MBL、ANXA5与儿童支气管哮喘急性发作的关系研究

Relationship between MBL,ANXA5 and acute attack of bronchial asthma in children

目的探讨支气管哮喘急性发作期患儿血浆甘露糖结合凝集素(MBL)、膜联蛋白A5(ANXA5)水平与肺功能及气道炎症反应的关系。方法选择2019年6月至2021年3月三亚市人民医院儿科收治的109例支气管哮喘急性发作期患儿,分为轻度组(32例)、中度组(47例)和重度组(30例),另选择35例健康儿童为对照组。所有受试者均检测血浆MBL、ANXA5,血清总免疫球蛋白E(IgE)水平,外周血嗜酸性粒细胞(EOS)计数和肺功能检测,分析MBL、ANXA5水平与血清总IgE水平、外周血EOS计数和肺功能的关系,以及MBL、ANXA5诊断支气管哮喘急性发作的价值。结果对照组、轻度组、中度组、重度组的MBL、ANXA5水平比较差异均有统计学意义(F值分别为64.636、81.818,P<0.05)。轻度组、中度组、重度组血清总IgE水平、外周血EOS计数、第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC、最大呼气峰流量占正常预计值的百分比(PEF%)比较差异均有统计学意义(F值分别为126.636、14.641、27.814、14.373、39.669、405.570,P<0.05)。MBL与血清总IgE水平、外周血EOS计数呈正相关(r值分别为0.351、0.478,P<0.05),与FEV_(1)、FEV_(1)/FVC、PEF%呈负相关(r值分别为-0.468、-0.495、-0.460,P<0.05);ANXA5与血清总IgE水平、外周血EOS计数呈负相关(r值分别为-0.305、-0.462,P<0.05),与FEV_(1)、FEV_(1)/FVC、PEF%呈正相关(r值分别为0.491、0.480、0.479,P<0.05)。MBL、ANXA5诊断支气管哮喘的曲线下面积分别为0.658、0.701,MBL、ANXA5联合诊断支气管哮喘急性发作的曲线下面积为0.855,高于单独诊断的曲线下面积。结论支气管哮喘急性发作期患儿血浆MBL水平升高,ANXA5水平降低,MBL、ANXA5水平与支气管哮喘患儿气道炎症反应及肺功能有关。

Objective To investigate the correlation between the plasma mannose-binding lectin(MBL)and Annexin A5(ANXA5)levels and lung function and airway inflammation in children with acute episode bronchial asthma.Methods A total of 109 children with acute episode bronchial asthma who were admitted to the department of pediatrics,Sanya People's Hospital from June 2019 to March 2021 were selected.The children were divided into the mild group(32 cases),the moderate group(47 cases)and the severe group(30 cases).In addition,35 healthy children were selected as the control group.The plasma MBL,ANXA5,serum total immunoglobulin E(IgE)level,peripheral blood eosinophils(EOS)count were detected and lung function examination was conducted in all subjects.The correlation between the MBL and ANXA5 levels and serum total IgE level,peripheral blood EOS count and lung function,and the values of MBL and ANXA5 in the diagnosis of acute bronchial asthma were analyzed.Results The differences of MBL and ANXA5 levels in the control group,the mild group,the moderate group and the severe group were statistically significant(F=64.636 and 81.818,respectively,P<0.05).The differences of serum total IgE level,peripheral blood EOS count,forced expiratory volume in the first second(FEV_(1)),forced vital capacity(FVC),FEV_(1)/FVC and percentage of maximum peak expiratory flow of the normal expected value(PEF%)in the mild group,the moderate group and the severe group were statistically significant(F=126.636,14.641,27.814,14.373,39.669 and 405.570,respectively,P<0.05).MBL was positively correlated with serum total IgE level and peripheral blood EOS count(r=0.351 and 0.478,respectively,P<0.05),and negatively correlated with FEV_(1),FEV_(1)/FVC and PEF%(r=-0.468,-0.495 and-0.460,respectively,P<0.05).ANXA5 was negatively correlated with serum total IgE level and peripheral blood EOS count(r=-0.305 and-0.462,respectively,P<0.05),and positively correlated with FEV_(1),FEV_(1)/FVC and PEF%(r=0.491,0.480 and 0.479,respectively,P<0.05).The areas under curve of MBL and ANXA5 for the diagnosis of bronchial asthma were 0.658 and 0.701,respectively.The area under curve of MBL combining with ANXA5 for the diagnosis of acute bronchial asthma was 0.855,which was higher than that for MBL and ANXA5 alone.Conclusion The plasma MBL level is increased and ANXA5 level is decreased in children with acute episode bronchial asthma.The MBL and ANXA5 levels are related to airway inflammation and lung function in children with bronchial asthma.