学龄前期支气管哮喘患儿哮喘发作情况及与肺表面活性蛋白水平的关系分析

doi:10.3969/j.issn.1006-6233.2024.12.019

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1264 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的: 探讨学龄前期支气管哮喘患儿哮喘发作情况及与肺表面活性蛋白(SP)水平的关系。方法: 选取2020年2月至2023年10月在本院确诊的112例支气管哮喘患儿(疾病组),根据哮喘发作频率分为高频组(n=52)和低频组(n=60)。纳入同期在本院体检正常的60例同龄儿童为对照组。比较疾病组与对照组、高频组与低频组患儿肺表面活性蛋白A(SP-A)、肺表面活性蛋白D(SP-D)水平,记录哮喘控制测试(ACT)评分、肺功能指标[(第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)]。采用Spearman等级相关分析评估哮喘发作情况与SP水平及肺功能之间的关系,并绘制ROC曲线分析SP对哮喘发作情况的预测能力。结果: 疾病组SP-A、SP-D水平高于对照组,ACT评分低于对照组,肺功能指标低于对照组(均P<0.05)。与低频组相比,高频组SP-A、SP-D水平明显升高(P<0.05),FEV1、FVC及FEV1/FVC比值降低(P<0.05),ACT评分明显降低(P<0.05)。单因素分析显示,SP-A、SP-D、FEV1、FVC及FEV1/FVC与哮喘发作频率相关(P<0.05)。多因素Logistic回归分析显示,SP-A、SP-D是哮喘发作频率的独立危险因素(P<0.05)。ROC曲线分析显示,SP-A、SP-D单独预测哮喘发作情况的AUC为0.784、0.816(P<0.05)。而SP水平联合预测的AUC为0.984,灵敏度为0.942,特异度为0.950(P<0.05)。结论: 学龄前期支气管哮喘患儿的哮喘发作频率与SP水平密切相关,SP水平可作为哮喘发作频率的预测指标,肺功能指标可用于评估患儿的呼吸功能状态,有助于临床早期干预和治疗。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：支气管哮喘, 学龄前期, 肺表面活性蛋白, 哮喘发作, 生物标志物

Abstract：Objective: To investigate the correlation between asthma attack frequency and pulmonary surfactant protein(SP) level in preschool children with bronchial asthma(BA). Methods: A total of 112 preschool children with BA (disease group) diagnosed in the hospital from February 2020 to October 2023 were enrolled, and children of disease group were divided into high-frequency subgroup (n=52) and low-frequency subgroup (n=60) based on the asthma attack frequency. At the same time, 60 healthy children of the same age with normal physical examination in our hospital were regarded as the control group. The pulmonary surfactant protein A (SP-A), pulmonary surfactant protein D (SP-D), Asthma Control Test (ACT) scores, pulmonary function indexes (forced expiratory volume in one second [FEV1], forced vital capacity [FVC], FEV1/FVC) were included as comparators between groups. Spearman rank correlation analysis was used to evaluate the correlation between asthma attack frequency with SP level and pulmonary function, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive ability of SP for asthma attack. Results: The disease group had significantly higher SP-A and SP-D levels, and lower ACT score and pulmonary function indexes relative to the control group (all P<0.05). The high-frequency subgroup presented significantly increased SP-A and SP-D levels, decreased ACT score and levels of FEV1, FVC and FEV1/FVC compared to the low-frequency subgroup (all P<0.05). Univariate analysis showed that SP-A, SP-D, FEV1, FVC and FEV1/FVC were correlated with the asthma attack frequency (P<0.05). Multivariate logistic regression analysis indicated that SP-A and SP-D were independent risk factors for the asthma attack frequency (P<0.05). ROC curve analysis indicated that the area under the curve (AUC) of SP-A and SP-D alone in predicting asthma attack frequency was 0.784 and 0.816, respectively (P<0.05). The AUC combined prediction were 0.984, with the sensitivity of 0.942 and the specificity of 0.950. Conclusion: The asthma attack frequency is closely related to SP level in preschool children with BA. SP level can be used as a predictor of asthma attack frequency. Pulmonary function indicators are useful for assessing the respiratory status, facilitating implementation of early interventions and treatments.

Key words： Bronchial asthma Preschool Pulmonary surfactant protein Asthma attack Biomarkers

基金资助:陕西省重点研发计划项目,(编号:2023-YBSF-087)

通讯作者: 王莉

引用本文:

毛华, 赵晓媛, 孙欢欣, 马杜婷, 王慧渊, 王莉. 学龄前期支气管哮喘患儿哮喘发作情况及与肺表面活性蛋白水平的关系分析[J]. 河北医学, 2024, 30(12): 2043-2048.
MAO Hua, ZHAO Xiaoyuan, SUN Huanxin, et al. Correlation between Asthma Attack Frequency and Pulmonary Surfactant Protein Level in Preschool Children with Bronchial Asthma. HeBei Med, 2024, 30(12): 2043-2048.

链接本文:

http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.12.019 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I12/2043

[1] Qian K,Xu H,Chen Z,Zheng Y.Advances in pulmonary rehabilitation for children with bronchial asthma[J].Zhejiang Da Xue Xue Bao Yi Xue Ban,2023,52(4):518-525.
[2] 龚亮,李文斌.FeNO联合外周血Eos在学龄前儿童支气管哮喘诊疗中的应用[J].医学研究杂志,2023,52(8):181-184.
[3] 邝少丹,岑敏,余琴.支气管肺发育不良患儿血清骨膜蛋白、表面活性蛋白D水平变化及意义[J].中国临床医生杂志,2023,51(12):1494-1497.
[4] Watson A,Madsen J,Clark HW.SP-A and SP-D:dual functioning immune molecules with antiviral and immunomodulatory properties[J].Front Immunol,2021,19(11):622598.
[5] 郑桂梅,唐兰芳.FEV0.5及FEV0.75在支气管哮喘儿童肺功能测定中的临床意义[J].上海交通大学学报(医学版),2023,43(10):1262-1267.
[6] 杨爱君.《儿童支气管哮喘诊断与防治指南(2016年版)》解读[J].中国医刊,2018,53(3):253-257.
[7] Zhou J,Guo Y,Teng Y,et al.Maternal anxiety during pregnancy and children's asthma in preschool age:the Ma'anshan birth cohort study[J].Journal of Affective Disorders,2023(340):312-320.
[8] Nikolaev K Y,Kharlamova O S,Kosarev I A,et al.Surfactant proteins SP-A and SP-D and conventional risk factors for chronic noncommunicable human diseases[J].Cell and Tissue Biology,2024,18(2):211-220.
[9] Principe S,Benfante A,Battaglia S,et al.The potential role of SP-D as an early biomarker of severity of asthma[J].Breath Res,2021,15(4):34428746.
[10] 段效军,张喜,安照辉,等.KL-6、SP-A及SP-D对儿童间质性肺疾病早期诊断及预后的评估价值[J].医学临床研究,2022,39(1):5-8,12.
[11] 刘晓佳,刘伟然,田中燕,等.基于“冬病夏治”理念的中药穴位贴敷疗法对哮喘患儿肺功能、血清炎症因子及肺表面活性蛋白表达水平的影响[J].临床和实验医学杂志,2022,21(15):1651-1655.
[12] Pantoja-Gomez OC,Agudelo-Agudelo J,Duenas-Mesa E,et al.Exhaled Nitric oxide fraction in asthma and obstructive sleep apnea among children at high altitudes.A cross-sectional study[J].Sleep Med,2022,10(119):584-588.
[13] Pinheiro DHA,Souza JVH,Justo AFO,et al.Asthma in the brazilian unified health care system:an epidemiological analysis from 2008 to 2021[J].Bras Pneumol,2024,50(2):364.