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| 血清sFasL LTB4联合检测对支气管哮喘儿童预后的预测价值 |
| The predictive value of joint detection of serum sFasL and LTB4 in prognosis for children with bronchial asthma |
| 投稿时间：2025-02-18 |
| DOI：10.3969/j.issn.1000-0399.2026.02.009 |
| 中文关键词: 支气管哮喘 儿童 可溶性Fas配体 白三烯B4 预后 |
| 英文关键词: Bronchial asthma Children Soluble Fas ligand Leukotriene B4 Prognosis |
| 基金项目:鄂东医疗集团市妇幼保健院课题(编号:HSMCHH2022013) |
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| 中文摘要: |
| 目的 研究支气管哮喘（以下称哮喘）患儿血清中可溶性Fas配体（sFasL）、白三烯B4(LTB4)水平变化及其对患儿预后的预测价值。方法 选取2023年9月至2024年9月在黄石市妇幼保健院确诊并治疗的哮喘患儿150例，根据哮喘的发病情况分为急性组（n=86例）和缓解组（n=64例），同期于本院接受健康筛查的97例儿童被纳入健康组。按照常规治理方法对患儿治疗4周，采用酶联免疫（ELISA）试剂盒检测血清sFasL、LTB4水平；应用儿童哮喘控制测试（C-ACT）评分对治疗后患儿病情控制情况进行判定；比较急性组、缓解组、健康组患儿血清sFasL、LTB4水平；比较不同预后患儿基础资料情况；采用Spearman法分析血清sFasL、LTB4与CACT评分之间的相关性；运用多变量logistic回归模型，对哮喘患儿预后相关的潜在影响因素进行统计分析；采用受试者工作特征（ROC）曲线分析血清血清sFasL、LTB4对哮喘患儿预后的预测价值。结果 sFasL、LTB4在哮喘患儿血清中呈高表达（P<0.05），且急性组大于缓解组（P<0.05）；预后不良组血清sFasL、LTB4水平高于预后良好组（P<0.05）,C-ACT评分则低于预后良好组（P<0.05）;sFasL、LTB4水平分别与C-ACT评分呈负相关（r=-0.319、-0.410,P<0.001）;sFasL、LTB4是影响哮喘患儿预后的因素，二者单独预测哮喘患儿的曲线下面积（AUC）为0.806、0.816，小于二者联合预测的AUC(0.887)。结论 血清sFasL和LTB4在哮喘患儿中异常高表达，且与疾病活动度及预后不良密切相关；联合检测二者水平对哮喘患儿的预后预测具有更高临床价值。 |
| 英文摘要: |
| Objective To investigate the changes in soluble Fas ligand(sFasL) and leukotriene B4(LTB4) in the serum of children with bronchial asthma(hereinafter referred to as asthma), and their predictive value for the prognosis of children. Methods Totally 150 children with asthma diagnosed and treated in Huangshi Maternal and Child Health Hospital between September 2023 and September 2024 were gathered. Complying with the incidence of asthma, they were assigned into the acute group(86 cases) and remission group(64 cases). Another 97 healthy children who underwent physical check ups were labeled as healthy group. After four weeks of regular treatment, enzyme-linked immunosorbent assay(ELISA) kits were used to detect serum sFasL and LTB4 in the children. The Children's Asthma Control Test(C-ACT) score was used to assess the control of condition after treatment. The serum sFasL and LTB4 were compared among the acute group, remission group, and healthy group. The basic data of children with different prognoses were compared. Spearman method was used to analyze the correlation between serum sFasL, LTB4, and C-ACT score. The multiple factor logistic regression model was used to analyze the influencing factors of prognosis in children with asthma. In addition, receiver operating characteristic(ROC) was used to analyze the predictive value of serum sFasL and LTB4 for the prognosis of children with asthma. Results The sFasL and LTB4 were highly expressed in the serum of children with asthma(P<0.05), with the acute group higher than the remission group(P<0.05). The poor prognosis group had higher sFasL and LTB4(P<0.05), and lower C-ACT score than good prognosis group(P<0.05). The sFasL and LTB4 were negatively correlated with C-ACT score, respectively(r=-0.319,-0.410, P<0.001). SFasL and LTB4 were factors that affected the prognosis of children with asthma. The area under the curve(AUC) predicted by the two alone for children with asthma was 0.806 and 0.816, respectively, and both were smaller than the AUC predicted by the joint of the two(0.887). Conclusion Serum sFasL and LTB4 are abnormally elevated in children with bronchial asthma, strongly associated with disease activity and poor prognosis. The combined detection of these two markers provides higher clinical value for predicting the prognosis of asthmatic children. |
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