摘要
目的 探讨重症肺炎支原体(MP)肺炎诱发哮喘患儿类黏蛋白1样蛋白3(ORMDL3)基因单核苷酸多态性及血清不规则趋化因子人驱动蛋白(CX3CL1)、CD40配体(CD40L)、转化生长因子-β1(TGF-β1)水平与患儿预后的关系.方法 选取2020年1月—2022年8月青岛市市立医院收治的80例重症MP感染诱发哮喘患儿作为A组,92例重症MP感染未诱发哮喘患儿作为B组;比较两组临床资料、ORMDL3基因单核苷酸多态性及血清CX3CL1、CD40L、TGF-β1 水平,不同预后血清 CX3CL1、CD40L、TGF-β1 水平,血清 CX3CL1、CD40L、TGF-β1 及联合检查对重症MP感染诱发哮喘患儿预后的预测价值采用受试者工作特征(ROC)曲线进行分析.结果 A组ORMDL3基因rs7216389位点TT基因型及T等位基因的频率均高于B组(65.00％vs.44.57％;79.38％vs.63.59％);A组ORMDL3基因rs4794820位点GG基因型及G等位基因的频率均高于B组(60.00％vs.42.39％;77.50％vs.61.41％,P＜0.05);相比于 B 组,A 组血清 CX3CL1、CD40L、TGF-β1 水平均更高(P＜0.05);相比于预后良好组,预后不良组血清CX3CL1、CD40L、TGF-β1水平均更高(P＜0.05);血清CX3CL1、CD40L、TGF-β1及联合检查预测重症MP感染诱发哮喘患儿预后的曲线下面积(AUC)分别为0.636、0.697、0.721和0.900,其中联合检测的AUC最高(P＜0.05).结论 ORMDL3基因单核苷酸多态性及CX3CL1、CD40L、TGF-β1与重症MP感染诱发哮喘密切相关,且CX3CL1、CD40L、TGF-β1对重症MP感染诱发哮喘患儿预后具有较高预测价值,其中联合检查的预测价值最高.
Abstract
OBJECTIVE To investigate the correlation of mucin-like protein-3(ORMDL3)gene single nucleotide polymorphisms(SNP),serum levels of irregular chemokine human driver protein(CX3CL1),CD40 ligand(CD40L)and transforming growth factor-β1(TGF-β1)with prognosis in children with severe Mycoplasma pneu-moniae(MP)infection induced asthma.METHODS A total of 80 children with asthma induced by severe MP in-fection treated in Qingdao Municipal hospital from Jan 2020 to Aug 2022 were recruited as the group A,and 92 children without asthma after severe MP infection were enrolled in the group B.The clinical data,SNP of ORM-DL3 gene and levels of serum CX3CL1,CD40L and TGF-β1 were compared between two groups,and levels of se-rum CX3CL1,CD40L and TGF-β1 between different prognoses were compared.The predictive value of serum CX3CL1,CD40L,TGF-β1 alone and combined detection in the prognosis of children with asthma induced by se-vere MP infection was analyzed by receiver operating characteristic(ROC)curves.RESULTS The TT genotype and T allele frequencies of rs7216389 locus of ORMDL3 gene in the group A were higher than those in the group B(65.00％vs.44.57％;79.38％vs.63.59％).The frequencies of GG genotype and G allele at rs4794820 locus of ORMDL3 gene in the group A were higher than those in the group B(60.00％vs.42.39％;77.50％vs.61.41％,P＜0.05).Compared with the group B,the levels of serum CX3CL1,CD40L and TGF-β1 in the group A were higher(P＜0.05).Compared with the good prognosis group,the levels of serum CX3CL1,CD40L and TGF-β1 in the poor prognosis group were higher(P＜0.05).The area under the curve(AUCs)of serum CX3CL1,CD40L,TGF-β1 individual and combined detection for predicting the prognosis of children with asthma induced by severe MP infection were 0.636,0.697,0.721 and 0.900,respectively,and the AUC of combined de-tection was the highest(P＜0.05).CONCLUSION ORMDL3 gene single nucleotide polymorphism and CX3CL1,CD40L and TGF-β1 levels are closely related to asthma induced by severe MP infection.CX3CL1,CD40L,TGF-β1 have high predictive value for children with severe MP infection induced asthma,and combined detection has the highest predictive value.
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