文章摘要
郑华月,张云涵,郑春阳.血清骨桥蛋白、维生素 D、白三烯 B4对支气管哮喘病儿诊断及预后的应用价值[J].安徽医药,2022,26(1):126-131.
血清骨桥蛋白、维生素 D、白三烯 B4对支气管哮喘病儿诊断及预后的应用价值
The value of serum osteopontin, vitamin D and leukotriene B4 in the diagnosis and prognosis of children with bronchial asthma
  
DOI:10.3969/j.issn.1009-6469.2022.01.029
中文关键词: 支气管哮喘  骨桥蛋白  维生素 D  白三烯 B4  受试者工作特征曲线  儿童
英文关键词: Bronchial asthma  Osteopontin  Vitamin D  Leukotriene B4  Receiver operating characteristic curve  Child
基金项目:
作者单位
郑华月 南阳医学高等专科学校第一附属医院儿二科河南南阳 473000 
张云涵 南阳医学高等专科学校妇儿教研室河南南阳 473000 
郑春阳 南阳医学高等专科学校第二附属医院心电图室河南南阳 473000 
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中文摘要:
      目的探究血清骨桥蛋白( OPN)、维生素 D[25(OH)D]、白三烯 B4(LTB4)对支气管哮喘( BA)病儿诊断及预后的应用价值。方法选取南阳医学高等专科学校第一附属医院 2017年 9月至 2019年 9月收治的 BA病儿 104例作为观察组,另选取同期健康体检儿童 98例作为对照组。检测对比两组及不同预后病儿血清 OPN、25(OH)D、LTB4水平,分析血清各指标对儿童 BA的诊断价值及与预后的关系。结果观察组治疗前血清 OPN(583.46±120.55)ng/L、LTB4(20.53±4.22)ng/L高于对照组(212.77±65.31)ng/L(8.06±2.18)ng/L,血清 25(OH)D(25.10±6.19)ng/L低于对照组(40.05±7.27)ng/L(P<0.05);有过敏史、有呼吸道反复感染史、父母有哮喘史以及治疗前血清 OPN、LTB4,25(OH)D均是儿童 BA的独立影响因素( P<0.05);血清 OPN、25(OH)D、LTB4及其联合诊断评估 BA的曲线下面积 AUC(95%CI)分别为 0.790(0.728~0.844)、 0.771(0.706~0.827)、 0.809(0.748~0.861)及 0.892(0.841~0.931)。治疗第 7天、第 14天控制者、部分控制者血清 OPN、LTB4低于治疗前, 25(OH)D高于治疗前( P<0.05);控制者治疗第 7天、第 14天血清 OPN、LTB4(391.29±73.20)ng/L、(300.47±68.81)ng/L、LTB4(15.42±2.63)ng/L、(11.90±2.81)ng/L低于部分控制者( 452.26±92.45)ng/L、(378.14±74.35)ng/L、(17.79±3.02)ng/L、(14.14±3.17)ng/L、未控制者(557.82±117.28)ng/L、(557.82±117.28)ng/L、(25.12±2.93)ng/L、(25.55±3.12)ng/L,25(OH)D(31.06±3.17)ng/L、(34.77±4.10)ng/L高于部分控制者( 28.21±3.02)ng/L、(30.64±3.76)ng/L、控制者( 25.12±2.93)ng/L、(25.12±2.93)ng/L(P<0.05)。 logistic回归分析显示,治疗第 14天血清 OPN、LTB4,25(OH)D均是预后不良的独立影响因素( P<0.05)。结论血清 OPN、25(OH)D、LTB4水平在 BA病儿中呈异常表达,三者联合应用有望成为 BA的更有效诊断手段,为临床选择针对性治疗方案及预后评估提供参考。
英文摘要:
      Objective To investigate the application value of serum osteopontin (OPN), vitamin D (25(OH)D), leukotriene B4(LTB4) in the diagnosis and prognosis of children with bronchial asthma (BA).Methods A total of 104 children with BA who were treated in The First Affiliated Hospital of Nanyang Medical College from September 2017 to September 2019 were selected as the obser-vation group, and 98 children with healthy physical examination during the same period were selected as the control group. The serumlevels of OPN, 25(OH)D, LTB4 in the two groups and children with different prognosis were detected and compared, and the diagnosticvalue of serum indicators and the relationship with the prognosis were analyzed.Results Serum OPN (583.46±120.55) ng/L and LTB4(20.53±4.22) ng/L of the observation group before treatment were higher than those of the control group (212.77±65.31) ng/L (8.06±2.18) ng/L, and serum 25(OH) D (25.10±6.19) ng/L was lower than the control group (40.05±7.27) ng/L (P<0.05); a history of allergies,a history of repeated respiratory tract infections, a history of parental asthma, and serum OPN and LTB4, 25 before treatment (OH)Dwere all independent influencing factors of BA in children (P<0.05); serum OPN, 25(OH)D, LTB4 and their combined diagnosis and as-sessment of BA area under the curve AUC (95%CI) were 0.790 (0.728-0.844), 0.771 (0.706-0.827), 0.809 (0.748-0.861) and 0.892 (0.841-0.931). Serum OPN and LTB4 of the totally controlled and partially controlled were lower than those before treatment on the 7th and 14th day of treatment, and 25(OH)D was higher than that before treatment (P<0.05); the serum OPN of the controllers on the 7thand 14th day of treatment , LTB4 (391.29±73.20) ng/L, (300.47±68.81) ng/L, LTB4 (15.42±2.63) ng/L, (11.90±2.81) ng/L are lowerthan some controls (452.26±92.45) pg/ mL, (378.14±74.35) ng/L, (17.79±3.02) ng/L, (14.14±3.17) ng/L, uncontrolled (557.82±117.28)ng/L, (557.82±117.28) ng/L, (25.12±2.93) ng/L, (25.55±3.12) ng/L, 25(OH)D (31.06±3.17) ng/L, (34.77±4.10) ng/L higher than somecontrols (28.21±3.02) ng/L, (30.64±3.76) ng/L, controller (25.12±2.93) ng/L, (25.12±2.93) ng/L (P<0.05). Logistic regression analysisshowed that serum OPN, LTB4, and 25(OH)D on the 14th day of treatment were independent influencing factors for poor prognosis (P< 0.05).Conclusion Serum OPN, 25(OH)D, LTB4 levels are abnormally expressed in children with BA. The combination of the three isexpected to be an effective diagnostic tool for BA, providing reference for clinical selection of targeted treatment and assessment of prog-nosis.
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