血清YKL-40、Gal-3水平预测复发性口腔溃疡患儿治疗后复发的临床价值

Clinical Values of Serum YKL-40 and Gal-3 Levels in Predicting the Recurrenc of Recurrent Oral Ulcers in Children After Treatment

目的探讨血清甲壳质酶蛋白-40(YKL-40)、半乳糖凝集素-3(Gal-3)预测复发性口腔溃疡(ROU)患儿治疗后复发的临床价值。方法选择2019年2月至2022年4月期间本院诊治的ROU患儿172例(观察组),根据治疗后是否再次复发,进一步分为复发组56例,未复发组116例。另选取同期健康体检无口腔溃疡者172例作为对照组。采用酶联免疫吸附法(ELISA)检测血清中YKL-40、Gal-3水平。采用Pearson法分析血清YKL-40、Gal-3水平与肿瘤坏死因子-α(TNF-α)、CD3^(+)、溃疡数目及溃疡面积的相关性。采用多因素Logistic回归分析影响ROU患儿治疗后复发的影响因素;通过受试者工作特征(ROC)曲线评估血清中YKL-40、Gal-3水平对ROU患儿治疗后复发的预测价值。结果观察组血清中YKL-40、Gal-3水平显著高于对照组(P<0.05);复发组血清YKL-40、Gal-3水平显著高于未复发组(P<0.05);复发组TNF-α水平、溃疡数目及溃疡面积显著高于未复发组,而复发组CD3^(+)显著低于未复发组,差异具有统计学意义(P<0.05);经Pearson相关性分析显示,血清YKL-40、Gal-3水平与TNF-α、溃疡数目及溃疡面积呈显著正相关(P<0.05),血清YKL-40、Gal-3水平与CD3^(+)呈显著负相关(P<0.05);多因素Logistic回归分析结果显示,血清YKL-40、Gal-3、TNF-α、CD3^(+)、溃疡数目及溃疡面积均为ROU患儿治疗后复发的影响因素(P<0.05);ROC曲线分析表明,YKL-40、Gal-3联合预测ROU患儿治疗后复发的曲线下面积(AUC)为0.949,YKL-40预测ROU患儿治疗后复发的AUC为0.885,Gal-3预测ROU患儿治疗后复发的AUC为0.866,二者联合优于YKL-40、Gal-3各自单独预测(Z=3.399、3.101,P均<0.05)。结论ROU治疗后复发患儿血清中YKL-40、Gal-3水平显著升高,对预测治疗后复发具有一定的价值。

Objective To explore clinical values of serum chitinase protein-40(YKL-40)and galectin-3(Gal-3)in predicting the recurrence of recurrent oral ulcer(ROU)in children after treatment.Methods A total of 172 children with ROU diagnosed and treated in our hospital from February,2019 to April,2022 were regarded as the observation group.According to whether there was a recurrence after treatment,these patients were further grouped into a recurrence group of 56 cases and a non-recurrence group of 116 cases.Another 172 healthy individuals without oral ulcers from physical examination during the same period were regarded as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to detect levels of YKL-40 and Gal-3 in serum.Pearson method was applied to analyze the correlation between serum YKL-40,Gal-3 levels and tumor necrosis factor-α(TNF-α),CD3^(+),ulcer number,and ulcer area.Multivariate logistic regression was applied to identify the influencing factors of postoperative recurrence in children with ROU;Receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of serum YKL-40 and Gal-3 levels for postoperative recurrence in children with ROU.Results Serum levels of YKL-40 and Gal-3 in the observation group were significantly higher than those in the control group(P<0.05);Serum levels of YKL-40 and Gal-3 in the recurrent group were significantly higher than those in the non-recurrent group(P<0.05);TNF-αlevel,number of ulcers,and ulcer area in the recurrent group were significantly higher than those in the non-recurrent group,while CD3^(+)in the recurrent group was significantly lower than that in the non-recurrent group(P<0.05);Pearson correlation analysis showed that serum YKL-40 and Gal-3 levels were significantly positively correlated with TNF-α,number of ulcers,and ulcer area(P<0.05),while serum YKL-40 and Gal-3 levels were significantly negatively correlated with CD3^(+)(P<0.05);Multivariate logistic regression analysis showed that serum YKL-40,Gal-3,TNF-α,CD3^(+),number of ulcers,and ulcer area were all influencing factors for postoperative recurrence in children with ROU(P<0.05);ROC curve showed that the area under the curve(AUC)of YKL-40 combined with Gal-3 to predict postoperative recurrence in children with ROU was 0.949,and the AUC of YKL-40 in predicting postoperative recurrence in children with ROU was 0.885,while Gal-3 in predicting postoperative recurrence in children with ROU was 0.866.The combination of the two was superior to YKL-40 and Gal-3 separately(Z=3.399,3.101,P<0.05).Conclusion Serum levels of YKL-40 and Gal-3 in recurrent children after ROU treatment significantly increase,which has certain value in predicting recurrence after treatment.