哮喘患儿Th免疫应答与病情程度、症状积分的相关性及对近期复发的预测价值

Correlations between Th Immune Response with Disease Severity and Symptom Score in Children with Asthma and Its Predictive Value for Short-term Recurrence

目的探究哮喘患儿Th免疫应答与病情程度、症状积分的相关性及对近期复发的预测价值。方法选取我院2019年7月—2020年12月哮喘患儿115例,根据治疗后6个月内是否复发分为控制组(83例)与复发组(32例),比较2组临床资料及Th免疫应答指标干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)、Th1/Th2比值,分析Th免疫应答指标与病情程度、症状积分的相关性,影响近期复发的相关因素,以及Th免疫应答指标对近期复发的预测价值。结果复发组病程长于控制组,病情程度、症状积分、常规对症治疗比例高于控制组,IFN-γ、IL-2、Th1/Th2比值低于控制组,IL-4、IL-10高于控制组(P<0.05,P<0.01)。重症患儿IFN-γ、IL-2、Th1/Th2比值低于轻症患儿,IL-4、IL-10高于轻症患儿(P<0.01)。IFN-γ、IL-2、Th1/Th2比值与病情程度、症状积分呈负相关,IL-4、IL-10与病情程度、症状积分呈正相关(P<0.01)。IFN-γ、IL-2、IL-4、IL-10、Th1/Th2比值是哮喘患儿近期复发的影响因素(P<0.01)。受试者工作特征曲线显示,IFN-γ、IL-2、IL-4、IL-10、Th1/Th2比值联合检测预测哮喘患儿近期复发的曲线下面积为0.854,95%CI为0.776,0.913,敏感度为90.62%,特异度为72.29%,显著优于各指标单独预测(P<0.01)。结论哮喘患儿Th免疫应答指标IFN-γ、IL-2、IL-4、IL-10、Th1/Th2比值与病情程度、症状积分联系紧密,联合检测可预测近期复发情况。

Objective To explore the correlations between Th immune response with disease severity and symptom score in children with asthma and its predictive value for short-term recurrence.Methods A total of 115 asthmatic children treated between July 2019 and December 2020 were divided into control group(n=83)and recurrence group(n=32)according to presence or absence of recurrence within 6 months after treatment.Clinical data and Th immune response index interferon-γ(IFN-γ),interleukin-2(IL-2),interleukin-4(IL-4),interleukin-10(IL-10)and Th1/Th2 ratio were compared between two groups,and the correlations between Th immune response index with disease severity and symptom score were analyzed.The relevant factors affecting short-term recurrence,and the value of Th immune response index in prediction of short-term recurrence were also analyzed.Results In recurrence group,course of disease was significantly longer,and values of disease severity,symptom score and the proportion of routine symptomatic treatment were significantly higher,while levels of IFN-γ,IL-2 and Th1/Th2 ratio were significantly lower,and IL-4 and IL-10 levels were significantly higher than those in control group(P<0.05,P<0.01).In severe asthma children,levels of IFN-γ,IL-2 and Th1/Th2 ratio were significantly lower,while IL-4 and IL-10 levels were significantly higher than those in mild asthma children(P<0.01).IFN-γ,IL-2 and Th1/Th2 ratio were negatively correlated with disease severity and symptom score,while IL-4 and IL-10 were positively correlated with disease severity and symptom score(P<0.01).IFN-γ,IL-2,IL-4,IL-10 and Th1/Th2 ratio were the influencing factors of short-term recurrence in children with asthma(P<0.01).Receiver operating characteristic(ROC)curve showed that area under ROC of combined detection of IFN-γ,IL-2,IL-4,IL-10 and Th1/Th2 ratio in predicting the short-term recurrence of children with asthma was 0.854(95%CI:0.776,0.913),and the sensitivity and specificity were 90.62%and 72.29%respectively,which was significantly superior to those predictions by each index alone(P<0.01).Conclusion Th immune response indexes IFN-γ,IL-2,IL-4,IL-10 and Th1/Th2 ratio are closely related to the disease severity and symptom score in children with asthma,and the combined detection of the above indicators may predict the short-term recurrence.