目的 探索新生儿脐血白细胞介素25(IL-25)、白细胞介素33(IL-33)水平与42d内婴儿湿疹发病的相关性,以期为早期婴儿湿疹的预防提供理论支持。方法 选取2020年10月－2021年10月在空军特色医学中心妇产科出生的符合纳入标准的145例新生儿为研究对象,出生时收集脐带静脉血并测定脐血中IL-25及IL-33水平;42d后随访记录婴儿湿疹的发病情况和严重程度。结果 在145例婴儿中,有79例患湿疹,患病率为54.5％。湿疹组脐血IL-25水平明显低于无湿疹组(Z=4.957,P<0.001),湿疹组脐血IL-33水平明显高于无湿疹组(Z=4.594,P<0.001),湿疹组有家族过敏史的概率明显高于无湿疹组(P<0.05)。Logistic回归分析结果显示,有家族过敏史、脐血IL-25低水平(<14.5pg/mL)、脐血IL-33高水平(>21.1pg/mL)是影响42d婴儿湿疹发生的危险因素(OR值分别为4.296、4.034、2.759,P<0.05),而出生体重与42d婴儿湿疹发病无关(P>0.05)。其中,脐血IL-33水平与分娩方式有关(P<0.05)。ROC曲线分析结果显示,最佳阳性截断值脐血IL-25为<14.0pg/mL(敏感度为62.0%,特异度为75.8%)、IL-33为>22.1pg/mL(敏感度为64.6%,特异度为69.7%)。Spearman相关性检验发现脐血IL-33水平与湿疹面积和严重程度指数(EASI评分)具有线性相关性(r=0.398,P<0.001)。结论 家族过敏史、较低水平的脐血IL-25及较高水平的脐血IL-33是42d婴儿湿疹的重要影响因素,且较高水平的脐血IL-33会加重42d婴儿湿疹的严重程度。
Abstract
Objective To investigate the correlation of the levels of interleukin-25 (IL-25) and interleukin-33 (IL-33) in cord blood with the development of infantile eczema within 42 days after birth, so as to provide theoretical support for the prevention of early infant eczema. Methods A total of 145 newborns who met the inclusion criteria and were born in the Obstetrics and Gynecology Department of the Air Force Special Medical Center from September 2020 to September 2021 were selected. Cord venous blood was collected at birth and the levels of IL-25 and IL-33 in cord blood were measured. The occurrence and severity of infantile eczema were recorded in 42 days. Results Among 145 infants, 79(54.5%) suffered from eczema. The level of IL-25 in cord blood in eczema group was significantly lower than that in non-eczema group (Z=4.957, P<0.001), and the level of IL-33 in cord blood in eczema group was significantly higher than that in non-eczema group (Z=4.594, P<0.001). The proportion of family history of allergy in the eczema group was significantly higher than that in non-eczema group (χ2=4.693, P<0.05). Logistic regression analysis showed that family history of allergy (OR=4.296), lower level of IL-25(＜14.5pg/mL) (OR=4.034) and higher level of IL-33(＞21.1pg/mL) (OR=2.759) in cord blood were risk factors for eczema (P<0.05), while birth weight was not associated with the onset of eczema in infants at 42 days (P>0.05). Meanwhile, the level of IL-33 in cord blood was related to the mode of delivery (P<0.05). ROC analysis showed that the optimized positive cutoff value was <14.0pg/mL for cord blood IL-25(sensitivity 62.0%, specificity 75.8%) and >22.1pg/mL for IL-33 (sensitivity 64.6%, specificity 69.7%). Spearman correlation test found that there was a linear correlation of the level of cord blood IL-33 with eczema area and severity index (EASI) score (r=0.398, P<0.01). Conclusion Family allergy history, lower level of cord blood IL-25 and higher level of cord blood IL-33 are important influencing factors of infant eczema in 42 days after birth, and higher level of cord blood IL-33 will aggravate the severity of early infantile eczema.
关键词
脐血 /
婴儿 /
湿疹 /
白细胞介素25 /
白细胞介素33
Key words
cord blood /
infant /
eczema /
interleukin-25 /
interleukin-33
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基金
北京市科技计划项目-首都临床特色应用研究(Z181100001718029)
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