高及特应性体质、烟雾接触是MP感染复发喘息的危险因素(P<0.05)。ROC曲线结果显示,EDN、IL-13、TGF-β1及三者联合预测MP感染复发喘息的曲线下面积(AUC)分别为0.688、0.662、0.689和0.765,联合预测效能最高。结论 MP感染复发喘息患儿血清EDN、IL-13、TGF-β1水平升高,三者可预测MP感染后患儿复发喘息,为临床干预提供指导。Objective To investigate serum levels of eosinophilic neurotoxin(EDN),interleukin(IL)-13 and transforming growth factor(TGF)-β1 in children with recurrent wheezing of mycoplasma pneumoniae(MP)infection and analyze risk factors of recurrent wheezing with MP infection.Methods A total of 80 children with MP infection were divided into the MP infection recurrence wheezing group(45 cases)and the MP infection non-wheezing group(35 cases)according to the previous history of MP infection with wheezing,and 35 children with acute attacks of bronchial asthma were selected as the asthma group.The levels of EDN,IL-13 and TGF-β1 were determined by enzyme-linked immunosorbent assay.Multivariate Logistic regression analysis was performed to analyze risk factors of MP infection recurrence and wheezing.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of EDN,IL-13 and TGF-β1 on MP infection recurrence and wheezing.Results Compared with the non-asthmatic group,levels of EDN,IL-13 and TGF-β1 were higher in the recurrent asthmatic group and the asthmatic group(P<0.05).There were no significant differences in EDN,IL-13 and TGF-β1 levels between the asthma group and the recurrent asthmatic group.Univariate analysis showed that the birth weight was lower in the recurrent wheezing group than that of the non-wheezing group,and the proportion of atopic constitution,the first and second degree relatives allergy history,smoke exposure and hospital stay≥7 d were higher than those of the non-wheezing group(P<0.05).Multivariate Logistic regression analysis showed that higher levels of EDN,IL-13,TGF-β1,atopic constitution and smoke exposure were risk factors for recurrent wheezing of MP infection(P<0.05).ROC curve results showed that the AUC of EDN,IL-13 and TGF-β1 for predicting the recurrence of MP infection and wheeting was 0.688,0.662 and 0.689,respectively,and the AUC of the combined prediction of EDN,IL-13 and TGF-β1 was 0.765,which was the most effective than each single index.Conclusion Serum

关 键 词：肺炎支原体 嗜酸细胞源神经毒素 转化生长因子β1 白细胞介素13 儿童 喘息 

分 类 号：R725.62[医药卫生—儿科]