摘要
目的探讨血清转化生长因子结合蛋白2(LTBP-2)、对氧磷脂酶-1(PON-1)水平对支气管哮喘患儿病情严重程度、急性发作的评估价值,以期为临床治疗提供参考。方法选取2020年8月—2024年6月秦皇岛市第一医院收治的116例支气管哮喘患儿为研究对象。根据患儿病情分为轻度组(n=52)、中度组(n=38)和重度组(n=26);再根据支气管哮喘患儿是否处于急性发作期将其分为急性组(n=71)与缓解组(n=45);另选取同期于本院体检的健康儿童100例作为健康组。收集所有研究对象的年龄、性别等一般资料及LTBP-2、PON-1水平;检测支气管哮喘患儿第一秒用力呼气容积(FEV_(1))、FEV_(1)占预计值百分比。结果轻度组、中度组、重度组支气管哮喘患儿血清LTBP-2水平明显高于健康组,血清PON-1水平低于健康组,差异均有统计学意义(P<0.05);随着病情的加重,患儿血清LTBP-2水平逐渐升高,血清PON-1水平逐渐下降,差异均有统计学意义(P<0.05)。急性组支气管哮喘患儿血清LTBP-2水平高于缓解组,血清PON-1、FEV_(1)水平及FEV_(1)占预计值百分比低于缓解组,差异均有统计学意义(P<0.05)。支气管哮喘患儿血清LTBP-2水平与病情严重程度呈正相关,与FEV_(1)、FEV_(1)占预计值百分比呈负相关(P<0.001);支气管哮喘患儿血清PON-1水平与病情严重程度呈负相关,与FEV_(1)、FEV_(1)占预计值百分比呈正相关(P<0.001)。血清LTBP-2、PON-1、LTBP-2+PON-1评估支气管哮喘患儿急性发作的曲线下面积(AUC)分别为0.784(95%CI:0.739~0.834)、0.837(95%CI:0.792~0.887)、0.919(95%CI:0.874~0.969)。结论血清LTBP-2、PON-1水平与支气管哮喘患儿病情严重程度及肺功能存在显著相关性。临床中可通过监测这2种指标的水平变化,评估患儿病情进展情况及急性发作风险;且二者联合检测对支气管哮喘患儿急性发作的评估价值高于单一指标检测,能为临床诊疗提供更可靠的参考依据。
Objective To investigate the evaluation value of serum latent transforming growth factorβ-binding protein-2(LTBP-2)and paraoxonase-1(PON-1)levels on the condition and acute exacerbation in children with bronchial asthma,aiming to provide a reference for clinical treatment.Methods A total of 116 children with bronchial asthma admitted to First Hospital of Qinhuangdao from August 2020 to June 2024 were selected as research participants.Based on disease severity,they were assigned to a mild group(n=52),moderate group(n=38),and severe group(n=26).According to whether the children were in an acute attack phase,they were allocated to an acute group(n=71)and a remission group(n=45).Additionally,100 healthy children undergoing physical examinations during the same period were selected as a healthy group.General data(e.g.,age,sex)and serum LTBP-2 and PON-1 levels were collected from all participants.Forced expiratory volume in one second(FEV_(1))and FEV_(1) as a percentage of predicted value were measured in children with bronchial asthma.Results LTBP-2 levels in the mild,moderate,and severe groups were significantly higher than those in the healthy group,while serum PON-1 levels were lower than those in the healthy group,with statistically significant differences(P<0.05).As disease severity increased,LTBP-2 levels gradually rose,and PON-1 levels gradually declined,with statistically significant differences(P<0.05).LTBP-2 levels in the acute group were higher than those in the remission group,while PON-1 levels,FEV_(1),and FEV_(1) as a percentage of predicted value were lower than those in the remission group,with statistically significant differences(P<0.05).LTBP-2 levels in children with bronchial asthma were positively correlated with disease severity and negatively correlated with FEV_(1) and FEV_(1) as a percentage of predicted value(P<0.001).PON-1 levels were negatively correlated with disease severity and positively correlated with FEV_(1) and FEV_(1) as a percentage of predicted value(P<0.001).The areas under the curve(AUC)for serum LTBP-2,PON-1,and LTBP-2 plus PON-1 in evaluating acute exacerbation in children with bronchial asthma were 0.784(95%CI:0.739-0.834),0.837(95%CI:0.792-0.887),and 0.919(95%CI:0.874-0.969),respectively.Conclusion Serum LTBP-2 and PON-1 levels are significantly correlated with disease severity and lung function in children with bronchial asthma.Clinically,monitoring changes in these two indicators can help assess disease progression and acute attack risk.Moreover,the study shows that combined detection of both indicators has a higher evaluation value for acute exacerbation in children with bronchial asthma than single-indicator detection,providing a more reliable reference for clinical diagnosis and treatment.
作者
阴悦
李若晗
柴小龙
张艳玲
王靓靓
刘文杰
苏文硕
Yin Yue;Li Ruohan;Chai Xiaolong;Zhang Yanling;Wang Liangliang;Liu Wenjie;Su Wenshuo(Department of Pediatrics,First Hospital of Qinhuangdao,Qinhuangdao Hebei 066000,China;Department of Anesthesiology and Surgery,The First Hospital of Hebei Medical University,Shijiazhuang 050000,China)
出处
《保健医学研究与实践》
2025年第6期58-63,共6页
Health Medicine Research and Practice
基金
河北省卫生健康委员会医学科学研究计划项目(20191374)。
关键词
转化生长因子结合蛋白-2
对氧磷脂酶-1
支气管哮喘
急性发作期
Latent transforming growth factorβ-binding protein-2
Paraoxonase-1
Bronchial asthma
Acute exacerbation phase
