白三烯水平与小儿毛细支气管炎及支气管哮喘关联分析

Significance of leukotriene level in the diagnosis of bronchiolitis and bronchial asthma in children

目的探讨检测毛细支气管炎及支气管哮喘患儿外周血及尿白三烯(LTs)水平的意义。方法收集南阳市第二人民医院2018-10-01-2020-01-31收治的80例毛细支气管炎患儿(毛支组)和60名哮喘患儿为研究对象(哮喘组);收集同时期来我院体检的60例健康儿童(对照组)作为对照。检测并比较各组受试儿童外周血白三烯C4(LTC4)和尿白三烯E4(LTE4)水平;采用Logistic回归分析鉴别毛细支气管炎和支气管哮喘的影响指标,ROC曲线分析其诊断性能。结果哮喘组、毛支组和对照组LTC4水平分别为(297.75±119.10)、(169.51±63.95)和(20.99±8.56)pg/mL,LTE4/Cr水平分别为(248.25±86.79)、(223.63±88.21)和(58.09±18.41)pg/mg,哮喘组和毛支组LTC4和LTE4水平均高于对照组,且哮喘组高于毛支组,差异均有统计学意义,均P<0.05;LTC4(OR=6.581,95%CI为2.910~14.881,P<0.001)、临床评分(OR=4.916,95%CI为2.097~11.525,P<0.001)及家族过敏史(OR=3.083,95%CI为1.142~8.319,P=0.026)是鉴别毛支和哮喘的独立影响因素;LTC4鉴别毛支组和哮喘组的曲线下面积为0.800,最佳诊断界限值为272.4 pg/mL,诊断特异性和敏感度分别为63.33%和93.75%。结论LTC4可以用于毛细支气管炎和哮喘的辅助鉴别诊断,对于毛细支气管炎患儿继发哮喘的风险有一定提示意义。

Objective To investigate the significance of detecting peripheral blood and urine leukotriene(LTs)in children with bronchiolitis or bronchial asthma.Methods Totally 80 children with bronchiolitis(bronchiolitis group)and 60 children with asthma(asthma group)were enrolled in Nanyang Second People’s Hospital from October 1 st to January 31 st,2018.60 healthy children(control group)during the same period were collected as control group.The levels of LTC4 in peripheral blood and LTE4 in urine were detected and compared.Logistic regression analysis was used to identify the influencing indexes of bronchiolitis and bronchial asthma,and ROC curve was used to analyze their diagnostic performance.Results The levels of LTC4 in asthma group,bronchiolitis group and control group were(297.75±119.10),(169.51±63.95)and(20.99±8.56)pg/ml,respectively,the LTE4/Cr levels were(248.25±86.79),(223.63±88.21)and(58.09±18.41)pg/mg,respectively.The levels of LTC4 and LTE4 in asthma group and bronchiolitis group were significantly higher than those in control group,and those in asthma group was higher than bronchiolitis group,the differences were statistically significant(all P<0.05);The LTC4(OR=6.581,95%CI:2.910-14.881,P<0.001),clinical score(OR=4.916,95%CI:2.097-11.525,P<0.001)and family history of allergy(OR=3.083,95%CI:1.142-8.319,P=0.026)were independent influencing factors in differentiating bronchiolitis from asthma.The area under the curve of LTC4 was 0.800,the optimal diagnostic threshold was 272.4 pg/ml,and the diagnostic specificity and sensitivity were 63.33%and 93.75%,respectively.Conclusion LTC4 can be used in the auxiliary differential diagnosis of bronchiolitis and asthma,which has certain significance for the risk of asthma in children with bronchiolitis.