腺样体肥大患儿腺样体组织病原菌和IL-25、CysLTR-1、CysLTR-2与IL-32及其预测价值

Pathogenic bacteria in adenoid tissue of children with adenoid hypertrophy and IL-25,CysLTR-1,CysLTR-2 and IL-32 and their predictive value

目的分析腺样体肥大患儿腺样体组织病原菌和白细胞介素-25(IL-25)、半胱氨酸白三烯受体1(CysLTR-1)、半胱氨酸白三烯受体2(CysLTR-2)、IL-32及其预测价值.方法纳入2020年3月-2023年3月菏泽市立医院收治的腺样体肥大患儿162例进行研究,术中留取腺样体表面分泌物及腺样体实体组织标本,行细菌培养,检出病原菌52例纳入研究组,未检出病原菌的110例纳入对照组;分析腺样体肥大患儿感染病原菌,分析两组临床症状评分、腺样体实体组织标本IL-25、CysLTR-1、CysLTR-2、IL-32表达水平,绘制受试者工作特征(ROC)曲线分析各项指标单独及联合检测对腺样体肥大患儿感染病原菌检出的预测价值.结果162例腺样体肥大患儿分泌物和(或)腺样体组织共检出感染病原菌52例,共培养分离出条件致病菌68株,主要为流感嗜血杆菌(58.82%)、金黄色葡萄球菌(14.71%)、肺炎链球菌(11.76%);研究组患儿症状(鼻塞、流涕、鼻痒、喷嚏)评分更高(P<0.05);研究组腺样体实体组织标本IL-25、CysLTR-1、CysLTR-2、IL-32水平较对照组更高(P<0.05).将腺样体肥大患儿感染病原菌纳入阳性组,腺样体肥大患儿无感染病原菌纳入阴性组,绘制ROC曲线,曲线下面积(AUC)为0.864、0.875、0.694、0.748和0.947,联合检测价值高于单独检测.结论腺样体肥大患儿感染病原菌检出以流感嗜血杆菌、金黄色葡萄球菌、肺炎链球菌为主,合并感染的患儿临床症状更明显,腺样体组织中IL-25、CysLTR-1、CysLTR-2、IL-32表达水平升高,且联合检测有助于腺样体肥大患儿感染的诊断.

OBJECTIVE To analyze the pathogenic bacteria in adenoid tissue of children with adenoid hypertrophy and the levels of interleukin-25(IL-25),cysteine leukotriene receptor 1(CysLTR-1),cysteine leukotriene receptor 2(CysLTR-2)and IL-32,and their predictive value.METHODS A total of 162 cases of children with adenoid hyperplasia treated in Heze Municipal Hospital from Mar.2020 to Mar.2023 were included as the study subjects.During the operation,adenoid surface secretions and adenoid solid tissue samples were retained for bacterial culture,and 52 cases with detected pathogenic bacteria were included in the study group,while l10 cases with undetected pathogenic bacteria were included in the control group.The infectious pathogenic bacteria of the children with adenoid hypertrophy were analyzed,the clinical symptom scores,the expression levels of IL-25,CysLTR-1,CysLTR-2 and IL-32 in adenoid solid tissue samples of the two groups were analyzed,and receiver operating characteristic(ROC)curves were drawn to analyze the predictive value of each indicator alone and in combination on the detection of pathogenic bacteria in children with adenoid hypertrophy.RESULTS A total of 52 pathogenic bacteria were detected in the secretions and/or adenoid tissues of 162 children with adenoid hypertrophy,and 68 strains of opportunistic bacteria were isolated and co-cultured,mainly Haemophilus influenzae(58.82%),Staphylococcus aureus(14.71%)and Streptococcus pneumoniae(11.76%).The scores of symptoms(nasal congestion,runny nose,itchy nose,sneezing)were higher in the study group(P<0.05).The levels of IL-25,CysLTR-1,CysLTR-2 and IL-32 in the solid tissue samples of adenoids in the study group were higher than those in the control group(P<o.05).Children with adenoid hypertrophy with infectious pathogens were included in the positive group,while children with adenoid hypertrophy without infectious pathogens were included in the negative group,ROC curve was plotted and the area under the curve(AUC)was 0.864,0.875,0.694,0.748 and 0.947,which showed that the value of combined testing was higher than that of single detection.CONCLUSION The pathogenic bacteria detected in children with adenoid hypertrophy dominated by Haemophilus influenzae,Staphylococcus aureus and Streptococcus pneumoniae,and clinical symptoms were more pronounced in children with co-in fections,and the expression levels of IL-25,CysLTR-1,CysLTR-2 and IL-32 were elevated in adenoid tissues,and the combined detection was helpful in the diagnosis of infection in children with adenoid hypertrophy.