支气管哮喘合并肺炎支原体感染患儿血浆内皮素1及肿瘤坏死因子α水平与疾病严重程度的相关性研究

Correlation between plasma endothelin-1,tumor necrosis factor-α levels and disease severity in children with bronchial asthma complicated with mycoplasma pneumoniae infection

目的分析支气管哮喘(BA)合并肺炎支原体(MP)感染患儿血浆内皮素1及肿瘤坏死因子α(TNF-α)水平与疾病严重程度的相关性。方法选取海南医学院第一附属医院2019年1月至2020年3月收治的96例BA合并MP感染患儿,将其设为观察组;纳入90例同期健康体检儿童,设立为对照组。观察组患儿接受药物对症治疗,病情缓解,对其进行为期8个月随访,根据非发作期病情严重程度分为重症组(22例)、中度组(35例)、轻微组(39例)。比较各组受试者内皮素1及TNF-α水平,比较随访期间不同严重程度患儿BA或MP感染发作次数、急诊次数、住院次数。分析血浆内皮素1及TNF-α水平与病情严重程度的关系。结果观察组患儿血浆内皮素1、TNF-α水平均高于对照组[(109±21) ng/L比(53±11) ng/L、(0.84±0.28)μg/L比(0.52±0.12)μg/L],差异均有统计学意义(t=22.689、1.082,均P <0.001)。轻微组患儿内皮素1、TNF-α水平、发作次数、急诊次数、住院次数低于/少于中度组、重症组,中度组以上指标水平低于/少于重症组,差异均有统计学意义(均P <0.05)。BA合并MP感染患儿血浆内皮素1水平与发作次数呈正相关(r=0.519,P <0.001),TNF-α水平与病情严重程度呈正相关(r=0.499,P <0.001)。结论相比于健康儿童,BA合并MP感染患儿血浆内皮素1、TNF-α明显较高。患儿疾病发作次数及病情严重程度分别与血浆内皮素1、TNF-α相关,二者可作为患儿预后结果的重要预测指标。

Objective To analyze the correlation between plasma endothelin-1,tumor necrosis factor-α(TNF-α)levels and disease severity in children with bronchial asthma(BA)and mycoplasma pneumoniae(MP)infection.Methods From January 2019 to March 2020,96 children with BA complicated with MP infection admitted to the First Affiliated Hospital of Hainan Medical University were selected as the observation group,and90 healthy children undergoing physical examination at same period were included as the control group.The children in observation group received symptomatic drug treatment,and their condition was relieved.They were followed-up for 8 months;according to the severity of non attack stage,the children were divided into severe group(22 cases),moderate group(35 cases)and mild group(39 cases).The levels of endothelin-1 and TNF-αwere compared among the groups;the attack times of BA or MP infection,emergency times and hospitalization times of children with different severity during the follow-up period were compared.The relationship between plasma endothelin-1,TNF-αlevels and the severity of the disease were analyzed.Results The plasma endothelin-1 and TNF-αlevels in observation group were higher than those in control group[(109±21)ng/L vs(53±11)ng/L,(0.84±0.28)μg/L vs(0.52±0.12)μg/L](t=22.689,1.082,both P<0.001).The levels of endothelin-1,TNF-αand times of attack,emergency and hospitalization in mild group were lower/less than those in moderate and severe groups,and the levels of above indexes in moderate group were lower/less than those in severe group(all P<0.05).There was a positive correlation between plasma endothelin-1 level and attack times(r=0.519,P<0.001).There was a positive correlation between plasma TNF-αlevel and the severity of the disease(r=0.499,P<0.001).Conclusions Compared with healthy children,plasma endothelin-1 and TNF-αlevels in children with BA complicated with MP infection are significantly higher.The frequency and severity of disease were correlated with plasma endothelin-1 and TNF-αrespectively,and the two indexes can be used as important predictors of prognosis in children.