支气管哮喘患儿外周血黏膜相关恒定T细胞表达及与病情的相关性

Peripheral blood mucosa-associated constant T cell expression in children with bronchial asthma and its relevance to severity

目的探讨支气管哮喘患儿外周血黏膜相关恒定T细胞(MAIT)表达及与病情的相关性。方法选择2016年5月至2019年5月湖北医药学院附属东风医院收治的98例支气管哮喘患儿作为哮喘组,同期选择进行健康体检的60例健康儿童作为对照组。采用美国BD FACSAriaⅡ流式细胞分析仪检测MAIT水平;采用耶格肺功能检测仪检测两组受试者肺功能。利用受试者工作特征(ROC)曲线评价外周血MAIT对支气管哮喘的诊断效能,并分析MAIT与肺功能指标的关系。结果两组在性别构成、年龄、体质量指数等方面比较差异无统计学意义(P>0.05);哮喘组哮喘控制测试(ACT)评分、第一秒用力呼气容积占预计值百分比(FEV1%)、第一秒用力呼气容积与用力肺活量比(FEV1/FVC)、最大呼气峰流速占预计值百分比(PEF%)、MAIT水平明显低于对照组,差异有统计学意义(P<0.05)。血清MAIT鉴别支气管哮喘和健康对照组的AUC为0.900,灵敏度为82.65%,特异度为85.00%。血清MAIT鉴别轻度持续组和健康对照组的AUC为0.910,灵敏度为94.64%,特异度为81.67%。相关性分析显示,支气管哮喘患儿MAIT细胞与FEV1%、FEV1/FVC、PEF%呈显著正相关(r=0.159、0.222、0.213,P<0.05)。结论支气管哮喘患儿外周血MAIT明显降低,与肺功能指标水平有关;MAIT可作为支气管哮喘患儿诊断及临床预后评估的指标之一。

Objective To investigate the peripheral blood mucosa-associated constant T cell(MAIT)expression in children with bronchial asthma and its relevance to severity.Methods Ninety-eight children with bronchial asthma who were treated in Affliated Dongfeng Hospital from May 2016 to May 2019 were selected as the asthma group.Another 60 healthy children who underwent health checkup during the same period were as control group.The levels of MAIT were detected by flow cytometry analyzer using BD FACSAria II flow cytometry,and the lung function was detected by Yage lung function tester.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of peripheral blood MAIT for bronchial asthma.Pearson analysis was used to examine the relationship between MAIT cells and pulmonary function.Results There were no significant differences in the general data of gender,age,and body mass index between the two groups(P>0.05).The asthma control test(ACT)score,the percentage of first second forced expiratory volume occupied estimated value(FEV1%),the percentage of first second forced expiratory volume occupied forced vital capacity(FEV1/FVC),the percentage of peak expiratory flowoccupied estimated value(PEF),and MAIT cells in asthma group were significantly lower than those in control group(P<0.05).Serum MAIT identified bronchial asthma and healthy controls with an area under curve(AUC)of 0.900,with a sensitivity of 82.65%,and a specificity of 85.00%.Serum MAIT identified the mild-sustained group and the healthy control group with an AUC of 0.910,with a sensitivity of 94.64%,and a specificity of 81.67%.Correlation analysis showed that MAIT cells in children with bronchial asthma were significantly positively correlated with pulmonary function indexes such as FEV1%,FEV1/FVC and PEF(r=0.159,0.222,0.213,P<0.05).Conclusions The peripheral blood MAIT in children with bronchial asthma is significantly reduced,which is related to the levels of lung function indicators.MAIT can be used as one of the indicators for the diagnosis and clinical prognosis of patients with bronchial asthma.