中性粒细胞弹性蛋白酶在学龄前儿童哮喘急性发作诊断中的作用

Role of serum neutrophil elastase determination in the diagnosis of acute exacerbation of asthma in preschool children

目的测定学龄前哮喘儿童外周血中性粒细胞弹性蛋白酶(NE)水平,阐明NE在哮喘急性发作诊断中的作用。方法收集2008年1月至2010年1月确诊为哮喘的学龄前儿童85例,分为哮喘急性发作组44例(急性组)和非急性发作组41例(非急性组);同期35例健康体检儿童作为对照组。用ELISA法检测各组外周血的NE和白细胞介素-8(IL-8)水平,并进行NE的受试者工作特征曲线(ROC)评价。结果哮喘组的NE和IL-8水平高于对照组,其中急性发作组高于非急性发作组(P<0.05);NE和IL-8水平呈正相关(r=0.48,P<0.01)。以NE水平>27.73μg/L作为判断哮喘急性发作的界值,其灵敏度为65.9%、特异度为95.1%,ROC曲线下面积为0.87(P<0.01)。结论通过检测学龄前哮喘儿童NE水平,有助于哮喘急性发作的诊断。

Objective To study the role of serum neutrophil elastase（NE）level in acute exacerbation of asthma in preschool children.Methods A total of 85 preschool children who were diagnosed with asthma between January 2008 and January 2010 were classified into acute exacerbation group（n=44）and non-acute exacerbation group（n=41）.Thirty-five children who received physical examination served as the control group.The enzyme-linked immunosorbent assay was used to determine the serum levels of NE and interleukin-8（IL-8）.The receiver operating characteristic（ROC）curve was used for NE evaluation.Results Both the acute and non-acute exacerbation groups had higher serum levels of NE and IL-8 than the control group,and the acute exacerbation group had significantly higher serum levels of NE and IL-8 than the non-acute exacerbation group（P〈0.05）.The serum level of NE was positively correlated with that of IL-8（r=0.48,P0.05）.With serum NE level 〉27.73 μg/L as the cut-off value for diagnosing acute exacerbation of asthma,the sensitivity was 65.9%,the specificity was 95.1%,and the area under the ROC curve was 0.87（P〈0.01）.Conclusions The determination of serum NE level in preschool children with asthma helps to diagnose the acute exacerbation of asthma.