支气管哮喘患儿痰液聚丝蛋白和CD18^(+)细胞水平与病情的相关性分析

Correlation analysis of the levels of polyfilament protein,CD18^(+)cells in sputum and disease condition of children with bronchial asthma

目的探讨支气管哮喘患儿痰液中聚丝蛋白(FLG)、CD18^(+)细胞水平与哮喘病情的相关性。方法选取2018年2月—2019年12月因支气管哮喘于台州市第一人民医院接受治疗的127例患儿为研究对象,其中急性发作期59例(急性发作组),临床缓解期68例(临床缓解组);同期选取62例健康体检儿童作为对照(对照组)。采用流式细胞仪检测痰液中CD18^(+)细胞水平,采用实时荧光定量PCR(qRT-PCR)法检测痰液上清中FLG mRNA水平;分析支气管哮喘患儿FLG mRNA、CD18^(+)细胞水平与肺功能指标、粒细胞水平相关性;分析影响支气管哮喘发生的因素。结果急性发作组痰液中FLG mRNA、CD18^(+)细胞水平、中性粒细胞及嗜酸粒细胞水平高于临床缓解组和对照组,第1 s用力呼气量(FEV1)、用力肺活量(FVC)及最大呼气峰流速(PEF)水平低于临床缓解组和对照组,差异有统计学意义(F=171.045、225.729、322.782,P<0.05);支气管哮喘患儿FLG mRNA、CD18^(+)细胞水平与FEV1、FVC及PEF水平均呈负相关(P<0.05),与中性粒细胞、嗜酸粒细胞水平均呈正相关(P<0.05);FLG mRNA、CD18^(+)细胞、嗜酸粒细胞水平是影响支气管哮喘发生的独立危险因素。结论FLG mRNA、CD18^(+)细胞水平与支气管哮喘病情密切相关,FLG mRNA、CD18^(+)细胞水平结合肺功能指标、粒细胞水平对评价支气管哮喘的早期危险性有重要意义。

Objective To detect the levels of polyfilament protein(FLG)and CD18^(+)cells in the sputum of children with asthma,and to explore the relationship between the expression levels and the condition of asthma.Methods From February 2018 to December 2019,127 children who were treated in our hospital for bronchial asthma were selected as the research objects,including 59 children in acute attack period(acute attack group)and 68 children in clinical remission period(clinical remission group);another 62 healthy children in physical examination were selected as the control group.The level of CD18^(+)cells in sputum was detected by flow cytometry,the level of FLG mRNA in sputum supernatant was detected by real-time fluorescence quantitative PCR(qRT-PCR);the correlations of FLG mRNA,CD18^(+)cell level with lung function index and granulocyte level in children with asthma were analyzed;and the influencing factors of asthma were analyzed.Results The levels of FLG mRNA,CD18^(+)cells,neutrophils and eosinophils in sputum of acute attack group were significantly higher than those of clinical remission group and control group(F=171.045,225.729,322.782,P<0.05);levels of FEV1,FVC and PEF in acute attack group were lower than those in clinical remission group and control group(P<0.05);FLG mRNA and CD18^(+)cells were negatively correlated with FEV1,FVC and PEF,and positively correlated with neutrophils and eosinophils(P<0.05);and FLG mRNA,CD18^(+)and eosinophils were independent risk factors for asthma.Conclusion The levels of FLG mRNA and CD18^(+)cells are closely related to the condition of asthma,and the combination of FLG mRNA and CD18^(+)cells with lung function indexes and granulocyte level is of great significance to evaluate the early risk of asthma.