MASP2在小儿上呼吸道感染中的意义

Plasma levels of mannan-binding lectin-associated serine protease 2 in children with upper respiratory tract infection

目的探讨血浆甘露聚糖结合凝集素(MBL)相关丝氨酸蛋白酶2(MASP2)水平在儿童上呼吸道感染(上感)中的意义。方法取103例上感患儿和35例健康体检儿童作为研究对象,测定其血浆MASP2和C反应蛋白(CRP)浓度并进行白细胞计数(WBC)。根据CRP和WBC值、感染不同时期及有无治疗,上感儿童分为CRP升高组(n=48)与正常组(n=54)、WBC升高组(n=61)与正常组(n=40)、感染早期未用药组(n=68)与感染中后期已用药组(n=35),对各组资料进行统计学分析。结果上感组MASP2浓度显著高于对照组(P<0.001),CRP升高组血浆MASP2浓度与CRP值正相关(r=0.310,P<0.05),WBC升高组MASP2水平与WBC值显著正相关(r=0.392,P<0.01),感染早期未用药组MASP2浓度显著高于感染中后期已用药组(P<0.01),MASP2、CRP、MBL2基因具有共同的转录因子HNF-4α结合位点。结论 MASP2蛋白可能为急性期蛋白,血浆MASP2水平可作为辅助诊断小儿上感的一个参考指标。

Objective To explore the significance of plasma levels of mannan-binding lectin（MBL）-associated serine protease 2（MASP2） in children with upper respiratory tract infection（URTI）. Methods A total of 103 children with URTI and 35 healthy children were examined for plasma levels of MASP2 and C-reactive protein（CRP）. According to CRP levels, white blood cell count（WBC）, stage of infection, and administration of treatments, the children with URTI were divided into the elevated CRP group（n=48） and the normal CRP group（n=54）, elevated WBC group（n=61） and normal WBC group（n=40）, the early stage of infection without treatment group（n=68） and mid-late stage of infection with treatment group（n=35）. Results Plasma MASP2 levels was significantly higher in URTI group than in the healthy control group（P〈0.001） and showed a close correlation with age（r=0.302, P〈0.01）. Plasma MASP2 level was significantly correlated with CRP level in elevated CRP group（r=0.310, P〈0.05）but not in normal CRP group（P〈0.05）, correlated with WBC in elevated WBC group（r=0.392, P〈0.01） but not in normal WBC group（P〈0.05）, and was significantly higher in early stage infection without treatment group than in mid-late stage of infection with treatment group（P〈0.01）. MASP2, MBL2 and CRP genes had a common binding site for the transcription factor HNF-4α.Conclusion MASP2 may be an acute-phase protein, and its plasma level might serve as a new reference index in the diagnosis of URTI in children.