摘要
目的 探讨血清金属蛋白酶组织抑制剂1(TIMP-1)水平预测小儿呼吸道合胞病毒(RSV)毛细支气管炎预后的价值。方法 选择2017年5月—2020年3月甘肃省民乐县妇幼保健院收治的297例RSV毛细支气管炎患儿为研究组,另选择医院同时间段体检健康儿童71例为对照组,入院时检测血清TIMP-1水平;患儿随访2年分为哮喘组与非哮喘组。对比对照组与研究组一般资料与血清TIMP-1水平,对比不同病情严重程度患儿血清TIMP-1水平,分析血清TIMP-1水平与RSV毛细支气管炎患儿病情严重程度的相关性,Logistic多因素回归法分析RSV毛细支气管炎患儿预后的影响因素,绘制受试者工作特征曲线(ROC),以曲线下面积(AUC)分析入院时血清TIMP-1水平对RSV毛细支气管炎患儿预后的预测价值。结果 研究组患儿血清TIMP-1水平[(289.73±35.56)ng/ml]高于对照组[(232.19±26.34)ng/ml](P<0.05);重度患儿血清TIMP-1水平[(334.80±41.38)ng/ml]高于轻度[(263.17±29.51)ng/ml]、中度患儿[(291.35±34.26)ng/ml](P<0.05),中度患儿血清TIMP-1水平[(291.35±34.26)ng/ml]高于轻度患儿[(263.17±29.51)ng/ml](P<0.05)。Spearman相关性分析结果 显示,血清TIMP-1水平与RSV毛细支气管炎患儿病情严重程度呈正相关(r=0.532,P<0.05)。哮喘组有接触过敏原史、病情为重度例数占比、入院时IL-17、血清TIMP-1水平高于非哮喘组(P<0.05)。Logistic多因素回归分析显示,有接触过敏原史、病情为重度、入院时血清TIMP-1水平升高为RSV毛细支气管炎患儿进展为哮喘的影响因素(P<0.05)。入院时血清TIMP-1水平预测RSV毛细支气管炎患儿进展为哮喘的AUC值为0.869(P<0.05)。结论 入院时血清TIMP-1水平在预测小儿RSV毛细支气管炎进展为哮喘中具有重要价值。
Objective To investigate the prognostic value of serum tissue inhibitor of metalloproteinase 1(TIMP-1) in children with respiratory virus(RSV) bronchiolitis. Methods A total of 297 children with RSV bronchiolitis admitted to the Minle County,Maternal and Child Health Care Hospital of Gansu Province from May 2017 to March 2020were selected as the study group,and 71 healthy children who underwent physical examination in the hospital during the same period were selected as the control group. The serum TIMP-1 levels of the control group and the study group were detected at admission. The patients had been followed up for 2 years and divided into asthma group and non-asthma group according to the prognosis. The general data and serum TIMP-1 level of the control group and the study group were compared,the serum TIMP-1 level of the children with different severity of RSV bronchiolitis was compared,the correlation between serum TIMP-1 level and the severity of RSV bronchiolitis was analyzed. The clinical data of the asthma group and non-asthma group were compared. Logistic multivariate regression analysis was used to analyze the prognostic factors of children with RSV bronchiolitis. The receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC) was used to analyze the predictive value of serum TIMP-1 level on admission for the prognosis of children with RSV bronchiolitis. Results The serum TIMP-1 level of the study group [(289.73±35.56) ng/ml] was higher than that of the control group [(232.19±26.34) ng/mL](P<0.05). The level of TIMP-1 in children with severe disease [(334.80±41.38) ng/ml] was higher than that in children with mild[(263.17±29.51) ng/mL] and moderate disease [(291.35±34.26) ng/ml](P<0.05). The level of TIMP-1 in moderate children [(291.35±34.26) ng/ml] was higher than that in mild children [(263.17±29.51) ng/ml](P<0.05). Spearman correlation analysis showed that serum TIMP-1 level was positively correlated with the severity of RSV bronchiolitis in children(r=0.532,P<0.05). The asthma group had a history of exposure to allergens,the proportion of cases with severe disease,the levels of IL-17 and serum TIMP-1 at admission were higher than those in non-asthma group(P<0.05).The results of Logistic multivariate regression analysis showed that history of exposure to allergens,severe disease and elevated serum TIMP-1 level on admission were the influencing factors of progression to asthma in children with RSV bronchiolitis(P<0.05). The AUC value of serum TIMP-1 level at admission for predicting the progression to asthma in children with RSV bronchiolitis was 0.869(P<0.05). Conclusion The serum TIMP-1 level at admission had an important value in predicting the progression of RSV bronchiolitis to asthma in children.
作者
陈才
韩凤
谢晓娟
高艳霞
CHEN Cai;HAN Feng;XIE Xiaojuan;GAO Yanxia(Minle County Maternal and Child Health Hospital of Gansu Province,Zhangye,Gansu 734500,China)
出处
《中国国境卫生检疫杂志》
CAS
2023年第3期249-252,共4页
Chinese Journal of Frontier Health and Quarantine
