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血清免疫球蛋白表达与咳嗽变异性哮喘患儿预后相关性分析

卢敬东   

  1. 北京市密云区中医医院儿科门诊 邮编 101500
  • 收稿日期:2017-07-21 修回日期:2018-01-24 出版日期:2017-12-25

Correlation between Serum Immunoglobulin Expression and Prognosis in Children with Cough Variant Asthma

卢敬东   

  1. Beijing Miyun District Chinese Medicine Hospital
  • Received:2017-07-21 Revised:2018-01-24 Online:2017-12-25

摘要: 目的:对咳嗽变异性哮喘患儿血清免疫球蛋白及其预后进行相关性分析。方法:选择2014年1月至2016年1月在我院儿科进行治疗的咳嗽变异性哮喘患儿68例作为研究对象,按照哮喘控制测试(asthma control test,ACT)评分及咳嗽症状评分将患儿分为轻度组和重度组,其中,轻度组42例,重度组26例。30例同期检查并且年龄相仿的健康儿童作为对照组。使用双抗体夹心酶联免疫吸附方法测定(enzyme linked immunosorbent assay,ELISA)对3组对象的血清免疫球蛋白E(immune globulin-E,IgE)、白细胞介素-6(interleukin 6,IL-6)、白细胞介素-8(interleukin 8,IL-8)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)进行检测,分析可能引起过敏性咳嗽病情加重的危险因素。结果:病例组患儿IgE、IL-6、IL-8、TNF-α的血清水平显著高于对照组,且重度组患儿IgE、IL-6、IL-8、TNF-α的血清水平显著高于轻度组患儿,差异有统计学意义(P<0.05)。经Pearson相关性分析,患儿咳嗽严重程度与IgE、IL-6、IL-8、TNF-α呈正相关(P<0.05)。将IgE、IL-6、IL-8、TNF-α、咳嗽症状评分、ACT评分作为引起过敏性咳嗽的自变量,引入多因素Logistic回归模型,结果显示,IgE、IL-6、IL-8、TNF-α、咳嗽症状评分、ACT评分均是引起患儿咳嗽变异性哮喘的危险因素(P<0.05)。选择多因素Logistic回归模型分析中OR值>1的因素做ROC曲线分析,ROC曲线面积(AUC)表现为IgE>ACT评分>咳嗽症状评分>IL-6>TNF-α>IL-8。结论:IgE、IL-6、IL-8、TNF-α均是引起患儿咳嗽变异性哮喘的危险因素,其中IgE升高,可能引发患儿病情加重。

Abstract: Objective:To analyze the correlation between serum immunoglobulin and prognosis in children with cough variant asthma. Methods:From January 2014 to January 2016, 68 patients with cough variant asthma treated in pediatric department of our hospital were selected as the case group. According to the ACT score and the cough symptom score, the children in the case group were divided into mild group (42 cases) and severe group (26 cases). 30 healthy children with similar age and accepted physical examination at the same time were enrolled in control group. The levels of immune globulin-E(IgE), interleukin 6(IL-6), interleukin 8(IL-8) and tumor necrosis factor-α(TNF-α) were measured by ELISA, and the risk factors that related to exacerbation of allergic cough were analyzed. Results:The levels of IgE, IL-6, IL-8 and TNF-α in serum in the case group were significantly higher than those in the control group, and the levels of IgE, IL-6, IL-8 and TNF-α in severe group were higher than the mild group, and there was statistical significance (P<0.05). Pearson correlation analysis showed that the severity of cough was positively correlated with the levels of IgE, IL-6, IL-8 and TNF-α (P<0.05). IgE, IL-6, IL-8, TNF-α, cough symptom score and ACT score were used as independent variables that inducing allergic cough, multivariate logistic regression analysis showed that IgE, IL-6, IL-8, TNF-α, cough symptom score and ACT score were all the risk factors of cough variant asthma in children (P<0.05). The factors of OR value>1 in multivariate logistic regression model were analyzed by the ROC curve, the area of ROC curve (AUC) showed IgE>ACT score> cough symptom score>IL-6>TNF-α>IL-8.Conclusion:IgE, IL-6, IL-8 and TNF-α are the risk factors of allergic cough, and with the increase of IgE, cough variant asthma may worsen in children.