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外周血嗜酸性粒细胞/中性粒细胞作为支气管哮喘患儿治疗后复发独立危险因子的探讨

Peripheral blood eosinophil/neutrophil as an independent risk factor for recurrence after treatment in children with bronchial asthma
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摘要 目的探讨外周血嗜酸性粒细胞(EOS)/中性粒细胞(NER)对支气管哮喘(BA)患儿治疗后哮喘复发的影响。方法采用前瞻性队列研究,将2020年2月至2022年2月该院收治的BA患儿作为研究对象,所有患儿经常规治疗且病情得到控制,后随访6个月,记录患儿复发情况,比较复发与未复发患儿治疗前、治疗1周时的EOS/NER、白细胞介素(IL)-4、IL-5;建立Logistic回归分析模型检验EOS/NER、IL-4、IL-5对BA患儿治疗后哮喘复发的影响;绘制受试者工作特征(ROC)曲线,分析治疗前EOS/NER对BA患儿治疗后复发风险的预测价值。结果共纳入128例BA患儿,治疗后随访6个月复发25例,复发率为19.53%;BA患儿治疗1周的EOS/NER、IL-4、IL-5水平均较治疗前降低(P<0.05),复发患儿治疗前、治疗1周的EOS/NER、IL-4、IL-5水平均高于未复发患儿,在治疗前和治疗1周时,不同性别、年龄段、治疗方案患儿之间的EOS/NER、IL-4、IL-5水平比较差异均无统计学意义(P>0.05);EOS/NER升高、IL-4水平升高、IL-5水平升高对BA患儿治疗后复发有影响,可能是复发的风险因子(OR>1,P<0.05);ROC曲线结果显示,治疗前EOS/NER预测BA患儿治疗后6个月复发的曲线下面积为0.810(95%CI:0.724~0.896,P<0.001),预测价值中等。结论BA患儿治疗前EOS/NER可能是治疗后复发的独立危险因子,且对复发风险有中等预测价值。 Objective To investigate the effect of eosinophil(EOS)/neutrophil(NER)in peripheral blood on asthma recurrence in children with bronchial asthma(BA)after treatment.Methods A prospective cohort study was conducted in the study.BA children admitted to the hospital from February 2020 to February 2022 were selected as the research objects.All children were treated regularly and their condition was under control.After a follow-up of 6 months,the recurrence of the children was recorded.EOS/NER,interleukin(IL)-4 and IL-5 of children with and without relapse before treatment and at 1 week of treatment were compared.Logistic regression analysis model was established to test the effect of EOS/NER on the recurrence of asthma in children with BA after treatment.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of EOS/NER,IL-4 and IL-5 before treatment for the recurrence risk of BA children after treatment.Results A total of 128 children with BA were included.25 cases recurred after 6 months of follow-up,with a recurrence rate of 19.53%.EOS/NER,IL-4 and IL-5 of BA children after 1 week of treatment were lower than those before treatment(P<0.05).EOS/NER,IL-4 and IL-5 of recurrent children before treatment and 1 week after treatment were higher than those of non-recurrent children(P<0.05).There were no statistically significant differences in EOS/NER,IL-4,IL-5 levels between children of different genders,age groups,and treatment regimens before and after 1 week of treatment(P>0.05).Increased EOS/NER,increased level of IL-4 and increased level of IL-5 had effect on the recurrence of BA children after treatment and may be risk factors for recurrence(OR>1,P<0.05).The ROC curve showed that area under the curve of EOS/NER before treatment for predicting the recurrence was 0.810(95%CI:0.724-0.896,P<0.001)in BA patients after 6 months of treatment,with moderate predictive value.Conclusion EOS/NER before treatment in BA children may be an independent risk factor for recurrence after treatment,and has moderate predictive value for recurrence risk.
作者 冯勤颖 宋晓钰 周信忠 陈治浩 FENG Qinying;SONG Xiaoyu;ZHOU Xinzhong;CHEN Zhihao(Central Laboratory,Beijing Jishuitan Hospital,Guizhou Hospital,Guiyang,Guizhou 550014,China)
出处 《国际检验医学杂志》 CAS 2024年第2期150-154,共5页 International Journal of Laboratory Medicine
基金 贵州省卫生健康委科学技术基金项目(gzwkj2022-179)。
关键词 儿童 支气管哮喘 复发 嗜酸性粒细胞/中性粒细胞 children bronchial asthma recurrence eosinophil/neutrophil
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