支气管哮喘患儿血清S100A8、S100A9表达及其与肺功能和气道炎症的关系

Expression of serum S100A8 and S100A9 in children with bronchial asthma and its relationship with pulmonary function and airway inflammation

目的探究支气管哮喘患儿血清S100A8、S100A9表达及其与肺功能和气道炎症的关系。方法选取本院2018年4月至2019年4月期间收治的支气管哮喘患儿80例作为研究对象设为患病组,根据病情的严重程度被分为重度组25例,中度组28例及轻度组27例,另外选择同期20例健康体检患儿设为对照组。测定患儿血清S100A8、S100A9表达水平、总免疫球蛋白E(Immunoglobulin E,IgE)水平、肺功能指标1秒用力呼气容积(FEV 1)占用力肺活量(FVC)百分比(FEV 1/FVC%)和FEV 1占预计值的百分比(FEV 1%)、外周血嗜酸性粒细胞(Eosinophil,EOS)计数,分析不同疾病程度患者血清S100A8、S100A9表达与肺功能各指标及总IgE水平、外周血EOS计数的相关性,并评估其表达水平对支气管哮喘的诊断价值。结果患病组血清S100A8、S100A9表达量、血清总IgE水平及外周血EOS计数均明显高于对照组,肺功能指标FEV 1/FVC%和FEV 1%均明显低于对照组(P<0.05);患病组患儿血清S100A8、S100A9表达水平、血清总IgE水平及外周血EOS计数随疾病严重程度的加重而不断升高,即重度组>中度组>轻度组(P<0.05);FEV 1/FVC%和FEV 1%随疾病严重程度的加重而不断降低,即重度组<中度组<轻度组(P<0.05);且患儿血清S100A8、S100A9表达水平均与肺功能指标FEV 1/FVC%和FEV 1%有负相关关系,与血清总IgE水平及外周血EOS计数有正相关关系;另外,ROC结果显示,血清S100A8、S100A9表达量及总IgE的AUC分别为0.880(95%CI:0.813-0.947),0.861(95%CI:0.784-0.939),0.843(95%CI:0.767-0.918),最佳临界值分别为1.572,1.314,217.833 IU/mL,对应的灵敏度和特异性分别为(72.50%,95.00%),(88.80%,75.00%),(72.50%,90.00%)。结论支气管哮喘患儿血清S100A8、S100A9表达水平明显升高,且与患者肺功能指标FEV 1/FVC%和FEV 1%及气道炎症因子血清总IgE水平、外周血EOS计数相关,该项指标可作为诊断支气管哮喘疾病的标志物。

Objective To investigate the expression of serum S100A8 and S100A9 in children with asthma and its relationship with pulmonary function and airway inflammation.Methods 80 children with asthma who were admitted to our hospital from April 2018 to April 2019 were selected as the study group.According to the severity of the disease,they were divided into the severe group(25 cases),the moderate group(28 cases)and the mild group(27 cases).In addition,20 healthy children during the same period were selected as the control group.The expression of S100A8 and S100A9,the level of total immunoglobulin E(total IgE)in serum,the ratio of forced expiratory volume in one second(FEV 1)to forced vital capacity(FVC)(FEV 1/FVC%),ratio of FEV 1 to predicted value(FEV 1%)and eosinophil(EOS)in peripheral blood were measured.The relationship between the expression of S100A8 and S100A9 in serum and the indexes of pulmonary function,the level of total IgE,the count of EOS in peripheral blood were analyzed,and the value of S100A8 and S100A9 expression in the diagnosis of asthma were evaluated.Results The levels of S100A8 and S100A9 in serum,total IgE and EOS in peripheral blood of the disease group were significantly higher than those of the control group,and the pulmonary function indexes FEV 1/FVC%and FEV 1%were significantly lower than those of the control group(P<0.05).The levels of S100A8 and S100A9 in serum,total IgE and EOS in peripheral blood increased with the severity of the disease(P<0.05).FEV 1/FVC%and FEV 1%decreased with the severity of the disease(P<0.05),and the expression of S100A8 and S100A9 was negatively correlated with FEV 1/FVC%and FEV 1%of pulmonary function indexes,and positively correlated with total IgE level in serum and EOS count in peripheral blood.In addition,ROC showed that the AUC of S100A8 and S100A9 expression in serum and total IgE were 0.880(95%CI:0.813-0.947),0.861(95%CI:0.784-0.939),0.843(95%CI:0.767-0.918),and the optimal critical values were 1.572,1.314,217.833 IU/mL,respectively.The corresponding sensitivity and specificity were(72.50%,95.00%),(88.80%,75.00%),and(72.50%,90.00%),respectively.Conclusion The expression of S100A8 and S100A9 in serum of asthmatic children is significantly increased,which is related to FEV 1/FVC%,FEV 1%of pulmonary function indexes,and serum total IgE level and EOS count of peripheral blood of airway inflammatory factors,and this index can be used as a marker for the diagnosis of asthma.