嗜酸性粒细胞及嗜酸性粒细胞/淋巴细胞比值预测不同季节儿童过敏性哮喘的意义

Significance of eosinophil and eosinophil/lymphocyte ratio predicting allergic asthma in children with different seasons

目的:探究嗜酸性粒细胞及嗜酸性粒细胞/淋巴细胞比值(ELR)预测不同季节儿童过敏性哮喘的意义。方法:回顾性分析2021年1月至2021年12月山东第一医科大学附属省立医院小儿呼吸科门诊及住院的哮喘患儿,过敏原特异性IgE(sIgE)、外周血细胞分析检查结果完整。以sIgE≥0.35 kUA/L入过敏性哮喘组,sIgE<0.35 kUA/L且过敏原总IgE<60 kUA/L入非过敏性哮喘组。分析两组患者一般资料、外周血细胞变化。结果:符合条件者1378人次,其中过敏性哮喘组999(72.5%)人次,非过敏性哮喘组379(27.5%)人次;过敏性哮喘组就诊人次呈季节性变化,秋季最多;过敏性哮喘患儿外周血淋巴细胞计数(LYMPH)、嗜酸性粒细胞计数(EOS)、ELR均高于非过敏性哮喘患儿(P<0.05);血小板/淋巴细胞比值(PLR)低于非过敏性哮喘患儿(P<0.05);过敏性哮喘患儿外周血LYMPH、PLT、EOS及ELR四季间有差异,EOS和ELR每个季节均高于非过敏性哮喘患儿,LYMPH在秋季显著高于非过敏性哮喘患儿,PLT在春季显著低于非过敏性哮喘患儿(P<0.05);EOS预测过敏性哮喘患儿春、夏、秋、冬季曲线下面积(AUC)分别为0.79、0.77、0.71和0.64;ELR预测过敏性哮喘患儿春、夏、秋、冬季AUC分别为0.72、0.48、0.73和0.68。结论:儿童过敏性哮喘呈季节性变化,且高峰在秋季。过敏性哮喘儿童外周血细胞中EOS和ELR在全年每个季节均高于非过敏性哮喘儿童,LYMPH在秋季显著高于非过敏性哮喘患儿,PLT在春季低于非过敏性哮喘儿童,提示过敏性哮喘Ⅱ型炎症持续存在,EOS和ELR对不同季节儿童过敏性哮喘均有一定预测价值。

Objective:To explore significance of eosinophil and eosinophil/lymphocyte ratio(ELR)in predicting allergic asthma in children in different seasons.Methods:Retrospective analysis of children with asthma who visited pediatric respiratory department outpatient clinic and ward of Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2021 to December 2021,whose allergen specific IgE(sIgE)and peripheral blood cell analysis were complete.sIgE≥0.35 kUA/L were included in allergic asthma group,sIgE<0.35 kUA/L and total allergen IgE<60 kUA/L were included in non-allergic asthma group.General data and changes in peripheral blood cells of two groups were analyzed.Results:There were 1378 qualified subjeats,including 999(72.5%)in allergic asthma group and 379(27.5%)in non-allergic asthma group.Number of visits in allergic asthma group varied seasonally,with the most in autumn.Peripheral blood lymphocyte count(LYMPH),eosinophil count(EOS)and ELR were all higher in children with allergic asthma than in children with non-allergic asthma(P<0.05),and platelet/lymphocyte ratio(PLR)was lower than that in children with non-allergic asthma(P<0.05).Peripheral blood LYMPH,PLT,EOS and ELR of children with allergic asthma differed between four seasons,which were higher than those of non-allergic asthma in each season in EOS and ELR,LYMPH was significantly higher than that of children with non-allergic asthma in autumn,and PLT was significantly lower than that of children with non-allergic asthma in spring(P<0.05).EOS predicted AUC of spring,summer,autumn and winter were 0.79,0.77,0.71 and 0.64 in children with allergic asthma,and ELR predicted AUC were 0.72,0.48,0.73 and 0.68 in children with allergic asthma.Conclusion:Allergic asthma in children is seasonally variable and peaks in autumn.EOS and ELR in peripheral blood cells in children with allergic asthma are higher than in children with non-allergic asthma in each season of year,LYMPH is significantly higher than children with nonallergic asthma in the fall,and PLT is lower than in children with non-allergic asthma in spring,suggesting that allergic asthma typeⅡinflammation persists,and EOS and ELR have predictive value for children's allergic asthma.