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| 分泌性中耳炎患儿血清sICAM-1 CDC42 FKN表达与免疫功能失调及病情程度的关系 |
| Relationship between serum sICAM-1, CDC42, FKN with immune dysfunction and disease severity in children with otitis media with effusion |
| 投稿时间：2025-01-15 |
| DOI：10.3969/j.issn.1000-0399.2025.11.007 |
| 中文关键词: 儿童,分泌性中耳炎 免疫功能 病情程度 可溶性细胞间粘附分子1 细胞分裂周期蛋白42 不规则趋化因子 |
| 英文关键词: Otitis media with effusion Children Immune function Disease severity Soluble intercellular adhesion molecule-1 Cell division cycle protein 42 Fractalkine |
| 基金项目:河北省2025年度医学科学研究课题(编号:20251398) |
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| 摘要点击次数: 697 |
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| 中文摘要: |
| 目的 探究分泌性中耳炎（OME）患儿血清可溶性细胞间粘附分子1（sICAM-1）、细胞分裂周期蛋白42（CDC42）、不规则趋化因子（FKN）表达与免疫功能失调及病情程度的关系。方法 选择2021年11月至2024年11月邢台市妇幼保健院收治的132例OME患儿作为疾病组，根据病情程度分为急性组（101例）与慢性组（31例）；选择同期在本院体检的100例健康儿童作为对照组。Pearson分析OME患儿血清sICAM-1、CDC42、FKN表达与免疫指标的相关性；logistic分析儿童发生OME的影响因素；受试者工作特征曲线分析血清sICAM-1、CDC42、FKN表达对OME患儿病情程度的预测价值。结果 疾病组CD4+、CD4+/CD8+低于对照组，CD8+、肿瘤坏死因子α（TNF-α）、降钙素原（PCT）、sICAM-1、CDC42、FKN高于对照组（P<0.05）;OME患儿血清sICAM-1、CDC42、FKN表达与CD4+、CD4+/CD8+呈负相关，与CD8+、TNF-α、PCT呈正相关（P<0.05）；血清sICAM-1、CDC42、FKN表达升高是儿童发生OME的危险因素（P<0.05）；急性组血清sICAM-1、CDC42、FKN表达高于慢性组（P<0.05）；血清sICAM-1、CDC42、FKN及3者联合预测OME患儿病情程度的曲线下面积为0.839（95%CI:0.759～0.919）、0.802（95%CI:0.716～0.888）、0.814（95%CI:0.734～0.895）和0.922（95%CI:0.874～0.970）,3者联合预测OME患儿病情程度的价值高于单独预测(Z3者联合-sICAM-1=2.042、P=0.041,Z3者联合-CDC42=3.239、P=0.001,Z3者联合-FKN=2.560、P=0.011)。结论 OME患儿血清sICAM-1、CDC42、FKN表达升高，血清sICAM-1、CDC42、FKN表达与免疫功能失调及病情程度有关，3者联合对OME患儿病情程度有一定预测价值。 |
| 英文摘要: |
| Objective To investigate the relationship between serum soluble intercellular adhesion molecule-1（sICAM-1）, cell division cycle protein 42（CDC42）, and fractalkine（FKN） with immune dysfunction and disease severity in children with otitis media with effusion（OME）. Methods A total of 132 children with OME admitted to our hospital from November 2021 to November 2024 were selected as the disease group, and were divided into the acute group（101 cases） and chronic group（31 cases） according to the severity of their condition. A hundred healthy children who underwent physical examinations at our hospital were selected during the same period as the control group. Pearson correlation analysis was used to analyze the correlation between serum sICAM-1, CDC42, FKN and immune indicators in children with OME. Logistics analysis was used to assess the influencing factors of OME in children. Receiver operating characteristic（ROC） was used to analyze the predictive value of serum sICAM-1, CDC42, and FKN for the severity of OME in children. Results The disease group had conspicuously lower CD4+ and CD4+/CD8+, and conspicuously higher CD8+, tumor necrosis factor alpha（TNF-α）, procalcitonin（PCT）, sICAM-1, CDC42, and FKN than healthy group（P＜0.05）. Serum sICAM-1, CDC42, and FKN in children with OME were negatively correlated with CD4+ and CD4+/CD8+, and positively correlated with CD8+, TNF-α, and PCT（P＜0.05）. Elevated serum sICAM-1, CDC42, and FKN were risk factors for OME in children（P＜0.05）. The acute group had conspicuously higher serum sICAM-1, CDC42, and FKN than chronic group（P＜0.05）. The area under curve of serum sICAM-1, CDC42, FKN, and their joint in predicting the severity of OME in children was 0.839（95% CI:0.759～0.919）, 0.802（95% CI:0.716～0.888）, 0.814（95% CI:0.734～0.895）, and 0.922（95% CI:0.874～0.970） respectively. The value of the joint of three factors in predicting the severity of OME in children was higher than that of single prediction(Zjoint-sICAM-1=2.042, P=00.041, Zjoint-CDC42=3.239, P=00.001, Zjoint-FKN=2.560, P=00.011). Conclusion Serum sICAM-1, CDC42, and FKN are elevated in children with OME. Serum sICAM-1, CDC42, and FKN are related to immune dysfunction and the disease severity. The joint of the three has certain predictive value for the severity of OME in children. |
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