儿童哮喘血清胱抑素C和体液免疫功能指标变化及其与肺炎支原体感染的相关性研究

doi:10.11852/zgetbjzz2020-2128

摘要/Abstract

摘要： 目的探究哮喘儿童血清胱抑素C(CysC)、体液免疫功能指标变化及其与肺炎支原体(MP)感染的相关性,为哮喘的治疗提供依据。方法以2017年9月—2020年6月在苏州市第九人民医院和吴江区儿童医院治疗的哮喘儿童95例为研究组,并以同期健康体检儿童63例为对照组。比较两组血清CysC水平、体液免疫功能指标[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)]及MP感染率;将哮喘患儿分为重症组及轻症组,比较血清CysC水平、体液免疫功能指标及MP感染率,分析MP感染与CysC水平、体液免疫功能指标的相关性,并分析各指标及联合检测对哮喘严重程度的评估价值;检测所有受试者的肺功能指标,根据MP感染情况将哮喘患儿分为MP感染组及未感染组,比较两组及对照组的肺功能指标。结果研究组CysC、IgM水平及MP感染率高于对照组(t=9.942、2.880,χ² =10.914,P<0.05),研究组IgA、IgG水平低于对照组(t=10.289、7.968,P<0.05);患儿CysC、IgM水平与MP感染呈正相关(r=0.170、0.183,P<0.05),IgG水平与MP感染呈负相关(r=-0.254,P<0.05);重症组CysC、IgM水平及MP感染率高于轻症组(t=3.695、2.090,χ²=18.459,P<0.05),IgA、IgG水平低于轻症组(t=3.016、3.192,P<0.05),血清CysC水平、IgA、IgG、IgM水平及MP感染联合检测对哮喘严重程度的AUC高于单独检测(Z=2.018、2.899、2.068、3.094、2.799,P<0.05);MP感染组用力肺活量(FVC)、第1秒最大呼气量(FEV₁)、FEV₁/FVC值小于未感染组(t=2.437、2.597、2.261,P<0.05)。结论哮喘患儿存在血清CysC水平及体液免疫功能异常的现象,并且血清CysC水平、体液免疫功能指标及MP感染联合检测对哮喘严重程度具有诊断价值。

关键词: 儿童哮喘, 胱抑素C, 体液免疫, 肺炎支原体

Abstract: Objective To explore the changes of serum cystatin C (CysC) and humoral immune function indexes in asthma children and their correlation with Mycoplasma pneumoniae (MP) infection, in order to provide reference for the treatment of asthma. Methods A total of 95 asthma children treated in Suzhou Ninth People's Hospital and Wujiang District Children's Hospital from September 2017 to June 2020 were enrolled into study group, meanwhile 63 children who took physical examination were selected as control group. Serum levels of CysC, humoral immune function indexes [immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM)] and MP infection rate were compared between the study group and control group. According to the severity of asthma, chidlren were divided into severe group and mild group. Serum CysC level, humoral immune function indexes and MP infection rate were compared. The correlation between MP infection and CysC level, humoral immune function indexes was analyzed. The evaluation value of each index and their combination for asthma severity was analyzed. The lung function indexes of all subjects were detected. According to MP infection, they were divided into MP infection group and non-infection group. The lung function indexes were compared between the two groups and control group. Results The levels of CysC and IgM, and MP infection rate in study group were higher than those in control group(t=9.942,2.880, χ²=10.914, P<0.05), while levels of IgA and IgG in study group were significantly lower than those in control group (t=10.289, 7.968, P<0.05). CysC and IgM levels were positively correlated with MP infection(r=0.170, 0.183, P<0.05), while IgG level was negatively related to MP infection (r＝-0.254, P<0.05). The levels of CysC and IgM, and MP infection rate in severe group were higher than those in mild group (t=3.695, 2.090, χ² =18.459, P<0.05), while levels of IgA and IgG in severe group were significantly lower than those in mild group (t=3.016, 3.192, P<0.05). The diagnostic value of serum CysC level combined with humoral immune function indexes and MP infection for predicting asthma severity was significantly higher than that of single index detection (Z=2.018, 2.899, 2.068, 3.094, 2.799, P<0.05). The forced vital capacity (FVC), forced expiratory volume in one second (FEV₁) and FEV₁/FVC in MP infection group were lower than those in non-infection group (t=2.437, 2.597, 2.261, P<0.05). Conclusions The serum CysC level and humoral immune function are abnormal in asthma children. The combined detection of serum CysC level, humoral immune function indexes and MP infection is of diagnostic value for asthma severity.

Key words: child asthma, cystatin C, humoral immunity, mycoplasma pneumoniae

中图分类号:

R725.6

胡春霞, 孔令军, 缪鑫霞, 吴建刚. 儿童哮喘血清胱抑素C和体液免疫功能指标变化及其与肺炎支原体感染的相关性研究[J]. 中国儿童保健杂志, 2021, 29(12): 1347-1350.

HU Chun-xia, KONG Ling-jun, MIAO Xin-xia, WU Jian-gang. Changes of serum cystatin C and humoral immune function indexes in asthma children and their correlation with mycoplasma pneumoniae infection[J]. Chinese Journal of Child Health Care, 2021, 29(12): 1347-1350.

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