白细胞介素-4、瘦素、趋化素与肥胖型哮喘患儿病情程度的关系及预测哮喘控制的价值  

Relationships of interleukin-4,leptin and chemerin with severity of asthma in obese children and their predictive values for asthma control

作　　者：木国法 李旭 龚应玲 MU Guofa;LI Xu;GONG Yingling(Department of Pediatrics,the First People′s Hospital of Zhaotong City in Yunnan Province,Zhaotong,Yunnan,657000)

机构地区：[1]云南省昭通市第一人民医院儿科,云南昭通657000

出　　处：《实用临床医药杂志》2025年第3期108-113,共6页Journal of Clinical Medicine in Practice

基　　金：云南省昭通市2021年度“凤凰计划”“鲲鹏计划”项目{昭党人才通[2021]6号}。

摘　　要：目的探讨血清白细胞介素-4(IL-4)、瘦素(Leptin)、趋化素(Chemerin)水平与肥胖型哮喘患儿病情程度的相关性及其预测哮喘控制的价值。方法选取102例肥胖型哮喘患儿为研究组,另选取102例健康肥胖儿童作为对照组,比较2组血清IL-4、Leptin、Chemerin水平。将研究组根据病情程度分为轻度组34例、中度组42例、重度组26例,比较各组血清IL-4、Leptin、Chemerin水平。分析血清IL-4、Leptin、Chemerin与病情程度的相关性。治疗4周后,将102例患儿根据哮喘控制情况分为控制组82例、未控制组20例,比较2组临床资料,血清IL-4、Leptin、Chemerin水平,并分析其对哮喘控制的影响。评价血清IL-4、Leptin、Chemerin水平对哮喘控制的预测价值。结果血清IL-4、Leptin、Chemerin水平在对照组儿童、轻度哮喘患儿、中度哮喘患儿、重度哮喘患儿中呈逐渐升高趋势,差异均有统计学意义(P<0.001)。Spearman相关性分析显示,血清IL-4、Leptin、Chemerin与病情程度呈正相关(P<0.001)。未控制组血清IL-4、Leptin、Chemerin水平高于控制组,差异均有统计学意义(P<0.001)。Logistic回归分析显示,校正病程后的血清IL-4(OR=1.514,95%CI:1.117~2.051)、Leptin(OR=1.534,95%CI:1.234~1.907)、Chemerin(OR=1.418,95%CI:1.026~1.959)仍是哮喘控制的独立危险因素(P<0.05)。血清IL-4、Leptin、Chemerin单项及联合预测哮喘控制的曲线下面积(AUC)分别为0.807(95%CI:0.717~0.879)、0.801(95%CI:0.711~0.874)、0.834(95%CI:0.748~0.901)、0.932(95%CI:0.864~0.972),联合预测的AUC优于各指标单独预测(P<0.05)。结论肥胖型哮喘患儿血清IL-4、Leptin、Chemerin水平与病情程度呈正相关,且为哮喘控制的独立危险因素。3项指标联合预测哮喘控制的价值更高。Objective To explore the correlations of serum interleukin-4(IL-4),leptin and chemerin levels with severity of asthma in obese children and their predictive values for asthma control.Methods A total of 102 obese children with asthma were selected as study group,and another 102 healthy obese children were selected as control group.The serum levels of IL-4,leptin and chemerin were compared between the two groups.The study group was divided into mild(n=34),moderate(n=42)and severe(n=26)asthma groups based on severity of disease,and the serum levels of IL-4,leptin and chemerin were compared among different groups.The correlations of serum IL-4,leptin and chemerin with disease severity were analyzed.After 4 weeks of treatment,the 102 children with asthma were divided into controlled group(n=82)and uncontrolled group(n=20)based on asthma control status.Clinical data and serum levels of IL-4,leptin and chemerin were compared between the two groups,and their impacts on asthma control were analyzed.The predictive values of serum IL-4,leptin and chemerin levels for asthma control were evaluated.Results The serum levels of IL-4,leptin and chemerin showed significant gradual increase trends among controlled children,mild asthma children,moderate asthma children,and severe asthma children(P<0.001).Spearman correlation analysis showed positive correlations of serum IL-4,leptin and chemerin with disease severity(P<0.001).The serum levels of IL-4,leptin and chemerin in the uncontrolled group were significantly higher than those in the controlled group(P<0.001).Logistic regression analysis showed that serum IL-4(OR=1.514,95%CI,1.117 to 2.051),leptin(OR=1.534,95%CI,1.234 to 1.907),and chemerin(OR=1.418,95%CI,1.026 to 1.959)after adjusting for disease duration were still the independent risk factors for asthma control(P<0.05).The areas under the curve(AUC)for predicting asthma control by single and combined detections of serum IL-4,leptin and chemerin were 0.807(95%CI,0.717 to 0.879),0.801(95%CI,0.711 to 0.874),0.834(95%CI,0.748 to

关 键 词：肥胖型哮喘 白细胞介素-4 瘦素 趋化素 病情 

分 类 号：R256.12[医药卫生—中医内科学] R723.14[医药卫生—中医学] R446.11