血清凋亡相关斑点样蛋白水平在儿童急性发作期支气管哮喘中的变化及意义

Changes and Significance of Serum Apoptosis-related Dot-like Protein Levels in Children with Acute Attack of Bronchial Asthma

目的研究血清凋亡相关斑点样蛋白(ASC)在儿童急性发作期支气管哮喘中的变化及与临床意义。方法方便选择2019年6月—2020年6月收治的48例急性发作期支气管哮喘儿童作为观察组,30名同龄段健康体检儿童作为对照组,通过酶联免疫吸附法测定外周血清中ASC的水平,比较两组儿童外周血ASC的水平差异,分析ASC与血清白细胞介素-18(IL-18)、白细胞介素1β(IL-1β)水平的相关性。比较ASC高水平和低水平急性发作期儿童治疗的效果,并通过ROC曲线预测以ASC水平作为治疗效果预测效能。结果观察组治疗前、观察组治疗后,以及对照组ASC水平分别为(46.71±19.91)、(9.76±3.79)、(7.65±2.99)pg/mL,IL-18水平分别为(230.89±76.17)、(79.97±30.78)、(13.43±8.38)pg/mL,IL-1β水平分别为(51.41±22.98)、(23.71±11.88)、(8.08±3.36)pg/mL,差异有统计学意义(P<0.001)。治疗前ASC水平与IL-18、IL-1β水平显著正相关(r=0.926、0.635,P<0.001)。治疗前ASC高水平组的疗效等级平均秩次29.29,显著高于ASC低水平组患儿的疗效等级平均秩次19.17,差异有统计学意义(Z=3.736,P<0.001)。以ASC水平作为预测儿童急性发作期支气管哮喘治疗效果ROC曲线下面积(AUC)为0.855(P<0.001),95%CI为0.743-0.968。结论急性发作期支气管哮喘儿童血清ASC水平显著升高,且与临床治疗相关,可能是早期预测患儿疗效的良好指标。

Objective To study the changes of serum apoptosis-related speckle-like protein(ASC)in children with acute bronchial asthma and its clinical significance.Methods Convenience selection 48 children with acute-onset bronchial asthma admitted from June 2019 to June 2020 as the observation group,and 30 children with healthy physical examination of the same age were selected as the control group.The level of ASC in peripheral serum was determined by enzyme-linked immunosorbent assay,and then the difference in the levels of ASC in the peripheral blood of the two groups of children,to analyze the correlation between ASC and the levels of serum interleukin-18(IL-18)and interleukin 1β(IL-1β).Compared the effects of treatment on children with high and low levels of ASC during acute episodes,and used the ROC curve to predict the ASC level as the efficacy of the treatment effect.Results The ASC levels of the observation group before treatment,after treatment,and the control group were(46.71±19.91)pg/mL,(9.76±3.79)pg/mL,(7.65±2.99)pg/mL,and IL-18 levels were(230.89±76.17)pg/mL,(79.97±30.78)pg/mL,(13.43±8.38)pg/mL,IL-1βlevels were(51.41±22.98)pg/mL,(23.71±11.88)pg/mL,(8.08±3.36)pg/mL,and the differences were statistically significant(P<0.001).ASC level before treatment was significantly positively correlated with IL-18 and IL-1βlevels(r=0.926,0.635,P<0.001).Before treatment,the average rank of the curative effect of the high-level ASC group was 29.29,which was significantly higher than the average rank of 19.17 of the children in the low-level ASC group,and the difference was statistically significant(Z=3.736,P<0.001).The area under the ROC curve(AUC)was 0.855(P<0.001),and the 95%CI was 0.743-0.968.Conclusion The level of serum ASC in children with bronchial asthma during acute episodes is significantly increased,and it is related to clinical treatment.It may be a good indicator for early prediction of the efficacy of children with bronchial asthma.