血清s-IgE/t-IgE、IL-10、IL-37水平预测变应性鼻炎患儿舌下含服免疫治疗的近期疗效

Application effect of serum s-IgE/t-IgE,IL-10 and IL-37 levels in predicting the short-term efficacy of sublingual immunotherapy on children with allergic rhinitis

目的探讨血清特异性免疫球蛋白E/总免疫球蛋白E(s-IgE/t-IgE)、白介素-10(IL-10)、白介素-37(IL-37)水平在预测变应性鼻炎(AR)患儿舌下含服免疫治疗(SLIT)近期疗效中的应用效果。方法选取2020年6月至2021年6月收治的AR患儿76例为观察组,同期选取健康儿童42例为对照组。比较2组血清s-IgE/t-IgE、IL-10、IL-37水平,分析AR患儿血清s-IgE/t-IgE、IL-10、IL-37水平与总鼻部症状评分(TNSS)评分的相关性,Logistic回归分析AR患儿SLIT近期疗效的影响因素,受试者工作特征(ROC)曲线分析血清s-IgE/t-IgE、IL-10、IL-37水平对治疗反应性的预测价值。结果观察组血清s-IgE/t-IgE、IL-10、IL-37水平低于对照组(P<0.05);AR患儿血清IL-10、IL-37水平与TNSS评分呈负相关(P<0.05);Logistic回归分析显示,校正TNSS评分、总用药评分(TMS)评分后,血清s-IgE/t-IgE、IL-10、IL-37水平均与SLIT近期疗效有关(P<0.05);ROC曲线显示,血清s-IgE/t-IgE、IL-10、IL-37联合预测SLIT近期疗效的AUC值0.925最大,对应敏感度为90.57%,特异度为91.30%。结论AR患儿血清s-IgE/t-IgE、IL-10、IL-37水平均异常低表达,其中IL-10、IL-37水平与病情程度呈负相关,各指标均可有效预测SLIT近期疗效,为及时采取有效、个体化治疗提供依据。

Objective To explore application effect of serum specific immunoglobulin E/total immunoglobulin E(s-IgE/t-IgE),interleukin-10(IL-10)and IL-37 levels in predicting the short-term efficacy of sublingual immunotherapy(SLIT)on children with allergic rhinitis(AR).Methods From June 2020 to June 2021,totally 76 AR children in our hospital were included in the observation group,and 42 healthy children during the same period were included the control group.Serum s-IgE/t-IgE,IL-10 and IL-37 levels were compared between groups.The correlation between serum s-IgE/t-IgE,IL-10 and IL-37 levels with the total nasal symptom score(TNSS)in children with AR was analyzed.Logistic regression analysis was performed to identify influencing factors of the short-term efficacy of SLIT on AR children.The receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of serum s-IgE/t-IgE,IL-10 and IL-37 levels on therapeutic response to SLIT.Results Serum levels of s-IgE/t-IgE,IL-10 and IL-37 in the observation group were significantly lower than those in the control group(all P<0.05).Serum IL-10 and IL-37 levels of AR children were negatively correlated with TNSS score(both P<0.05).Logistic regression analysis showed that after adjusting the TNSS and the total medication score(TMS),serum s-IgE/t-IgE,IL-10,and IL-37 levels were significantly correlated with the short-term efficacy of SLIT(all P<0.05).The ROC curve showed that the combination of serum s-IgE/t-IgE,IL-10,and IL-37 had the largest area under the curve(AUC=0.925)in predicting the short-term efficacy of SLIT,the corresponding sensitivity and specificity of 90.57%and 91.30%,respectively.Conclusion Serum levels of s-IgE/t-IgE,IL-10,and IL-37 of AR children were abnormally low,and the latter two were negatively correlated with the severity of AR.They all effectively predict the short-term efficacy of SLIT,providing references for timely individualized treatment of AR.