摘要
目的探讨血清25-羟维生素D[25-(OH)D]、白细胞介素(IL)-17与支气管哮喘患儿气道炎症及气道重塑的相关性。方法前瞻性选择2021年12月至2023年6月上海市嘉定区安亭医院收治的162例支气管哮喘患儿作为研究对象,其中急性发作期86例(急性发作期组)、临床缓解期76例(临床缓解期组);根据哮喘严重程度分级标准将急性发作期患儿分为轻度组(n=36)、中度组(n=28)和重度组(n=22)。患儿均在治疗前,采用化学发光法检测血清25-(OH)D水平,酶联免疫吸附法检测血清IL-17水平;应用呼出气优呼吸BA200一氧化氮检测仪检测呼出气一氧化氮(FeNO)水平,XS-500i全自动血细胞分析仪检测嗜酸性粒细胞(EOS)计数,C16000全自动生化分析仪检测血清IL-6、肿瘤坏死因子-α(TNF-α)水平;应用Philips 16排螺旋CT机行高分辨率螺旋CT检查,计算气道重塑指标[气道壁厚度占气道外径百分比(T/D)、气道壁面积占气道总截面积百分比(WA)]。采用Pearson相关性分析血清25-(OH)D、IL-17与支气管哮喘患儿气道炎症及气道重塑指标的关系。结果急性发作期组患儿血清25-(OH)D水平显著低于缓解期组,血清IL-17、FeNO、IL-6、EOS计数、TNF-α、T/D及WA显著高于缓解期组(P<0.05)。重度组急性发作期患儿血清25-(OH)D水平显著低于中度组和轻度组,中度组急性发作期患儿血清25-(OH)D水平显著低于轻度组(P<0.05)。重度组急性发作期患儿血清IL-17、FeNO、IL-6、EOS计数、TNF-α、T/D及WA显著高于中度组和轻度组,中度组急性发作期患儿血清IL-17、FeNO、IL-6、EOS计数、TNF-α、T/D及WA显著高于轻度组(P<0.05)。Pearson相关分析结果显示,血清25-(OH)D与FeNO、IL-6、EOS计数、TNF-α、T/D及WA呈负相关(r=-0.410、-0.311、-0.258、-0.325、-0.224、-0.511,P<0.05),血清IL-17与FeNO、IL-6、EOS计数、TNF-α、T/D及WA呈正相关(r=0.511、0.511、0.392、0.405、0.464、0.682,P<0.05);支气管哮喘患儿血清25-(OH)D与IL-17之间呈负相关(r=-0.592,P<0.001)。结论支气管哮喘患儿的血清25-(OH)D降低、IL-17升高,且血清25-(OH)D、IL-17与气道炎症和气道重塑指标存在相关性,其可能参与了气道炎症与气道重塑的发生、发展过程。
Objective To investigate the correlation of serum 25-hydroxyvitamin D[25-(OH)D]and interleukin-17(IL-17)with airway inflammation and airway remodeling in children with bronchial asthma.Methods A prospective study was conducted on 162 children with bronchial asthma admitted to Shanghai Jiading District Anting Hospital from December 2021 to June 2023.Among them,86 cases were in the acute attack stage(acute attack stage group)and 76 cases were in the clinical remission stage(clinical remission stage group).According to the severity grading criteria of asthma,the children in the acute attack stage were divided into a mild group(n=36),a moderate group(n=28),and a severe group(n=22).The serum 25-(OH)D levels of all patients were tested by chemiluminescence,and the IL-17 levels of all patients were tested by enzyme-linked immunosorbent assays before treatment.The fractional exhaled nitric oxide(FeNO)level in exhaled breath was detected by a UBREATH exhalation analyzer BA200,the eosinophil(EOS)count was detected by an XS-500i fully automatic blood cell analyzer,and serum IL-6 and tumor necrosis factor-α(TNF-α)levels were detected by C16000 fully automatic biochemical analyzer.The Philips 16 slice spiral CT machine was used for high-resolution spiral CT examination,and airway remodeling indicators[including wall thickness to airway diameter(T/D)and wall area to total airway cross sectional area(WA)]were calculated.Pearson correlation analysis was made to explore the relationship of serum 25-(OH)D and IL-17 with airway inflammation and airway remodeling indictors in children with bronchial asthma.Results Compared with children at the remission stage,children at the acute attack stage showed significantly lower serum 25-(OH)D levels but significantly higher serum IL-17 levels,FeNO levels,IL-6 levels,EOS counts,TNF-αlevels,T/D,and WA(P<0.05).The serum 25-(OH)D levels in the severe group were significantly lower than those in the moderate and mild groups(P<0.05),and the serum 25-(OH)D levels in the moderate group were significantly lower than those in the mild group(P<0.05).The serum levels of IL-17,FeNO,IL-6,EOS,TNF-α,T/D,and WA in children with acute attacks in the severe group were significantly higher than those in the moderate group and mild groups(P<0.05).The serum IL-17 levels,FeNO levels,IL-6 levels,EOS counts,TNF-αlevels,T/D,and WA in the severe group were significantly higher than those in the moderate and mild groups(P<0.05).The serum IL-17 levels,FeNO levels,IL-6 levels,EOS counts,TNF-αlevels,T/D,and WA in the moderate group were significantly higher than those in the mild group(P<0.05).Pearson correlation analysis showed that FeNO levels,IL-6 levels,EOS counts,TNF-αlevels,T/D,and WA were correlated negatively with serum 25-(OH)D levels(r=-0.410,-0.311,-0.258,-0.325,-0.224,-0.511;P<0.05),but positively with serum IL-17 levels(r=0.511,0.511,0.392,0.405,0.464,0.682;P<0.05).There was also a negative correlation between serum 25-(OH)D and IL-17 levels in children with bronchial asthma(r=-0.592,P<0.001).Conclusion Serum 25-(OH)D levels decrease and serum IL-17 levels increase in children with bronchial asthma,and both of them are correlated with airway inflammation and airway remodeling indicators,so they may be involved in the occurrence and development of airway inflammation and airway remodeling.
作者
陆凡
赵辉
许亚洲
LU Fan;ZHAO Hui;XU Yazhou(Department of Pediatrics,Shanghai Jiading District Anting Hospital,Shanghai 201805,China)
出处
《新乡医学院学报》
2025年第4期294-299,共6页
Journal of Xinxiang Medical University
