闭塞性细支气管炎患儿血清炎症因子水平与肺功能指标的关系

Relationship between serum inflammatory factors and pulmonary function indexes in children with bronchiolitis obliterans

目的分析闭塞性细支气管炎(BO)患儿血清炎症因子白细胞介素6(IL-6)、IL-8、IL-12、IL-17、肿瘤坏死因子α(TNF-α)与肺功能指标潮气量(VT)、达峰容积比(VPEF/VE)、达峰时间比(TPTEF/TE)的关系。方法本研究为病例对照研究,采用非随机抽样方法选取2018年12月至2021年12月湖南省儿童医院收治的160例BO患儿的临床资料,根据BO患儿病情严重程度分为轻度组53例、中度组65例和重度组42例。比较3组患儿血清IL-6、IL-8、IL-12、IL-17、TNF-α水平,分析3组患儿VT、VPEF/VE、TPTEF/TE情况。采用Pearson相关性分析上述血清炎症因子水平与肺功能指标的相关性。结果3组BO患儿血清炎症因子IL-6、IL-8、IL-12、IL-17和TNF-α水平中度组高于轻度组,重度组高于中度组和轻度组,差异有统计学意义(F值分别为22.23、15.56、11.01、497.04、15.39,P值均<0.01)。3组VPEF/VE和TPTEF/TE差异均有统计学意义(F值分别为12.87、22.02,P值均<0.01),轻度组、中度组和重度组VPEF/VE分别为(24.78±4.12)%、(22.57±4.30)%、(20.30±4.46)%;TPTEF/TE分别为(23.69±4.23)%、(21.05±3.85)%、(18.37±3.48)%;Pearson相关性分析结果显示,IL-6、IL-8、IL-12、IL-17、TNF-α与VPEF/VE、TPTEF/TE均呈负相关(r值分别为-0.53、-0.59、-0.44、-0.61、-0.56;-0.50、-0.52、-0.42、-0.55、-0.51,P值均<0.01)。结论血清IL-6、IL-8、IL-12、IL-17、TNF-α参与BO的发生,且与BO严重程度及肺功能均有较好的相关性,可为患儿气道炎症及肺功能评估提供帮助。

Objective To analyze the relationship between inflammatory factors including interleukin-6(IL-6),IL-8,IL-12,IL-17,tumor necrosis factor-α(TNF-α)and pulmonary function indexes involving tidal volume(VT),ratio of volume at peak tidal expiratory flow to expiratory tidal volume(VPEF/VE),and ratio of time to peak tidal expiratory flow to total expiratory time(TPTEF/TE)in children with bronchiolitis obliterans(BO).Methods In this case-control study included 160 BO children(n=160)who visited Hunan Children′s Hospital from December 2018 to December 2021.Using a non-random sampling method,these patients were enrolled to the mild group(n=53),moderate group(n=65)and severe group(n=42)based on BO classification.The level of serum IL-6,IL-8,IL-12,IL-17,TNF-α,VT,VPEF/VE and TPTEF/TE in 3 groups were included as comparators.Pearson correlation analysis was performed to evaluate the relationships between inflammatory factors and pulmonary function indexes.Results Serum inflammatory factors IL-6,IL-8,IL-12,IL-17 and TNF-αin three groups of children with BO The level of the moderate group was higher than that of the mild group,and the level of the severe group was higher than that of the moderate group and the mild group,with a statistically significant difference(F values were 22.23,15.56,11.01,497.04,15.39,respectively,P<0.01).VPEF/VE and TPTEF/TE in the three groups were statistically significant(F values were 12.87 and 22.02,respectively,P<0.01).VPEF/VE in mild group,moderate group and severe group were(24.78±4.12)%,(22.57±4.30)%and(20.30±4.46)%,respectively;TPTEF/TE were(23.69±4.23)%,(21.05±3.85)%and(18.37±3.48)%respectively.Pearson correlation analysis showed that,IL-6,IL-8,IL-12,IL-17,TNF-αwere negatively correlated with VPEF/VE and TPTEF/TE(r=-0.53,-0.59,-0.44,-0.61,-0.56;-0.50,-0.52,-0.42,-0.55,-0.51,all P<0.01).Conclusions Serum IL-6,IL-8,IL-12,IL-17 and TNF-αparticipate the development of BO,which are greatly related to the severity of BO and lung function,facilitating the evaluation on airway inflammation and pulmonary functions in children.