血清Periostin及TGF-β_(1)表达水平在呼吸道合胞病毒毛细支气管炎患儿中的临床意义

Clinical Significance of Serum Periostin and TGF-β_(1) Expression in Children with Bronchiolitis Caused by Respiratory Syncytial Virus

目的研究呼吸道合胞病毒(RSV)毛细支气管炎患儿血清骨膜蛋白(Periostin)及转化生长因子β_(1)(TGF-β_(1))的表达水平,分析二者关系,评估其临床意义。方法选取2019年11月至2020年11月在广州医科大学附属第一医院及中山市博爱医院儿科住院的RSV毛细支气管炎患儿72例为毛细支气管炎组,按病情严重程度分为轻度组(n=27)、中度组(n=25)及重度组(n=20)。另以同期正常健康体检的婴幼儿25例作为对照组。ELISA法检测研究组患儿急性期、恢复期以及正常对照组的血清Periostin及TGF-β_(1)水平,Pearson相关分析二者的相关性。结果急性期毛细支气管炎组血清Periostin与TGF-β_(1)水平均显著高于对照组(P<0.01),恢复期毛细支气管炎组血清Periostin仍高于对照组(P<0.01),但血清TGF-β_(1)水平与对照组比较差异无统计学意义(P>0.05)。恢复期毛细支气管炎组血清Periostin与TGF-β_(1)水平较急性期均显著下降(P<0.01)。毛细支气管炎重度组急性期血清的Periostin、TGF-β_(1)水平最高,均显著高于轻、中度患儿(均P<0.01);毛细支气管炎重度组恢复期血清的Periostin仍持续高水平,均显著高于轻、中度患儿(均P<0.01);但恢复期毛细支气管炎三组及对照组之间血清TGF-β_(1)水平比较差异无统计学意义(均P>0.05)。相关性分析表明,毛细支气管炎组患儿急性期血清Periostin与TGF-β_(1)水平均呈正相关(r=0.717,P<0.01)。结论检测血清Periostin与TGF-β_(1)水平有助于对RSV所致毛细支气管炎患儿病情严重程度及治疗后转归的判断;TGF-β_(1)仅参与了RSV所致毛细支气管炎的急性过程,而血清Periostin高表达水平在RSV所致毛细支气管炎中持续时间可能更长。

Objective To study the expression levels of serum Periostin and transforming growth factor-β_(1)(TGF-β_(1))in children with bronchiolitis caused by respiratory syncytial virus(RSV)and to analyze the relationship between them,while evaluating their clinical significance.Methods A total of 72 patients with RSV bronchiolitis confirmed by clinical examination from November 2019 to November 2020 were selected in Department of Pediatrics,the First Affiliated Hospital of Guangzhou Medical University and Zhongshan Boai Hospital Guangzhou Medical University.According to the severity of the disease,they were divided into three subgroups:mild group(n=27),moderate group(n=25)and severe group(n=20).Another 25 infants with normal physical examination outcome in the same period were selected as the control group.The serum levels of periostin and TGF-β_(1) in the experimental group were detected by ELISA,and the correlation between them was analyzed.Results In acute stage,the serum levels of Periostin and TGF-β_(1) in bronchiolitis group were significantly higher than those in control group(P<0.01).In the convalescent period,the level of serum Periostin in bronchiolitis group was still higher than that in control group(P<0.01),but there was no significant difference in the level of serum TGF-β_(1) between bronchiolitis group and control group(P>0.05).Compared with children of bronchiolitis in the acute stage,children of recovery stage had a significant reduction in the level of both Periostin and TGF-β_(1) in serum(P<0.01).The serum levels of Periostin and TGF-β_(1) in severe bronchitis group were the highest,which were significantly higher than those in mild and moderate bronchitis groups(all P<0.01);In the recovery period,the serum level of periostein in severe bronchitis group was higher than that in mild and moderate bronchitis groups(all P<0.01);However,there was no significant difference in serum TGF-β_(1) levels among the three bronchiolitis groups and the control group.Correlation analysis showed that there was a positive correlation between serum Periostin and TGF-β_(1) levels in children with bronchiolitis at acute stage(r=0.717,P<0.01).Conclusions Detection of serum Periostin and TGF-β_(1) levels is helpful to judge the severity of the disease and prognosis of children with RSV induced bronchiolitis.TGF-β_(1) may only participates in the acute stage of RSV induced bronchiolitis,and the high expression of serum Periostin may last longer in RSV induced bronchiolitis.