支气管哮喘患儿血清CCL2、CCL3表达水平及临床意义

Relationships between serum CCL2 and CCL3 levels with airway inflammation and airflow limitation in children with bronchial asthma

目的检测支气管哮喘患儿血清CCL2、CCL3水平,并探讨其与气道炎症和气流受限的关系。方法选取2015年1月至2017年4月本院小儿呼吸科收治的急性发作期支气管哮喘患儿78例,选取同期支气管哮喘缓解期患儿60例,另选取体检正常儿童40例,空腹抽取静脉血,采用ELISA方法检测血清中CCL2、CCL3水平,检测气道炎症与气流受限相关指标,分析比较支气管哮喘患儿CCL2、CCL3检测水平与气道炎症与气流受限之间相关性。结果急性发作期CCL2、CCL3水平[(42.98±6.21)、(20.35±4.32)pg/mL]均高于哮喘缓解期[(35.48±5.14)、(12.15±3.21)pg/mL]与健康对照组[(14.05±3.27)、(6.58±1.52)pg/mL],差异有统计学意义(P<0.05);哮喘急性发作期气道炎症指标嗜酸粒细胞计数、尿液白三烯E4、FeNO水平[(0.47±0.10)×10~9/L,(251.25±46.35)ng/L、(38.25±9.34)ppb]均明显高于哮喘缓解期与健康对照组,差异有统计学意义(P<0.05);急性发作期哮喘气流受限指标FVC、FEV_1、FEV_1/FVC水平[(2.51±0.24)L、(1.44±0.23)L、(57.41±10.23)%]明显低于缓解期哮喘与健康对照组,差异有统计学意义(P<0.05);Pearson分析显示CCL2、CCL3均与嗜酸粒细胞、FeNO呈明显正相关(r=0.724、0.637,r=0.652、0.614,P<0.05),与尿液白三烯E4呈弱相关(r=0.341、0.325,P<0.05);CCL2与FVC、FEV_1、FEV_1/FVC呈负相关(r=-0.721、-0.743、-0.651,P<0.05);CCL3与FVC、FEV_1、FEV_1/FVC呈明显负相关(r=-0.658、-0.612、-0.635,P<0.05)。Logistic回归分析显示CCL2、CCL3均是作为影响支气管哮喘患儿气流受限的危险因素。结论支气管哮喘患儿血清CCL2、CCL3升高,与气道炎症发病过程及气流受限密切相关,CCL2、CCL3是影响支气管哮喘患儿气流受限的危险因素。

Objective To detect the serum levels of CCL2 and CCL3 in children with bronchial asthma,and explore their relationships with airway inflammation and airflow limitation.Methods A total of 78 children with acute attack of bronchial asthma admitted to pediatric respiratory department of our hospital from January 2015 to April 2017,and 60 children with bronchial asthma in the same period were selected for the study,while 40 cases of normal physical examination were selected,and venous blood was taken on the empty stomach.The serum levels of CCL2 and CCL3 were detected by ELISA.The related indexes of airway inflammation and airflow limitation,the correlations between CCL2 and CCL3 levels with airway inflammation and airflow limitation in children with bronchial asthma were analyzed and compared.Results The levels of CCL2 and CCL3 in acute attack stage[(42.98±6.21),(20.35±4.32)pg/mL]were higher than those in remission stage[(35.48±5.14),(12.15±3.21)pg/mL]and healthy control group[(14.05±3.27),(6.58±1.52)pg/mL](P<0.05);the eosinophil count,urinary leukotriene E4 and FeNO levels in acute attack stage[(0.47±0.10)×109/L,(251.25±46.35)ng/L,(38.25±9.34)ppb]were significantly higher than those in remission stage and healthy control group(P<0.05);the levels of FVC,FEV,and FEV1/FVC in acute attack stage[(2.51±0.24)L,(1.44±0.23)L,(57.41±10.23)%]were significantly lower than those in remission stage.Pearson analysis showed that CCL2 and CCL3 were positively correlated with eosinophil and FeNO(r=0.724,0.637;r=0.652,0.614;P<0.05).CCL2 was negatively correlated with FVC,FEV1,and FEV1/FVC(r=-0.721,-0.743,-0.651,P<0.05);CCL3 was negatively correlated with FVC,FEV1,FEV1/FVC(r=-0.658,-0.612,-0.635,P<0.05).Logistic regression analysis showed that CCL2 and CCL3 were risk factors for airflow limitation in children with bronchial asthma.Conclusions The elevation of serum CCL2 and CCL3 levels in children with bronchial asthma was closely related to airway inflammation and airflow limitation.CCL2 and CCL3 were risk factors for airflow restriction in children with bronchial asthma.