目的 研究咳嗽变异性哮喘(CVA)患儿血清微小RNA-155(miR-155)、趋化性细胞因子8(CXCL8)表达水平及其临床意义。方法 选取2017年3月-2019年2月于北京市大兴区妇幼保健院接受治疗的CVA患者86例作为试验组,另选取同期在本院进行体检的健康儿童90例作为对照组。收集受试者一般临床资料,检测受试者痰嗜酸粒细胞(EOS)计数、呼出气一氧化氮(FeNO)及肺功能指标第1秒最大呼气量(FEV₁)、最大呼气峰流速(PEF)、第1秒用力呼气容积/用力肺活量(FEV₁/FVC)。Pearson法分析miR-155、CXCL8水平与EOS、FeNO及肺功能指标的相关性。受试者工作特征曲线(ROC)分析血清中miR-155、CXCL8水平对CVA的预测价值。结果 与对照组相比,试验组EOS、FeNO、miR-155、CXCL8水平均升高(t=11.606、27.562、19.721、10.754, P＜0.05),FEV₁、PEF、FEV₁/FVC水平均降低(t=17.471、10.975、33.605, P<0.05)。Pearson法分析结果显示,miR-155、CXCL8与EOS、FeNO水平均呈正相关(P＜0.05),与FEV₁、PEF、FEV₁/FVC均呈负相关(P＜0.05)。miR-155、CXCL8水平预测CVA的曲线下面积分别为0.821(95%CI:0.675~0.967)、0.851(95%CI:0.741~0.961);联合检测预测CVA的曲线下面积为0.935(95%CI:0.914~0.975)。结论 CVA患儿血清中miR-155、CXCL8水平均升高,对CVA具有一定的预测价值,可能作为诊断CVA的潜在血清学标志物。

Objective To investigate the expression levels of serum microRNA-155 (miR-155) and chemokine 8 (CXCL8) in children with cough variant asthma (CVA), and to discuss the clinical significance of these indicators. Methods A total of 86 CVA patients treated in Daxing Maternal and Child Health Hospital of Beijing from March 2017 to February 2019 were selected as study objects (experiment group), and 90 healthy children who underwent physical examination at the same time were selected as the control group.The general clinical data were collected, sputum eosinophil (EOS) count, exhaled nitric oxide (FeNO) and pulmonary function indexes including forced expiratory volume in one second (FEV₁), peak expiratory flow rate (PEF) and forced expiratory volume in one second/forced vital capacity (FEV₁/FVC) were measured.Pearson method was used to analyze the correlation between miR-155, CXCL8 levels and EOS, FeNO, lung function.In addition, receiver operating characteristic curve (ROC) was used to analyze the predictive value of serum miR-155 and CXCL8 levels for CVA. Results Compared with the control group, the levels of EOS, FeNO, miR-155 and CXCL8 in the experiment group were significantly higher(t=11.606, 27.562, 19.721, 10.754, P＜0.05), while the levels of FEV₁, PEF and FEV₁/FVC were significantly lower (t=17.471, 10.975, 33.605, P<0.05).Pearson analysis showed that miR-155 and CXCL8 were positively correlated with EOS and FeNO (P<0.05), and negatively correlated with FEV₁, PEF and FEV₁/FVC (P<0.05).The area under the curve of miR-155 and CXCL8 was 0.821 (95% CI:0.675-0.967) and 0.851 (95% CI:0.741-0.961), respectively.The area under the curve of combined detection in predicting CVA was 0.935 (95% CI:0.914-0.975). Conclusion The levels of serum miR-155 and CXCL8 in children with CVA are increasing, which has certain predictive value for CVA, and may be used as potential serological markers for the diagnosis of CVA.