毛细支气管炎患儿鼻分泌物抗菌肽水平与急性期病情严重程度及反复喘息的相关性研究-东南大学学报医学版

毛细支气管炎患儿鼻分泌物抗菌肽水平与急性期病情严重程度及反复喘息的相关性研究

单位：邯郸市妇幼保健院小儿呼吸科, 河北邯郸 056001

分类号：R725.6

出版年·卷·期（页码）：2022·41·第六期（824-830）

摘要：

目的: 分析毛细支气管炎患儿鼻分泌物抗菌肽水平与急性期病情严重程度及反复喘息的关系。方法: 选取2017年2月至2020年4月间我院101例毛细支气管炎患儿,采用化学发光微粒免疫法检测血清25-羟维生素D[25(OH)D]水平,酶联免疫吸附试验法检测β-防御素2(hBD2)和N端含有双亮氨酸的37个氨基酸残基的小分子肽(LL-37)水平。根据改良Wang氏毛细支气管炎严重程度评分及住院治疗时间来衡量患儿急性期疾病严重程度。结果: 患儿鼻分泌物LL-37水平与血清25(OH)D水平呈正相关(r＝0.257,P＝0.009),与住院时间、改良Wang评分呈负相关性(r＝-0.343、r＝-0.495,P＜0.001)。经Logistic回归分析,鼻分泌物LL-37水平为影响患儿发生反复喘息的独立临床因素(P＜0.001)。经受试者工作特征曲线分析,鼻分泌物LL-37和hBD2水平预测毛细支气管炎患儿反复喘息的曲线下面积为0.773(95%CI为0.669~0.876)和0.555(95%CI为0.410~0.699)。结论: 鼻分泌物LL-37低水平与毛细支气管炎患儿急性期疾病严重程度增加及反复喘息相关。

Objective: To analyze the relationship between the nasal secreted anti-microbial peptides and the severity of acute bronchiolitis and recurrent wheezing in children with bronchiolitis. Methods: A total of 101 children with bronchioles treated in our hospital from February 2017 to April 2020 were selected for analysis. Serum levels of 25-hydroxyvitamin D[25(OH)D] were determined by chemiluminescence microparticle immunoassay, and β-defensin-2(hBD2) and 37 amino acid residues with dileucine at the N-terminus(LL-37) were detected by enzyme linked immunosorbent assay. The severity of disease in acute stage was measured by modified Wang's bronchiolitis severity score and length of hospital stay. Results: The nasal secreted LL-37 level was positively correlated with the serum 25(OH)D level(r＝0.257, P＝0.009), and negatively correlated with the length of hospital stay and modified Wang score(r＝-0.343, r＝-0.495, P＜0.001). Logistic regression analysis showed that the nasal secreted LL-37 level was an independent clinical factor influencing the occurrence of recurrent wheezing(P＜0.001). Receiver operating characteristic curve showed that the area under the curve for predicting recurrent wheezing with nasal secreted LL-37 and hBD2 level was 0.773(95%CI 0.669-0.876) and 0.555(95%CI 0.410-0.699),respectively. Conclusion: The low level of LL-37 in nasal secretion is associated with increased severity of disease in acute stage and recurrent wheezing in children with bronchiolitis.

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