成都地区支气管哮喘急性发作期患儿血清IgE、TNF-α、FeNO水平及与病情严重程度的相关性分析

Serum IgE, TNF-α and FeNO levels in children with acute attack of bronchial asthma and their correlation with disease severity in Chengdu

摘要:

目的分析支气管哮喘急性发作患儿IgE,TNF-α,FeNO水平情况及与病情严重程度的相关性，为临床上评估支气管哮喘病情提供理论依据。方法 选取2020年1月-2020年12月成都市妇女儿童中心医院收治的支气管哮喘急性发作患儿547例，根据患儿病情严重程度分为轻度组（n=287）、中度组（n=186）和重度组（n=74），所有患儿经治疗后症状均得到控制；对比试验组患儿急性发作期和临床控制期血清IgE、TNF-α、FeNO水平，采用Spearman相关分析患儿血清IgE、TNF-α、FeNO水平与病情严重程度的相关性，绘制支气管哮喘患儿ROC曲线分析血清IgE、TNF-α、FeNO水平对支气管哮喘急性发作期患儿的鉴别诊断价值。结果急性发作期患儿血清IgE、TNF-α、FeNO水平显著高于临床控制期(P<0.05)；重度组患儿血清IgE、TNF-α、FeNO水平显著高于轻度组和中度组(P<0.05)；中度组患儿血清IgE、TNF-α、FeNO水平显著高于轻度组(P<0.05)；Spearman相关分析结果表明血清IgE、TNF-α、FeNO水平与支气管哮喘病情严重程度均呈正相关(r=0.419,0.438,0.502,P<0.05)；经ROC曲线分析结果表明，血清IgE、TNF-α、FeNO水平联合诊断支气管哮喘急性发作患者病情严重程度的AUC为0.938(95%CI:0.912~0.982)，敏感性为83.47%，准确性为92.06%，特异性为94.28%。结论：哮喘急性发作患儿血清IgE、TNF-α、FeNO水平升高程度与病情严重程度密切相关，联合检测三者可用于评估患儿病情严重程度。

Abstract:

Objective To analyze the levels of IgE,TNF-α and FeNO in children with acute attack of bronchial asthma and their correlation with the severity of bronchial asthma, so as to provide theoretical basis for clinical evaluation of bronchial asthma. Methods A total of 547 children with acute bronchial asthma treated in Chengdu Women and Children's Central Hospital from January 2020 to December 2020 were selected and divided into mild group (n=287), moderate group (n=186) and severe group (n=74) according to the severity of their disease. All the children's symptoms were controlled after treatment. The serum IgE, TNF-α and FeNO levels in the experimental group were compared between the acute attack stage and the clinical control stage. Spearman correlation analysis was used to analyze the correlation between the serum IgE, TNF-α and FeNO levels and the severity of the disease. ROC curve of children with bronchial asthma was drawn to analyze the differential diagnosis value of serum IgE, TNF-α and FeNO levels in children with acute bronchial asthma. Results The levels of IgE, TNF-α and FeNO in acute stage were significantly higher than those in clinical control stage (P<0.05). The levels of serum IgE, TNF-α and FeNO in severe group were higher than those in mild and moderate groups significantly (P<0.05). The levels of serum IgE, TNF-α and FeNO in moderate group were higher than those in mild group significantly (P<0.05). Spearman correlation analysis showed that serum IgE, TNF-α and FeNO water were positively correlated with the severity of bronchial asthma (r=0.419 , 0.438 , 0.502 , P<0.05). ROC curve analysis showed that the AUC, sensitivity, accuracy and specificity of serum IgE, TNF-α and FeNO levels combined in diagnosing the severity of bronchial asthma in patients with acute attack was 0.938 (95% CI: 0.912-0.982 ), 83.47%, 92.06%, 94.28%. Conclusion The level of serum IgE, TNF-α and FeNO in children with acute attack of bronchial asthma is closely related to the severity of the disease, and combined detection of the three can be used to evaluate the severity of the disease in children.