支气管哮喘急性发作患儿SAA/CRP与气道炎症及病情严重程度的关系

Relationship between SAA/CRP and airway inflammation and disease severity in childrenwith acute exacerbation of bronchial asthma

目的探讨支气管哮喘急性发作患儿血清淀粉样蛋白A(SAA)/C反应蛋白(CRP)与气道炎症及病情严重程度的关系。方法选取2020年7月至2023年7月安徽省儿童医院收治的82例支气管哮喘急性发作患儿作为研究对象,根据患儿入院病情严重程度分为轻度组(23例)、中重度组(59例)。检测并对比两组患儿SAA/CRP、气道炎症指标[(白细胞介素-6(IL-6)、降钙素原(PCT)]。采用受试者工作特征(ROC)曲线评估SAA/CRP对支气管哮喘急性发作患儿病情严重程度的诊断价值,采用多因素Logistic逐步回归分析探讨支气管哮喘急性发作患儿病情严重程度的影响因素。结果轻度组血清IL-6、PCT水平均低于中重度组(P<0.05),轻度组血清SAA、CRP、SAA/CRP均低于中重度组(P<0.05)。支气管哮喘急性发作患儿SAA/CRP与IL-6、PCT水平呈正相关(r=0.317、0.324,P=0.010、0.001)。SAA、CRP及SAA/CRP诊断支气管哮喘急性发作患儿病情严重程度的曲线下面积分别为0.854、0.753、0.916。多因素Logistic逐步回归分析显示,哮喘家族史(OR=3.622,95%CI:1.556~8.430)、哮喘控制测试评分(OR=4.175,95%CI:1.652~10.550)、SAA/CRP(OR=5.254,95%CI:2.108~13.097)是影响支气管哮喘急性发作患儿病情严重程度的危险因素(P<0.05)。结论支气管哮喘急性发作患儿的SAA/CRP与其气道炎症相关,且对支气管哮喘急性发作患儿病情严重程度具有一定评估价值。

Objective To explore the relationship between amyloid A(SAA)/C-reactive protein(CRP)and airway inflammation and disease severity in children with acute exacerbation of bronchial asthma.Methods A total of 82 children with acute exacerbation of bronchial asthma admitted to Anhui Provincial Children′s Hospital from July 2020 to July 2023 were selected as the study objects,and were divided into mild group(23 cases)and moderate and severe group(59 cases)according to the disease severity at admission.SAA/CRP and airway inflammation indicators[interleukin-6(IL-6),procalcitonin(PCT)]in the two groups were compared.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of SAA/CRP for the disease severity of children with acute exacerbation of bronchial asthma,and multivariate Logistic stepwise regression analysis was used to explore the influencing factors for the disease severity of children with acute exacerbation of bronchial asthma.Results The serum levels of IL-6 and PCT in the mild group were lower than those in the moderate and severe group(P<0.05),and the serum SAA,CRP and SAA/CRP in the mild group were lower than those in the moderate and severe group(P<0.05).SAA/CRP was positively correlated with IL-6 and PCT levels in children with acute exacerbation of bronchial asthma(r=0.317,0.324,P=0.010,0.001).The area under the curve of SAA,CRP and SAA/CRP for diagnosing the disease severity of children with acute exacerbation of bronchial asthma were 0.854,0.753 and 0.916,respectively.Family history of asthma(OR=3.622,95%CI:1.556~8.430),asthma control test score(OR=4.175,95%CI:1.652-10.550),SAA/CRP(OR=5.254,95%CI:2.108-13.097)were the risk factors for children with acute exacerbation of bronchial asthma(P<0.05).Conclusion The SAA/CRP in children with acute exacerbation of bronchial asthma is related to airway inflammation,and has a certain value in evaluating the disease severity of children with acute exacerbation of bronchial asthma.