血清骨膜蛋白和脂联素联检诊断儿童支气管哮喘价值研究

Diagnostic Value of Serum Periosteal Protein and Adiponectin in Children with Bronchial Asthma

目的探讨支气管哮喘患儿血清骨膜蛋白及脂联素(ADP)水平检测对诊断支气管哮喘的临床价值。方法选取选取2017年1月～12月在常州儿童医院儿科就诊的40例支气管哮喘患儿(哮喘组)和40名同期健康儿童体检者(对照组)作为研究对象,ELISA法检测哮喘组急性发作期和缓解期及对照组的血清Periostin、ADP及IgE水平;采用ROC曲线评价Periostin及ADP对支气管哮喘病情评估效能预测。结果哮喘组患儿发作期及缓解期血清Periostin和血清ADP水平均高于对照组(P<0.05)且发作期高于缓解期(P<0.05);采用血清Periostin和ADP水平诊断支气管哮喘,其诊断灵敏度分别为85.02%和80.48%,特异度为92.51%和81.98%,当血清Periostin和血清ADP分别在147.52μg/L和20.31 mg/L时,其Youden值最大,分别为0.7752和0.7504,其AUC分别为0.8262和0.7823,两者联检可将灵敏度和特异性分别提高到87.03%和95.52%。支气管哮喘急性发作期和缓解期血清Periostin与IgE的相关系数分别为0.9916和0.9358,而急性发作期和缓解期血清ADP与IgE的相关系数分别为0.4767和0.2344。结论动态监测支气管哮喘患儿血清中Periostin及ADP水平有助于判断支气管哮喘病情转归效果;二者联检可作为排查儿童支气管哮喘的指标,血清Periostin可作为诊断支气管哮喘良好血清学指标。

Objective To explore the clinical value of serum Periostin and Adiponectin in children with bronchial asthma. Methods 40 children with bronchial asthma （asthma group） and 40 healthy children （control group） were selected as the subjects.The serum levels of Periostin, ADP and IgE in the acute and remission stages of the asthma group and the control group were detected by ELISA. The ROC curve was used to evaluate the efficacy of Periostin and ADP in evaluating the effectiveness of bronchial asthma.Results The levels of serum Periostin and serum ADP in the asthmatic group were higher than those in the control group （P〈0.05） and the attack period was higher than the remission period （P〈0.05）. The diagnosis of bronchial asthma was diagnosed by serum Periostin and ADP levels. The sensitivity was 85.02% and 80.48%, and the specificity was 92.51% and 81.98%. When serum Periostin and serum ADP were 147.52μg/L and 20.31 mg/L, respectively, the Youden value was the highest, 0.7752 and 0.7504, respectively.The AUC was 0.8262 and 0.7823, respectively, and the combined detection increased the sensitivity and specificity to 87.03% and 95.52%, respectively. The correlation coefficients of serum Periostin and IgE in acute and remission stages of bronchial asthma were 0.9916 and 0.9358, respectively, while the correlation coefficients of serum ADP and IgE in acute attack and remission were 0.4767 and 0.2344, respectively. Conclusion Dynamic monitoring of serum levels of Periostin and ADP in children with bronchial asthma can help to determine the outcome of bronchial asthma.The combined detection can be used as an indicator for bronchial asthma in children.Serum Periostin can be used as a good serological marker for diagnosing bronchial asthma.