支气管哮喘患儿血清suPAR、JAK、STAT异常表达及临床意义  

Abnormal Expression and Clinical Significance of Serum suPAR,JAK,and STAT in Children with Bronchial Asthma

作　　者：古伟强 林甄琪 曾子坤 GU Weiqiang;LIN Zhenqi;ZENG Zikun(Department of Pediatric Medicine,Dongguan People′s Hospital,Dongguan,Guangdong 523000,China)

机构地区：[1]东莞市人民医院小儿内科,广东东莞523000

出　　处：《临床肺科杂志》2025年第3期370-376,共7页Journal of Clinical Pulmonary Medicine

基　　金：东莞市社会科技发展(一般)项目(201950715001504)。

摘　　要：目的观察支气管哮喘患儿血清suPAR、JAK、STAT表达情况,分析其与患儿预后的相关性。方法选择支气管哮喘患儿134例(疾病组)和健康体检儿童134例(对照组),比较两组血清suPAR、JAK、STAT水平,并比较疾病组不同严重程度、不同病程患儿血清suPAR、JAK、STAT水平,比较不同严重程度、不同病程患儿第1秒用力呼气容积(FEV_(1))占预计值的百分比(FEV_(1)%)、FEV_(1)占用力肺活量(FVC)百分比(FEV_(1)/FVC)、气道壁厚度与气道外径之比(T/D)、气道管壁面积占气道总面积的百分比(WA%)。分析suPAR、JAK、STAT与FEV_(1)%、FEV_(1)/FVC、T/D、WA%的相关性,Logistic回归分析支气管哮喘患儿不良预后的影响因素,绘制受试者工作特征曲线(ROC)分析suPAR、JAK、STAT对支气管哮喘患儿不良预后的预测价值。结果疾病组患儿suPAR、JAK、STAT均高于对照组(P<0.01);间歇状态组、轻度组、中重度组suPAR、JAK、STAT、T/D、WA%逐渐升高(P<0.01),FEV_(1)%、FEV_(1)/FVC逐渐降低(P<0.01);<1年组、1~5年组、>5年组suPAR、JAK、STAT、T/D、WA%逐渐升高(P<0.01),FEV_(1)%、FEV_(1)/FVC逐渐降低(P<0.01),疾病组患儿病程与气道重构指标T/D、WA%均呈正相关(P<0.01),与suPAR、JAK、STAT呈正相关(P<0.01);T/D、WA%与suPAR、JAK、STAT均呈正相关(P<0.01);多因素Logistic回归分析显示病情程度、T/D、WA%、suPAR、JAK、STAT为哮喘患儿预后不良的独立影响因素;suPAR、JAK、STAT联合应用预测支气管哮喘患儿不良预后的AUC为0.912(95%CI:0.842~0.989),高于各指标单独应用(Z=4.225、3.539、3.486,P=0.009、0.017、0.015)。结论支气管哮喘患儿血清suPAR、JAK、STAT表达与肺功能和气道重塑有关,是支气管哮喘患儿不良预后的独立影响因素,联合应用对预后有较高的预测价值。Objective To observe the expression of serum soluble urokinase type plasminogen activator receptor(suPAR),Janus kinanse(JAK),and signal transducer and activator of transcription(STAT)in children with bronchial asthma,and to analyze their correlation with the prognosis of the children.Methods 134 children with bronchial asthma were selected as the disease group and 134 healthy children who underwent physical examinations were selected as the control group.The serum levels of suPAR,JAK,and STAT were compared between the two groups.The serum levels of suPAR,JAK,and STAT were also compared among the children with different degrees of severity and different courses of illness of disease groups.The percentage of first second forced expiratory volume(FEV_(1))to expected value(FEV_(1)%),FEV_(1) to forced vital capacity(FVC),the ratio of airway wall thickness to airway outer diameter(T/D),and the percentage of airway wall area to total airway area(WA%)were also compared among the children in different degrees of severity and different courses of illness of disease groups.The correlation between suPAR,JAK,STAT and FEV_(1)%,FEV_(1)/FVC,T/D,and WA%were analyzed,the influencing factors of poor prognosis in children with bronchial asthma were logistic regression analyzed,and receiver operating characteristic curves(ROC)was drawn to analyze the predictive value of suPAR,JAK,STAT for poor prognosis in children with bronchial asthma.Results The levels of suPAR,JAK,and STAT of the disease group were higher than those of the control group(P<0.01);The levels of suPAR,JAK,STAT,T/D,and WA%gradually increased in the intermittent state group,mild group,and moderate to severe group(P<0.01),while EV1%and FEV_(1)/FVC gradually decreased(P<0.01).The levels of suPAR,JAK,STAT,T/D,and WA%gradually increased in the groups with a disease duration of less than 1 year,1-5 years,and>5 years(P<0.01),while EV1%and FEV_(1)/FVC gradually decreased(P<0.01);The disease course of the disease group was positively correlated with airway remodeling indicator

关 键 词：支气管哮喘 预后 可溶性尿激酶型纤溶酶原激活物受体 JANUS激酶 信号转导和转录激活因子 

分 类 号：R72[医药卫生—儿科]