血清TIMP-1、YKL-40、CRP及ANCA在学龄期支气管炎诊断及预后评估中的价值

The Value of Serum TIMP-1,YKL-40,CRP,and ANCA in the Diagnosis and Prognostic Assessment of Bronchitis in School-aged Children

【目的】探讨血清基质金属蛋白酶抑制物-1(TIMP-1)、人软骨糖蛋白39(YKL-40)、C反应蛋白(CRP)、抗中性粒细胞胞浆抗体(ANCA)在学龄期支气管炎诊断及预后评估中的价值。【方法】选取100例学龄期支气管炎患儿作为观察组,接受体检的100名健康学龄期儿童作为对照组。观察组行常规治疗1~2周后,按疗效分为预后良好组和预后不良组。比较两组儿童TIMP-1、YKL-40、CRP及ANCA水平,采用受试者工作特征(ROC)曲线分析TIMP-1、YKL-40、CRP及ANCA诊断学龄期支气管炎的价值。比较治疗前后及预后良好组和预后不良组患儿TIMP-1、YKL-40、CRP及ANCA水平,对患儿预后和TIMP-1、YKL-40、CRP及ANCA行相关性分析。【结果】观察组血清TIMP-1、YKL-40、CRP及ANCA水平显著高于对照组(P<0.05)。ROC曲线分析证实,TIMP-1≥228.510 pg/mL、YKL-40≥26.755 ng/L、CRP≥12.130 mg/L、ANCA≥167.850 AU/mL可用于学龄期支气管炎的诊断,曲线下面积分别为0.895、0.892、0.874、0.866(均P<0.05)。治疗后,观察组患儿TIMP-1、YKL-40、CRP及ANCA较治疗前均显著降低(P<0.05)。预后良好组患儿四项指标均低于预后不良组(P<0.05),且其均与学龄期支气管炎患儿预后呈正相关。【结论】支气管炎患儿血清TIMP-1、YKL-40、CRP及ANCA较正常儿童水平高,治疗后各项指标均下降,其与患儿预后呈正相关,临床上可通过检测血清TIMP-1、YKL-40、CRP及ANCA水平来辅助诊断学龄期支气管炎及评估患儿预后。

【Objective】This study investigated the significance of serum tissue inhibitor of metalloproteinases-1(TIMP-1),chitinase-3-like protein 1(YKL-40),C-reactive protein(CRP),and anti-neutrophil cytoplasmic antibodies(ANCA)in the diagnosis and prognostic evaluation of bronchitis in school-aged children.【Methods】One hundred children with bronchitis were selected as the observation group,and one hundred healthy school-aged children undergoing physical examination were selected as the control group.After 1-2 weeks of standard treatment,the observation group was divided into a good prognosis group and a poor prognosis group based on treatment outcomes.Levels of TIMP-1,YKL-40,CRP,and ANCA were compared between the observation and the control groups.The diagnostic value of these biomarkers for school-aged bronchitis was analyzed using receiver operating characteristic(ROC)curves.Additionally,levels of these biomarkers before and after treatment,as well as between the good and the poor prognosis groups,were compared,and correlations with prognosis were analyzed.【Results】Serum levels of TIMP-1,YKL-40,CRP,and ANCA were significantly higher in the observation group compared to the control group(P<0.05).ROC analysis confirmed that TIMP-1≥228.510 pg/mL,YKL-40≥26.755 ng/L,CRP≥12.130 mg/L,and ANCA≥167.850 AU/mL could be used to diagnose bronchitis in school-aged children,with area under the curve values of 0.895,0.892,0.874,and 0.866 respectively(all P<0.05).After treatment,levels of TIMP-1,YKL-40,CRP,and ANCA in the observation group significantly decreased(P<0.05).The good prognosis group had lower levels of these markers compared to the poor prognosis group(P<0.05),and there was a positive correlation between these biomarkers and prognosis in children with bronchitis.【Conclusion】Serum levels of TIMP-1,YKL-40,CRP,and ANCA are elevated in children with bronchitis compared to healthy children;The levels of TIMP-1,YKL-40,CRP,and ANCA in bronchitis children decrease after treatment;And they are correlated positively with the prognosis.Clinically,levels of serum TIMP-1,YKL-40,CRP,and ANCA can assist in the diagnosis of bronchitis in school-aged children and in the assessment of prognosis.