血清IgE 呼出气一氧化氮及呼出气冷凝液8-异前列腺素水平对儿童哮喘发生和发展的影响

Effect of serum IgE,FeNO,and EBC 8-iso-PG on occurrence and development of asthma in children

目的探讨血清中IgE、呼出气一氧化氮(FeNO)、呼出气冷凝液(EBC)8-异前列腺素(8-iso-PG)及水平对儿童哮喘发生、发展的影响。方法选择2018年1月—2019年12月宁波市鄞州人民医院儿科收治的90例儿童支气管哮喘患儿为观察组,同期行健康体检的90例健康儿童为对照组。依据《儿童支气管哮喘诊断与防治指南(2016年版)》中的分级标准,按哮喘分期分为急性组(急性发作期)43例、缓解组(临床缓解期)47例;按病情严重程度分为轻度组32例、中度组37例、重度组21例。测定儿童的血清IgE、FeNO及EBC 8-iso-PG水平,比较两组血清IgE、FeNO及EBC 8-iso-PG水平,比较不同分期、不同病情严重程度分级哮喘患儿的血清IgE、FeNO及EBC 8-iso-PG水平,并分析血清IgE、FeNO及EBC 8-iso-PG水平与儿童支气管哮喘发生、发展的相关性。结果观察组的血清IgE、FeNO及EBC 8-iso-PG水平均高于对照组(P<0.05)。急性组的血清IgE、FeNO及EBC 8-iso-PG水平均高于缓解组(P<0.05)。轻度组、中度组及重度组的血清IgE、FeNO及EBC 8-iso-PG水平比较均有统计学差异(均P<0.05),从高至低依次排列为重度组、中度组及轻度组。经相关性分析,血清IgE、FeNO及EBC 8-iso-PG水平与儿童支气管哮喘发生、病情阶段及病情严重程度均密切相关,呈正相关。结论哮喘患儿的血清IgE、FeNO及EBC 8-iso-PG表达水平普遍处于异常增高状态,血清IgE、FeNO及EBC 8-iso-PG可反映儿童哮喘的发生及发展,可能参与到哮喘发生及发展过程中,可将其作为儿童哮喘早期诊断、病情评估的辅助指标。

Objective To explore the effect of serum IgE,fractional exhaled nitric oxide(FeNO),and exhaled breath condensate(EBC)8-isoprostanes(8-iso-PG)on occurrence and development of asthma in children.Methods From January 2018 to December 2019,90 children with bronchial asthma treated in Department of Pediatrics in Ningbo Yinzhou People’s Hospital were selected as observation group,90 healthy children receiving healthy physical examination were selected as control group.According to the grading standard of Guidelines for Diagnosis and Prevention of Bronchial Asthma in Children(2016),the asthma children were divided into acute group(acute attack phase,43 cases)and remission group(clinical remission stage,47 cases).According to the severity of asthma,the asthma children were divided into mild group(32 cases),moderate group(37 cases),and severe group(21 cases).The levels of serum IgE,FeNO,and EBC 8-iso-PG were detected.The levels of serum IgE,FeNO,and EBC 8-iso-PG in observation group and control group were compared.The levels of serum IgE,FeNO,and EBC 8-iso-PG in asthma children with different stages and different degrees of severity were compared.The correlations between serum IgE,FeNO,EBC 8-iso-PG levels and occurrence and development of asthma in children were analyzed.Results The levels of serum IgE,FeNO,and EBC 8-iso-PG in observation group were statistically significantly higher than those in control group(P<0.05).The levels of serum IgE,FeNO,and EBC 8-iso-PG in acute group were statistically significantly higher than those in remission group(P<0.05).There were statistically significant differences in the levels of serum IgE,FeNO,and EBC 8-iso-PG among mild group,moderate group,and severe group,the levels of serum IgE,FeNO,and EBC 8-iso-PG in severe group were the highest,followed by moderate group and mild group.Correlation analysis showed that the levels of serum IgE,FeNO,and EBC 8-iso-PG were positively correlated with occurrence,development,and severity of asthma in children.Conclusion The expression levels of serum IgE,FeNO,and EBC 8-iso-PG in asthma children increase abnormally,which reflect occurrence and development of asthma in children and participate in occurrence and development of asthma,serum IgE,FeNO,and EBC 8-iso-PG can be used as auxiliary indexes of early diagnosis and disease evaluation in children with asthma.