Abstract:

Objective　To analyze the relationships between serum levels of eosinophilic chemokine (Eotaxin), tumor necrosis factor-α (TNF-α), and leukocyte cell-derived chemokine 2 (LECT2) and prognosis in children with bronchial asthma. Methods　The data of 137 children with bronchial asthma admitted to Shaanxi Provincial Armed Police Corps Hospital from May 2021 to November 2023 were retrospectively analyzed. All the children received conventional treatment, and were followed up for 4 months. They were divided into a good prognosis group and a poor prognosis group according to the prognosis of the children. The clinical data and serum levels of Eotaxin, TNF-α, and LECT2 were compared between the two groups, and the influencing factors of poor prognosis in children with bronchial asthma were analyzed. The receiver operating characteristic curve (ROC) was drawn to analyze the predictive values of serum Eotaxin, TNF-α, and LECT2 levels and their combination for poor prognosis in children with bronchial asthma by using the area under curve (AUC). χ² test and independent sample t test were used. Results　The incidence of poor prognosis was 22.63% (31/137). In the poor prognosis group, there were 14 boys and 17 girls, aged (7.37±1.46) years. In the good prognosis group, there were 42 boys and 64 girls, aged (7.85±1.12) years. The proportions of allergic history and history of recurrent respiratory tract infection in the poor prognosis group were higher than those in the good prognosis group, and the serum levels of LECT2, TNF-α, and Eotaxin in the poor prognosis group were higher than those in the good prognosis group (all P<0.05). Logistic regression analysis showed that history of recurrent respiratory tract infection (OR=4.125, 95%CI: 1.777-9.577), Eotaxin (OR=4.415, 95%CI: 1.902-10.251), TNF-α (OR=3.947, 95%CI: 1.700-9.164), and LECT2 (OR=2.735, 95%CI: 1.178-6.349) were the prognostic factors in children with bronchial asthma (all P<0.05). The areas under the curves of serum TNF-α, Eotaxin, and LECT2 levels and their combination in predicting poor prognosis in children with bronchial asthma were 0.843, 0.799, 0.797, and 0.905, respectively (all P<0.05). Conclusion　Combination of serum LECT2, TNF-α, and Eotaxin has higher prognostic value in children with bronchial asthma.

Key words:

Bronchial asthma, Children, Eosinophilic chemokine, Tumor necrosis factor-α, Leukocyte cell-derived chemokine 2, Prognosis

摘要：

目的　分析血清嗜酸性粒细胞趋化因子（Eotaxin）、肿瘤坏死因子-α（TNF-α）、白细胞衍生趋化因子2（LECT2）水平与支气管哮喘患儿预后的关系。方法　选择武警陕西省总队医院2021年5月至2023年11月收治的137例支气管哮喘患儿的病例资料进行回顾性分析。所有患儿均采用常规治疗，随访4个月，按照患儿预后分为预后良好组与预后不良组。对比两组临床资料与血清Eotaxin、TNF-α、LECT2水平，分析支气管哮喘患儿预后不良的影响因素，绘制受试者操作特征曲线（ROC），以曲线下面积（AUC）分析血清Eotaxin、TNF-α、LECT2水平及三者联合对支气管哮喘患儿预后不良的预测价值。采用χ²检验、独立样本t检验。结果　137例患儿中，预后不良发生率为22.63%（31/137）。预后不良组男14例，女17例，年龄（7.37±1.46）岁；预后良好组男42例，女64例，年龄（7.85±1.12）岁。预后不良组过敏史、有呼吸道反复感染史占比均高于预后良好组，预后不良组血清LECT2、TNF-α、Eotaxin水平均高于预后良好组（均P<0.05）。logistic回归分析显示，呼吸道反复感染史（OR=4.125，95%CI：1.777～9.577）、Eotaxin（OR=4.415，95%CI：1.902～10.251）、TNF-α（OR=3.947，95%CI：1.700～9.164）、LECT2（OR=2.735，95%CI：1.178～6.349）均为支气管哮喘患儿预后不良的影响因素（均P<0.05）。血清TNF-α、Eotaxin、LECT2水平与三者联合预测支气管哮喘患儿预后不良的曲线下面积（AUC）分别为0.843、0.799、0.797、0.905（均P<0.05）。结论　血清LECT2、TNF-α、Eotaxin联合预测支气管哮喘患儿预后的价值更高。

关键词:

支气管哮喘, 儿童, 嗜酸性粒细胞趋化因子, 肿瘤坏死因子-α, 白细胞衍生趋化因子2, 预后