摘要
目的探讨肺炎支原体(mycoplasma pneumoniae,MP)感染合并哮喘患儿的微小RNA-23a(miR-23a)、血清25(OH)D3、呼出气一氧化氮(FeNO)的变化与肺功能的关系。方法选取80例MP感染合并哮喘患儿作为病例组,80例MP感染不伴哮喘的患儿作为MP组,80例体检健康儿童作为对照组,检测3组儿童的血清miR-23a、25(OH)D3、FeNO、肺功能指标[最大呼气峰值流速(PEF)、第一秒用力呼气容积(FEV_(1))、用力肺活量(FVC)]、炎症因子[白细胞介素4(IL-4)、白细胞介素10(IL-10)、干扰素-γ(IFN-γ)]以及免疫球蛋白(IgE、IgM、IgG)水平,并分析miR-23a、25(OH)D3、FeNO与肺功能指标的相关性。结果病例组患儿miR-23a、FeNO水平高于MP组和对照组,25(OH)D3水平低于MP组和对照组,差异有统计学意义(P<0.05);MP组miR-23a、FeNO水平高于对照组,25(OH)D3水平低于对照组,差异有统计学意义(P<0.05);病例组IL-10水平低于MP组和对照组,病例组IL-4、IFN-γ水平高于MP组和对照组,差异有统计学意义(P<0.05);MP组患儿免疫球蛋白IgE、IgM、IgG指标水平均高于对照组,差异有统计学意义(P<0.05);病例组患儿的肺功能(PEF、FEV_(1)、FVC占预计值的百分比)受损较MP组和对照组严重,差异有统计学意义(P<0.05);MP组患儿的PEF、FEV_(1)、FVC占预计值的百分比均低于对照组,差异有统计学意义(P<0.05);MP感染合并哮喘患儿miR-23a、FeNO与PEF、FEV_(1)、FVC均呈负相关关系(r值分别为-0.774、-0.729、-0.688、-0.670、-0.638、-0.652,均P<0.05),血清25(OH)D3与PEF、FEV_(1)、FVC均呈正相关关系(r值分别为0.677、0.620、0.598,均P<0.05)。结论MP感染合并哮喘患儿的miR-23a、FeNO水平显著增高,血清25(OH)D3水平显著降低,并且与患儿肺功能受损程度密切相关。提示哮喘合并MP感染患儿的肺功能损伤更为严重,在治疗哮喘的同时需要积极处理MP感染。另外,适当的补充维生素D可能对患儿的免疫调节和降低炎症反应起到积极作用。
Objective To investigate the relationship between changes in microRNA-23a(miR-23a),serum 25-hydroxyvitamin D3[25(OH)D3],fractional exhaled nitric oxide(FeNO),and pulmonary function in children with Mycoplasma pneumoniae(MP)infection complicated with asthma.Methods A total of 80 children with MP infection complicated with asthma were enrolled as the case group,80 children with MP infection without asthma as the MP group,and 80 healthy children undergoing physical examination as the control group.Serum levels of miR-23a and 25(OH)D3,FeNO levels,pulmonary function indices[peak expiratory flow(PEF),forced expiratory volume in 1 second(FEV_(1)),forced vital capacity(FVC)],inflammatory factors[interleukin-4(IL-4),interleukin-10(IL-10),interferon-γ(IFN-γ)],and immunoglobulin levels(IgE,IgM,IgG)were detected in all three groups.The correlations between miR-23a,25(OH)D3,FeNO and pulmonary function indices were analyzed.Results The levels of miR-23a and FeNO in the case group were significantly higher than those in the MP group and control group,while the level of 25(OH)D3 was significantly lower(P<0.05).The MP group showed higher miR-23a and FeNO levels and lower 25(OH)D3 level compared with the control group,with statistically significant differences(P<0.05).The level of IL-10 in the case group was lower than that in the MP group and control group,whereas the levels of IL-4 and IFN-γwere higher(P<0.05).The levels of immunoglobulins(IgE,IgM,IgG)in the MP group were significantly higher than those in the control group(P<0.05).Pulmonary function impairment(percentage of predicted values for PEF,FEV_(1),and FVC)in the case group was more severe than that in the MP group and control group(P<0.05).The percentage of predicted values for PEF,FEV_(1),and FVC in the MP group were lower than those in the control group(P<0.05).In children with MP infection complicated with asthma,miR-23a and FeNO were significantly negatively correlated with PEF,FEV_(1),and FVC(r values:-0.774,-0.729,-0.688,-0.670,-0.638,-0.652,all P<0.05),while serum 25(OH)D3 was significantly positively correlated with PEF,FEV_(1),and FVC(r values:0.677,0.620,0.598,all P<0.05).Conclusion Children with MP infection complicated with asthma exhibit significantly increased levels of miR-23a and FeNO,and significantly decreased serum 25(OH)D3 level,which are closely associated with the degree of pulmonary function impairment.These findings suggest that pulmonary function damage is more severe in children with asthma complicated with MP infection.Active management of MP infection is necessary while treating asthma.Additionally,appropriate vitamin D supplementation may play a positive role in immune regulation and reducing inflammatory responses in these children.
作者
卓艳霞
李瑞士
孙明华
ZHUO Yanxia;LI Ruishi;SUN Minghua(Department of Pediatrics,Puyang People’s Hospital,Puyang Henan 457005,China)
出处
《河南医学高等专科学校学报》
2025年第4期369-373,382,共6页
Journal of Henan Medical College
基金
河南省医学科技攻关计划项目(LHGJ20210932)。
