NLR、PLR、血清IL-5和IL-37在学龄前儿童支气管哮喘中的临床意义

Clinical significance of NLR,PLR,serum IL-5 and IL-37 in preschool children with bronchial asthma

目的对比分析不同病情严重程度的学龄前儿童支气管哮喘中性粒细胞/淋巴细胞比值(Neutrophil-lymphocyte ratio,NLR)、血小板/淋巴细胞比值(Platelet-lymphocyte ratio,PLR)、血清IL-5和IL-37,探讨以上指标对学龄前儿童支气管哮喘诊断意义。方法选取2018年10月至2020年3月我院收治的初次诊断为支气管哮喘的学龄前期患儿100例为研究组,根据病情严重程度分为轻度组和重度组,选择同期在我院行健康体检学龄前儿童60名为对照组。记录所有入选者血常规指标、血清IL-5和IL-37指标,计算出NLR、PLR,对比各组入选者NLR、PLR、IL-5及IL-37的差异,应用ROC曲线评估以上指标对学龄前儿童支气管哮喘的诊断价值。结果研究组中所有患儿顺利完成研究,无剔除病例。各组间NLR、PLR及血清IL-5指标比较差异均有统计学意义(P<0.0167);哮喘重度组患儿血清IL-37分别与轻度组及健康对照组比较差异有统计学意义(P<0.0167),哮喘轻度组患儿血清IL-37与健康对照组比较差异无意义(P>0.0167);ROC曲线检测:NLR、PLR及血清IL-5指标对学龄前儿童支气管哮喘诊断的曲线下面积分别为0.861、0.785、0.982;最佳临界值分别为3.295、134.585、0.175;灵敏度分别为82.0%、78.0%、92.0%;特异度分别为78.3%、70.0%、98.3%。结论学龄前儿童支气管哮喘外周血NLR、PLR及血清IL-5指标均升高,对学龄前儿童支气管哮喘诊断具有一定指导意义。

Objective:To explore the diagnostic significance of the above indexes in preschool children with bronchial asthma.Methods:A total of 100 preschool children with initial diagnosis of bronchial asthma in our hospital from October 2018 to March 2020 were selected as the study group.According to the severity of the disease,they were divided into mild group and severe group,and 60 preschool children who underwent physical examination in our hospital during the same period were selected as the control group.The blood routine indexes,serum IL-5 and IL-37 indexes were recorded,and NLR and PLR were calculated.The differences of NLR,PLR,IL-5 and IL-37 were compared among the three groups,and the diagnostic value of the above indexes for bronchial asthma in preschool children was evaluated by ROC curve.Results:All the children in the study group successfully completed the study,and no cases were excluded.There were significant differences in NLR,PLR and serum IL-5 among the three groups(P<0.0167);the serum IL-37 in severe asthma group was significantly different from that in mild asthma group and healthy control group(P<0.0167),but there was no significant difference between mild asthma group and healthy control group(P>0.0167);ROC curve detection:the area under the curve of NLR,PLR and serum IL-5 were 0.861,0.785 and 0.982 respectively;the optimal critical values were 3.295,134.585,0.175;the sensitivity were 82.0%,78.0%,92.0%;the specificity were 78.3%,70.0%,98.3%.Conclusion:The levels of peripheral blood NLR,PLR and serum IL-5 were increased in preschool children with bronchial asthma,which had certain guiding significance for the diagnosis of preschool children with bronchial asthma.