肺炎支原体感染哮喘患儿血清CD40L和VCAM-1水平及意义

Significance of serum CD40L and VCAM-1 levels in children with asthma infected by Mycoplasma pneumoniae

目的探讨肺炎支原体(MP)感染的哮喘患儿血清中CD40L、血管细胞黏附分子-1(VCAM-1)的水平变化及意义。方法收集2019年1月-2019年12月朝阳市第二医院儿科接诊的80例支气管哮喘患儿及健康儿童40名的资料进行回顾性分析,依据患儿的诊断结果分为三个组,健康儿童作为A组(n=40),诊断为单纯哮喘的患儿作为B组(n=40),诊断为MP感染合并哮喘的患儿作为C组(n=40)。统计分析三组研究对象的血清CD40L和VCAM-1水平,比较C组不同MP-IgM滴度水平的血清CD40L和VCAM-1水平。分析血清CD40L和VCAM-1水平对于哮喘患儿是否合并MP感染的诊断价值。结果三组研究对象血清CD40L和VCAM-1水平数据差异均具有统计学意义(P<0.05)。A组血清CD40L和VCAM-1均低于B组,B组低于C组(P<0.05)。C组不同MP-IgM滴度水平的血清CD40L和VCAM-1水平数据差异均具有统计学意义(P<0.05)。低滴度组血清CD40L和VCAM-1均低于中滴度组,中滴度组低于高滴度组(P<0.05)。血清CD40L、VCAM-1水平对于哮喘患儿是否合并MP感染诊断的受试者工作特征曲线下面积分别为0.663、0.701。CD40L截断值为2.80 ng/ml,VCAM-1截断值为662.75 ng/ml。结论哮喘儿童合并肺炎支原体感染时,血清CD40L和VCAM-1水平会持续增高并加重呼吸道的慢性炎性反应,加剧呼吸道的反应性,使哮喘加重。血清CD40L和VCAM-1水平的监测对于患儿病情的诊断以及变化监测均具有重要的意义。

OBJECTIVE To investigate the change and significance of serum CD40 L and VCAM-1 levels in asthmatic children with asthmatic mycoplasma(MP) infection. METHODS The data of 80 children with bronchial asthma and 40 healthy children admitted to the Department of Pediatrics of the second hospital of Chaoyang from Jan. 2019 to Dec. 2019 were recruited for the retrospective analysis. The children were divided into three groups based on the diagnosis results. Healthy children were divided into the group A(n=40);children diagnosed with simple asthma were divided into the group B(n=40);children diagnosed with MP infection combined with asthma were divided into the group C(n=40). The serum CD40 L and VCAM-1 levels in the three groups were compared, and the serum CD40 L and VCAM-1 levels of different MP-IgM titers in group C were also compared. The diagnostic value of serum CD40 L and VCAM-1 levels in children with asthma with MP infection were evaluated. RESULTS The differences of serum CD40 L and VCAM-1 levels in the three groups were significantly significant(P<0.05). The levels of serum CD40 L and VCAM-1 in the group A were significantly lower than that in the group B, which was significantly lower than that in the group C(P<0.05). The differences of serum CD40 L and VCAM-1 levels in different MP-IgM titers of group C were significant(P<0.05). The values of serum CD40 L and VCAM-1 were significantly lower in the low-titer group than that in the medium-titer group, which was significantly lower than that in the high-titer group(P<0.05). The AUCs of serum CD40 L and VCAM-1 levels for the diagnosis of MP infection in children with asthma were 0.663 and 0.701, respectively. The cut-off value for CD40 L was 2.80 ng/ml, and the cut-off value for VCAM-1 was 662.75 ng/ml. CONCLUSION When asthmatic children infected with Mycoplasma pneumoniae, serum CD40 L and VCAM-1 levels will continue to increase and aggravate the chronic inflammatory response in the respiratory tract, to exacerbate respiratory responsiveness and aggravate asthma. Monitoring of serum CD40 L and VCAM-1 levels should be important for the diagnosis of the disease and evaluation of children’s condition.