| 陈 宇,金 芳,刘一勋,程 实,王凤革.YKL-40、CD4+/CD8+比值与腺病毒肺炎患儿炎性因子和并发喘息的关系研究[J].,2023,(10):1969-1973 |
| YKL-40、CD4+/CD8+比值与腺病毒肺炎患儿炎性因子和并发喘息的关系研究 |
| Relationship Study between YKL-40, CD4+/CD8+ Ratio with Inflammatory Factors and Concurrent Wheezing in Children with Adenovirus Pneumonia |
| 投稿时间：2022-10-13 修订日期：2022-11-06 |
| DOI：10.13241/j.cnki.pmb.2023.10.032 |
| 中文关键词: 腺病毒肺炎 壳多糖酶3样蛋白1 CD4+/CD8+比值 炎性因子 喘息 |
| 英文关键词: Adenovirus pneumonia Chitinase 3-like protein 1 CD4+/CD8+ ratio Inflammatory factor Wheezing |
| 基金项目:中国儿童健康医学专项基金（Z-2017-27-1701-01） |
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| 中文摘要: |
| 摘要 目的：探讨血清壳多糖酶3样蛋白1（YKL-40）、外周血CD4+/CD8+比值与腺病毒肺炎（AP）患儿炎性因子和并发喘息的关系。方法：选取2019年10月～2022年10月湖北省妇幼保健院收治的97例AP患儿为AP组，根据是否并发喘息分别为喘息组和无喘息组，另选取同期50例体检健康儿童为对照组。收集AP患儿的临床资料，采用酶联免疫吸附法检测血清YKL-40和炎性因子[白细胞介素（IL）-6、IL-8、肿瘤坏死因子-α（TNFα）]水平，流式细胞术检测外周血CD4+、CD8+比例并计算CD4+/CD8+比值。采用Spearman相关性分析AP患儿血清YKL-40、CD4+/CD8+比值与炎性因子水平的相关性，多因素Logistic回归分析AP患儿并发喘息的影响因素。结果：与对照组比较，AP组血清YKL-40、外周血CD8+比例升高，CD4+比例、CD4+/CD8+比值降低（P＜0.05）。AP组血清IL-6、IL-8、TNF-α水平高于对照组（P＜0.05）。Spearman相关性分析显示，AP患儿血清YKL-40与IL-6、IL-8、TNF-α水平呈正相关，外周血CD4+/CD8+比值与IL-6、IL-8、TNF-α水平呈负相关（P＜0.05）。97例AP患儿住院期间喘息发生率为50.52%（49/97）。多因素Logistic回归分析显示，呼吸衰竭、小气道病变、特应性体质和血清IL-6、IL-8、TNF-α、YKL-40升高为AP患儿并发喘息的独立危险因素，外周血CD4+/CD8+比值升高为独立保护因素（P＜0.05）。结论：AP患儿血清YKL-40水平升高和外周血CD4+/CD8+比值降低，与炎性因子水平升高和并发喘息密切相关。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between serum chitinase 3-like protein 1(YKL-40) and peripheral blood CD4+/CD8+ ratio with inflammatory factors and concurrent wheezing in children with adenoviral pneumonia (AP). Methods: 97 children with AP who were admitted to Hubei Provincial Maternal and Child Health Hospital from October 2019 to October 2022 were selected as the AP group. They were divided into wheezing group and non-wheezing group according to whether they were or not concurrent wheezing, and 50 healthy children in the same period were selected as the control group. Clinical data of children with AP were collected. Serum YKL-40 and inflammatory factors [interleukin (IL)-6, IL-8, tumor necrosis factor-α(TNF-α)] levels were measured by enzyme-linked immunosorbent assay, and peripheral blood CD4+ and CD8+ ratios were measured by flow cytometry and CD4+/CD8+ ratios were calculated. Spearman correlation was used to analyze the correlation between serum YKL-40, peripheral blood CD4+/CD8+ ratio and inflammatory factor levels in children with AP, and multi-factor logistic regression was used to analyze the factors influencing the complications of wheezing in children with AP. Results: Compared with the control group, serum YKL-40 and peripheral blood CD8+ ratio were increased and CD4+ ratio and CD4+/CD8+ ratio were decreased in the AP group (P<0.05). The levels of serum IL-6, IL-8, TNF-α in the AP group were higher than the control group (P<0.05). Spearman correlation analysis showed that serum YKL-40 was positively correlated with IL-6, IL-8 and TNF-α levels and the peripheral blood CD4+/CD8+ ratio was negatively correlated with IL-6, IL-8 and TNF-α levels in children with AP (P<0.05). The incidence rate of wheezing in 97 cases of children with AP during hospitalization was 50.52% (49/97). Multivariate Logistic regression analysis showed that respiratory failure, small airway lesions, atopic body mass and increased serum IL-6, IL-8, TNF-α and YKL-40 were independent risk factors for concurrent wheezing in children with AP, and increased peripheral blood CD4+/CD8+ ratio was an independent protective factor (P＜0.05). Conclusion: Increased serum YKL-40 levels and reduced peripheral blood CD4+/CD8+ ratios in children with AP are strongly associated with increased levels of inflammatory factors and concomitant wheezing. |
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