支气管哮喘患儿血清LCN2、SDC⁃1水平及临床意义

Levels and clinical significance of serum LCN2 and SDC⁃1 in children with bronchial asthma

目的分析支气管哮喘患儿血清脂质运载蛋白2(LCN2)和多配体蛋白聚糖1(SDC⁃1)水平,并探讨两者与病情严重程度、哮喘控制水平的关系,以及对儿童支气管哮喘的诊断价值。方法纳入112例支气管哮喘患儿作为哮喘组,104例健康儿童作为正常组。根据病情严重程度再将哮喘组患儿分为轻度间歇组(36例)、轻度持续组(25例)、中度持续组(32例)和重度持续组(19例)。比较哮喘组与正常组之间,以及哮喘组不同病情严重程度患儿之间血清LCN2、SDC⁃1水平。分析哮喘组患儿血清LCN2和SDC⁃1的相关性,以及二者与第1秒用力呼气量(FEV_(1))、FEV_(1)/用力肺活量(FVC)值、儿童哮喘控制测试(C⁃ACT)评分的相关性。绘制受试者工作特征(ROC)曲线分析血清LCN2、SDC⁃1水平对儿童支气管哮喘的诊断价值。结果与正常组相比,哮喘组血清LCN2、SDC⁃1水平升高(P<0.05)。轻度间歇组、轻度持续组、中度持续组、重度持续组支气管哮喘患儿血清LCN2、SDC⁃1水平依次升高(P<0.05)。支气管哮喘患儿血清LCN2水平与血清SDC⁃1水平呈正相关,血清LCN2和SDC⁃1水平分别与FEV_(1)、FEV_(1)/FVC值、C⁃ACT评分呈负相关(P<0.05)。血清LCN2、SDC⁃1水平联合诊断儿童支气管哮喘的曲线下面积(AUC)为0.881,大于血清LCN2、SDC⁃1水平单独诊断的AUC(分别为0.778和0.768,P<0.05)。结论支气管哮喘患儿血清LCN2、SDC⁃1水平升高,且与病情严重程度和哮喘控制水平有关。血清LCN2、SDC⁃1水平可作为辅助诊断儿童支气管哮喘的生物标志物,且两者联合诊断的效能更高。

Objective To analyze the levels of serum lipocalin 2(LCN2)and syndecan 1(SDC⁃1)in children with bronchial asthma,and to explore the relation of the two as above with disease severity and asthma control level,as well as to explore the diagnostic value on children with bronchial asthma.Methods A total of 112 children with bronchial asthma were enrolled into asthma group,and 104 healthy children were into normal group.According to disease severity,children of the asthma group were further assigned to mild intermittent group(36 cases),mild persistence group(25 cases),moderate persistence group(32 cases),or severe persistence group(19 cases).Serum LCN2 and SDC⁃1 levels were compared between the asthma group and the normal group,and between children with different disease severity in the asthma group.The correlation of serum LCN2 and SDC⁃1 in children with bronchial asthma,and the correlations of the aforementioned indices with forced expiratory volume in one second(FEV_(1)),FEV_(1)to force vital capacity(FVC)ratio(FEV_(1)/FVC)value,Childhood Asthma Control Test(C⁃ACT)score were analyzed.Drawing receiver operating characteristic(ROC)curve to analyze the diagnostic value of serum LCN2 and SDC⁃1 levels in children with bronchial asthma.Results Compared with the normal group,the asthma group exhibited elevated serum LCN2 and SDC⁃1 levels(P<0.05).Serum LCN2 and SDC⁃1 levels in children with bronchial asthma were elevated successively in the mild intermittent group,the mild persistence group,the moderate persistence group,and the severe persistence group(P<0.05).Serum LCN2 level positively correlated with serum SDC⁃1 level in children with bronchial asthma,and serum LCN2 and SDC⁃1 levels negatively correlated with FEV_(1),FEV_(1)/FVC value,and C⁃ACT score,respectively(P<0.05).Area under the curve(AUC)of serum LCN2 and SDC⁃1 levels for jointly diagnosing children with bronchial asthma was 0.881,which was larger than AUC of serum LCN2 and SDC⁃1 levels for simple diagnosis(AUC of 0.778 and 0.768,respectively,P<0.05).Conclusion Serum LCN2 and SDC⁃1 levels are elevated in children with bronchial asthma,and are related to disease severity and asthma control level.Serum LCN2 and SDC⁃1 levels can be regarded as biomarkers for adjuvant diagnosis of children with bronchial asthma,and the combined diagnosis of the two exhibits higher efficiency.