摘要
目的 检测急性支气管炎患儿血清骨膜蛋白、鳞状上皮细胞癌抗原(SCCA)水平,并探讨二者表达的临床意义.方法 回顾性选取2018年10月至2020年4月于山东第二医科大学附属医院住院并接受治疗的78例急性支气管炎患儿为研究对象,纳入支气管炎组,根据疾病严重程度分为轻度52例和重度26例.选取同期健康体检的儿童86名作为对照组.检测并比较支气管炎组与对照组的骨膜蛋白、SCCA水平.比较轻度和重度急性支气管炎患儿的炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]、肺功能指标[第1秒用力呼气量(FEV1)、FEV1/用力肺活量(FVC)、最大呼气中段流量(MMEF)、最大呼气峰流速(PEF)]水平.采用Pearson法分析重度急性支气管炎患儿血清骨膜蛋白、SCCA水平与炎症因子水平、肺功能指标的相关性;以多因素Logistic回归分析对影响急性支气管炎加重的因素进行分析.结果 支气管炎组患儿的血清骨膜蛋白、SCCA水平分别为(409.37±98.24)ng/L、(1.42±0.43)ng/mL,均明显高于对照组[(264.31±82.54)ng/L、(0.95±0.31)ng/mL],差异均有统计学意义(P＜0.05).重度急性支气管炎患儿的血清骨膜蛋白、SCCA、IL-6、TNF-α、hs-CRP水平分别为(524.46±123.94)ng/L、(1.82±0.52)ng/mL、(16.62±4.18)ng/L、(17.62±5.21)ng/L、(18.46±6.02)mg/L,均明显高于轻度急性支气管炎患儿[(348.92±64.28)ng/L、(1.22±0.24)ng/mL、(4.62±1.38)ng/L、(3.83±1.09)ng/L、(9.34±0.71)mg/L],FEV1、FEV1/FVC、MMEF、PEF 水平分别为(2.06±0.27)V/L、56.62±6.26、(1.47±0.36)L/s、(4.33±0.62)L/s,均明显低于轻度急性支气管炎患儿[(3.12±0.46)V/L、67.38±6.14、(2.36±0.43)L/s、(5.64±0.71)Us],差异均有统计学意义(P＜0.05).重度急性支气管炎患儿血清骨膜蛋白、SCCA水平与炎症因子均呈正相关(P＜0.05),与肺功能指标均呈负相关(P＜0.05).骨膜蛋白、SCCA是影响急性支气管炎加重的独立危险因素(P＜0.05).结论 急性支气管炎患儿血清骨膜蛋白、SCCA水平均显著升高,且随病情加重,血清骨膜蛋白、SCCA水平进一步升高,在急性支气管炎的病情评估中可能有重要作用.
Abstract
Objective To detect the levels of serum periostin and squamous cell carcinoma antigen(SCCA)in children with acute bron-chitis,and to explore the clinical significance of their expressions.Methods A total of 78 children with acute bronchitis who were hospitalized and treated in Department of Pediatrics,Shandong Second Medical University Affiliated Hospital from October 2018 to April 2020 were retrospec-tively selected as the study objects,and were included in the bronchitis group,according to the severity of the disease,there were 52 mild cases and 26 severe cases.Eighty-six healthy children who underwent physical examination at the same period were selected as the control group.The levels of periosteal protein and SCCA were detected and compared between the bronchitis group and the control group.The levels of inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high sensitivity C-reactive protein(hs CRP)],lung function indica-tors[first second forced expiratory volume(FEV1),FEV1/forced vital capacity(FVC),maximum mid expiratory flow(MMEF),maximum peak expiratory flow rate(PEF)]between the mild and severe child were compared.The correlation between serum periosteal protein,SCCA levels,inflammatory factor levels,and lung function indicators in children with acute bronchitis was analyzed using Pearson correlation analysis.The fac-tors affecting the exacerbation of acute bronchitis were analyzed using multivariate Logistic regression analysis.Results The levels of serum peri-ostin and SCCA in bronchitis group were(409.37±98.24)ng/L,(1.42±0.43)ng/mL,respectively,which were higher than those in the con-trol group[(264.31±82.54)ng/L,(0.95±0.31)ng/mL],the differences were statistically significant(P＜0.05).The levels of serum periostin,SCCA,IL-6,TNF-α and hs-CRP in severe acute bronchitis child were(524.46±123.94)ng/L,(1.82±0.52)ng/mL,(16.62±4.18)ng/L,(17.62±5.21)ng/L,(18.46±6.02)mg/L,respectively,which were higher than those in mild acute bronchitis child[(348.92±64.28)ng/L,(1.22±0.24)ng/mL,(4.62±1.38)ng/L,(3.83±1.09)ng/L,(9.34±0.71)mg/L],and the levels of FEV1,FEV1/FVC,MMEF and PEF were(2.06±0.27)V/L,56.62±6.26,(1.47±0.36)L/s,(4.33±0.62)L/s,respectively,which were lower than those in mild acute bronchitis child[(3.12±0.46)V/L,67.38±6.14,(2.36±0.43)L/s,(5.64±0.71)L/s],the differ-ences were statistically significant(P＜0.05).The levels of serum periostin and SCCA were positively correlated with IL-6,TNF-α and hs-CRP(P＜0.05),and negatively correlated with FEV1,FEV1/FVC,MMEF and PEF(P＜0.05).Periostin and SCCA were independent risk factors for exacerbation of acute bronchitis(P＜0.05).Conclusion The levels of serum periostin and SCCA in children with acute bronchitis are significantly increased,with the aggravation of the disease,the serum levels of Periostin and SCCA increased further,which may play an im-portant role in the assessment of acute bronchitis.
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