血清25-(OH)D3、IgE及SAA水平对CVA患儿预后评估的价值

Prognostic value of serum 25-(OH)D3,IgE and SAA levels in children with CVA

目的探究血清25羟基维生素D3[25-(OH)D3]、免疫球蛋白E(immunoglobulin E,IgE)、血清淀粉样蛋白A(serum amyloid A protein,SAA)水平对咳嗽变异性哮喘(cough variant asthma,CVA)患儿预后的评估价值。方法选择2020年2月至2021年2月于济宁医学院附属医院就诊的60例CVA儿童作为实验组,按照疾病的严重程度划分为症状较轻组(n=37)和症状较重组(n=23);另选60例同期健康体检儿童作为对照组,分别测定各组儿童血清中25-(OH)D3、IgE、SAA含量,分析以上各项指标在CVA诊断中的应用价值。结果实验组儿童血清SAA、25-(OH)D3、IgE水平均高于参照组[(116.49±11.26)mg/L比(47.92±4.16)mg/L,(135.62±13.46)nmol/L比(76.18±8.23)nmol/L,(335.27±33.76)IU/mL比(126.54±12.43)IU/mL,t值分别为44.25、29.18、44.94,P值均<0.05];症状较轻组儿童血清SAA、IgE水平均低于症状较重组[(91.07±9.18)mg/L比(127.42±12.00)mg/L,(283.12±28.68)IU/mL比(355.68±35.45)IU/mL,t值分别为13.24、8.70,P值均<0.05],25-(OH)D3高于症状较重组[(43.71±4.28)nmol/L比(25.68±2.25)nmol/L,t=18.63,P<0.05],状况较好组SAA、IgE水平低于状况较差组(107.27±10.46)mg/L比(146.39±14.58)mg/L,(313.77±31.89)IU/mL比(388.92±38.04)IU/mL,t值分别为12.09、8.24,P值均<0.05),25-(OH)D3显著高于状况较差组[(35.19±3.68)nmol/L比(20.28±2.54)nmol/L,t=17.05,P<0.05),干预前两组最大1秒钟用力呼气量(first second of expiratory volume,FEV1)、用力肺活量(forced vital capacity,FVC)、FEV1/FVC值比较,差异无统计学意义[L:(0.85±0.23)比(0.84±0.21),(1.95±0.41)比(1.96±0.42),%:(42.59±6.31)比(42.18±6.22),t值分别为0.20、0.11、0.29,P值均>0.05),干预后观察组FEV1、FVC、FEV1/FVC值高于对照组[L:(1.67±0.31)比(1.21±0.35),(2.89±0.48)比(2.24±0.52)、%:(58.63±5.27)比(52.11±5.39),t=6.22、5.81、5.47,P值均<0.05),CVA患儿预后与SAA、IgE水平负相关(r=-0.43、-0.47,P值均<0.05),与25-(OH)D3正相关(r=0.47,P<0.05)。结论CVA儿童血清中25-(OH-D3)水平下降,IgE及SAA水平上升增加预后不良发生的几率,可能为CVA预后的临床评估提供依据。

Objective To investigate the values of serum 25 hydroxyvitamin D3[25-(OH)D3],immunoglobulin E(IgE)and amyloid A protein(SAA)in the prognosis of children with cough variant asthma(CVA).Methods A total of 60 children with CVA treated in the Affiliated Hospital of Jining Medical College from February 2020 to February 2021 were selected as the experimental group.According to the severity of the disease,they were divided into mild symptoms group(n=37)and severe symptoms group(n=23).Sixty healthy children in the same period were selected as the control group.The contents of 25-(OH)D3,IgE and SAA in serum of each group were determined,and the application value of the above indexes in the diagnosis of CVA was analyzed.Results The levels of SAA,25-(OH)D3 and IgE in the experimental group were higher than those in the control group[(116.49±11.26)mg/L vs(47.92±4.16)mg/L,(135.62±13.46)nmol/L vs(76.18±8.23)nmol/L,(335.27±33.76)IU/mL vs(126.54±12.43)IU/mL,t values were 44.25,29.18,44.94,all P values<0.05].The levels of serum SAA and IgE in the mild symptom group were lower than those in the symptom group[(91.07±9.18)mg/L vs(127.42±12.00)mg/L,(283.12±28.68)IU/mL vs(355.68±35.45)IU/mL,t values were 13.24,8.70,both P values<0.05],25-(OH)D3 was higher than that of symptom recombination[(43.71±4.28)nmol/L vs(25.68±2.25)nmol/L,t=18.63,P<0.05].The levels of SAA and IgE in the better group was lower than that in the worse group(107.27±10.46)mg/L vs(146.39±14.58)mg/L,(313.77±31.89)IU/mL vs(388.92±38.04)IU/mL,t values were12.09,8.24,both P values<0.05),25-(OH)D3 was significantly higher than that in the poor group[(35.19±3.68)nmol/L vs(20.28±2.54)nmol/L,t=17.05,P<0.05).Before intervention,there was no significant difference in the first second of expiratory volume(FEV1),forced vital capacity(FVC)and FEV1/FVC values between the two groups[L:(0.85±0.23)vs(0.84±0.21),(1.95±0.41)vs(1.96±0.42),%:(42.59±6.31)vs(42.18±6.22),t values were 0.20,0.11,0.29,all P values<0.05).After intervention,FEV1,FVC and FEV1/FVC values in the observation group were higher than those in the control group[L:(1.67±0.31)vs(1.21±0.35),(2.89±0.48)vs(2.24±0.52)、%:(58.63±5.27)vs(52.11±5.39),t values were 6.22,5.81,5.47,all P values<0.05).The prognosis of children with CVA was negatively correlated with the levels of SAA and IgE(r values were-0.43,-0.47,both P values<0.05),and positively correlated with 25-(OH)D3(r=0.47,P<0.05).Conclusion The decrease of serum 25-(OH-D3)level and the increase of IgE and SAA levels in children with CVA increase the probability of poor prognosis,which may provide a basis for the clinical evaluation of CVA prognosis.