支气管哮喘患儿血清CXCR4、BDNF水平及其与气道炎症反应和糖皮质激素疗效的关系  

Serum levels of CXCR4 and BDNF in children with bronchial asthma and their relationship with airway inflammatory response and efficacy of glucocorticoids

作　　者：司媛 王丽阳 刘欢[1] 王艺璁 李慧玲 衣兰云 SI Yuan;WANG Liyang;LIU Huan;WANG Yicong;LI Huiling;YI Lanyun(The Second Department of Respiratory Medicine,Beijing Children′s Hospital affiliated to Capital Medical University Heilongjiang Hospital,Harbin,Heilongjiang 150001,China)

机构地区：[1]首都医科大学附属北京儿童医院黑龙江医院呼吸二科,黑龙江哈尔滨150001

出　　处：《检验医学与临床》2025年第5期619-624,共6页Laboratory Medicine and Clinic

基　　金：黑龙江省卫生健康委员会科研课题(2019-235)。

摘　　要：目的探讨支气管哮喘患儿(BA)血清C-X-C基序趋化因子受体4(CXCR4)、脑源性神经营养因子(BDNF)水平及其与气道炎症反应和糖皮质激素疗效的关系。方法选取2021年1月至2023年12月该院收治的146例BA患儿作为BA组,根据糖皮质激素治疗3个月后的疗效将其分为无效组和有效组。另选取同期该院75例健康体检儿童作为对照组。检测各组血清CXCR4、BDNF及气道炎症指标[嗜酸性粒细胞(EOS)计数、呼出气一氧化氮(FeNO)]水平。采用Pearson相关分析BA患儿血清CXCR4、BDNF水平与EOS计数、FeNO水平的相关性。采用多因素Logistic回归分析BA患儿糖皮质激素治疗无效的影响因素。采用受试者工作特征(ROC)曲线分析血清CXCR4、BDNF对BA患儿糖皮质激素治疗无效的预测价值。结果BA组血清CXCR4、BDNF、FeNO水平及EOS计数均高于对照组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,BA患儿血清CXCR4、BDNF水平与FeNO水平、EOS计数均呈正相关(P<0.05)。146例BA患儿糖皮质激素治疗无效率为34.25%(50/146)。无效组血清CXCR4、BDNF水平均高于有效组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,重度BA及EOS计数、FeNO水平、CXCR4水平、BDNF水平升高均为BA患儿糖皮质激素治疗无效的独立危险因素(P<0.05)。ROC曲线分析结果显示,血清CXCR4、BDNF联合检测预测BA患儿糖皮质激素治疗无效的曲线下面积为0.867,大于血清CXCR4、BDNF单独检测的0.783、0.775,差异均有统计学意义(Z=2.842、2.977,P<0.05)。结论血清CXCR4、BDNF水平升高与BA患儿气道炎症反应加重及糖皮质激素治疗无效均密切相关,血清CXCR4、BDNF联合检测对BA患儿糖皮质激素治疗无效的预测价值较高。Objective To investigate the serum levels of C-X-C motif chemokine receptor 4(CXCR4)and brain-derived neurotrophic factor(BDNF)in children with bronchial asthma(BA)and their relationship with airway inflammation and the efficacy of glucocorticoids.Methods A total of 146 children with BA admitted to the hospital from January 2021 to December 2023 were selected as the BA group,and they were divided into ineffective group and effective group according to the effect of glucocorticoid treatment for 3 months.Another 75 healthy children who underwent physical examination in the hospital were selected as the control group.The levels of serum CXCR4,BDNF and airway inflammatory indicators including eosinophil(EOS)count and fractional exhaled nitric oxide(FeNO)were detected in each group.Pearson correlation analysis was used to analyze the correlation of serum CXCR4 and BDNF levels with EOS count and FeNO levels in BA children.Multivariate Logistic regression was used to analyze the influencing factors of ineffective glucocorticoid treatment in children with BA.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum CXCR4 and BDNF levels in children with BA who did not respond to glucocorticoid therapy.Results The serum levels of CXCR4,BDNF,FeNO and ESO count in BA group were significantly higher than those in control group(P<0.05).Pearson correlation analysis showed that the levels of serum CXCR4 and BDNF were positively correlated with FeNO level and EOS count in BA children(P<0.05).The ineffective rate of glucocorticoid treatment in 146 children with BA was 34.25%(50/146).The serum levels of CXCR4 and BDNF in the ineffective group were higher than those in the effective group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that severe BA and increased EOS count,FeNO level,CXCR4 level,and BDNF level were independent risk factors for ineffective glucocorticoid treatment in children with BA(P<0.05).ROC curve analysis showed

关 键 词：儿童 支气管哮喘 C-X-C基序趋化因子受体4 脑源性神经营养因子 气道炎症反应 糖皮质激素 疗效 

分 类 号：R562.25[医药卫生—呼吸系统] R446.1[医药卫生—内科学]