支气管哮喘儿童血清VAP-1、SDC-1水平及其临床意义

Levels and Clinical Significance of Serum VAP-1 andSDC-1 in Children with Bronchial Asthma

目的探讨支气管哮喘儿童血清血管黏附蛋白-1(VAP-1)、多配体蛋白聚糖-1(SDC-1)水平及其临床意义。方法选取2021年10月至2022年10月于本院进行诊治的60例支气管哮喘患儿作为研究组,患儿依据临床分期分为38例缓解期及22例急性期,另取30例同期体检的健康儿童为对照组。收集各组受试者血清,利用酶联免疫吸附测定法检测受试者血清中VAP-1、SDC-1水平以及炎症因子水平[肿瘤坏死因子(TNF-α)、白细胞介素-4(IL-4)];利用便携式肺功能仪测定肺功能指标[第1秒用力呼气容积(FEV1)、呼气峰流速(PEF)以及用力肺活量(FVC),计算FEV1/FVC值];Pearson法分析支气管哮喘患儿血清VAP-1、SDC-1水平的相关性,同时分别分析其与炎症因子(TNF-α、IL-4)水平及肺功能指标(FEV/FVC、FEV1、PEF)的相关性;采用ROC曲线分析血清VAP-1、SDC-1水平对支气管哮喘患儿的诊断价值。结果与对照组相比,研究组血清中VAP-1、SDC-1、炎症因子TNF-α、IL-4水平显著增加,但FEV/FVC、FEV1、PEF水平显著降低(P<0.05);与对照组相比,缓解期组、急性期组血清中VAP-1、SDC-1水平显著增加(P<0.05);与缓解期组相比,急性期组血清中VAP-1、SDC-1水平显著增加(P<0.05);Pearson法分析显示,支气管哮喘患儿血清中VAP-1与SDC-1水平呈正相关,且分别与TNF-α、IL-4呈正相关,与FEV/FVC、FEV1、PEF呈负相关(P<0.05);血清VAP-1与SDC-1水平诊断支气管哮喘患儿的曲线下面积分别为0.962、0.952,灵敏度分别为96.6%、90.0%,最佳截断值分别为532.3pg/mL、2089.6μg/L,特异性分别为86.6%、90.0%;血清VAP-1、SDC-1联合诊断支气管哮喘患儿的曲线下面积、灵敏度、特异性分别为0.981、93.3%、96.6%。结论支气管哮喘患儿血清中VAP-1与SDC-1水平显著增加,与炎症因子及肺功能相关,血清中VAP-1与SDC-1联合诊断支气管哮喘患儿临床价值更高。

Objective To investigate levels of serum vascular adhesion protein-1(VAP-1)and syndecan-1(SDC-1)in children with bronchial asthma and their clinical significances.Methods Sixty children with bronchial asthma who were diagnosed and treated in our hospital from October,2021 to October,2022 were selected as the study group.According to the clinical stage,these children were divided into 38 cases of remission and 22 cases of acute stage,while another 30 healthy children who underwent physical examination were enrolled as the control group.Serum samples were collected from subjects in each group,and enzyme-linked immunosorbent assay was applied to detect levels of VAP-1,SDC-1 and inflammatory factors[tumor necrosis factor(TNF-α),interleukin(IL)-4]in the serum;The indexes of lung function[the forced expiratory volume(FEV1),peak expiratory flow rate(PEF)and forced vital capacity(FVC)in the first second,and the FEV/FVC value was calculated]were measured with a portable lung function instrument;Pearson method was applied to analyze the correlation between serum VAP-1 and SDC-1 levels in children with bronchial asthma,as well as the correlation between these markers and inflammatory factors(TNF-α,IL-4)and lung function indicators(FEV/FVC,FEV1,PEF);ROC curve was drawn to evaluate the diagnostic value of serum VAP-1 and SDC-1 levels in children with bronchial asthma.Results Compared with the control group,levels of VAP-1,SDC-1,TNF-αand IL-4 in the serum of the study group were significantly higher,while levels of FEV/FVC,FEV1 and PEF were significantly lower(P<0.05);Compared with the control group,levels of VAP-1 and SDC-1 in the serum of the remission group and the acute group were significantly higher(P<0.05);Compared with the remission group,levels of VAP-1 and SDC-1 in the serum of the acute group were significantly higher(P<0.05);Pearson analysis showed that serum VAP-1 and SDC-1 levels in children with bronchial asthma were positively correlated,and they were positively correlated with TNF-αand IL-4,respectively,while negatively correlated with FEV/FVC,FEV1 and PEF(P<0.05);The area under the curve of serum VAP-1 and SDC-1 levels in the diagnosis of children with bronchial asthma were 0.962 and 0.952,respectively,wiht the sensitivity of 96.6%and 90.0%respectively,and the best cutoff value of 532.3 pg/mL and 2089.6μg/L respectively,the specificity of 86.6%and 90.0%,respectively;The area under the curve,sensitivity and specificity of the combined diagnosis of serum VAP-1 and SDC-1 in children with bronchial asthma were 0.981,93.3%and 96.6%,respectively.Conclusion Levels of VAP-1 and SDC-1 in serum of children with bronchial asthma are significantly increased,which are related to inflammatory factors and lung function.The combined diagnosis of VAP-1 and SDC-1 in serum of children with bronchial asthma has a higher clinical value.