哮喘合并肺炎支原体感染患儿血清VCAM-1和RBP与γ干扰素及TARC变化

目的探讨哮喘(BA)合并肺炎支原体(MP)感染患儿血清血管细胞黏附分子-1(VCAM-1)、视黄醇结合蛋白(RBP)、γ干扰素(IFN-γ)、胸腺活化调节趋化因子(TARC)变化及与感染程度关系。方法选取舟山市普陀区人民医院BA合并MP感染患儿64例为感染组,同期单纯BA患儿40例为未感染组。Logistic回归模型、受试者工作特征曲线(ROC)分析血清VCAM-1、RBP、IFN-γ、TARC水平变化的价值。结果感染组血清VCAM-1、TARC水平高于未感染组,RBP、IFN-γ低于未感染组(均P<0.05);Logistic回归分析结果显示,血清VCAM-1、TARC是BA合并MP感染发病独立危险因素,RBP、IFN-γ是BA合并MP感染发病独立保护因素(均P<0.05);急性期重症、轻症、恢复期重症、轻症血清VCAM-1、TARC水平依次呈降低趋势,RBP、IFN-γ依次呈升高趋势(P<0.05);ROC曲线分析显示,IFN-γ曲线下面积为0.796大于VCAM-1、RBP、TARC,当RBP截断值>36.25时,敏感度为81.25%,特异度为55.00%。结论BA合并MP感染患儿存在血清VCAM-1、RBP、IFN-γ、TARC水平异常情况,且与感染严重程度关系密切,可为临床鉴别诊断、评估病情提供数据支持。

Changes of serum VCAM-1, RBP,interferon gamma,TARC in bronchial asthma children complicated with Mycoplasma pneumoniae infection

OBJECTIVE To explore the correlation between the changes of serum vascular cell adhesion molecule-1(VCAM-1),retinol binding protein(RBP),interferonγ(IFN-γ),thymus activation regulates chemokines(TARC)in bronchial asthma children complicated with Mycoplasma pneumoniae(MP)infection and the severity of infection.METHODS Totally 64 BA children complicated with MP infection who were treated in Putuo District People’s Hospital,Zhoushan City were assigned as the infection group,meanwhile,40 children with simple BA were set as the non-infection group.The values of changes of the serum VCAM-1,RBP,IFN-γand TARC were analyzed by means of logistic regression model and receiver operating characteristic(ROC)curve.RESULTS The levels of serum VCAM-1 and TARC of the infection group were significantly higher than those of the non-infection group,the levels of RBP and IFN-γof the infection group were significantly lower than those of the non-infection group(all P<0.05).The result of logistic regression analysis showed that the serum VCAM-1 and TARC were the independent protective factors for the MP infection in the children with BA(all P<0.05).The levels of serum VCAM-1 and TARC of the children with severe,mild infection in acute stat and the children with severe,mild infection in recovery stage showed downward trends,while the levels of RBP and IFN-γshowed upward trends(P<0.05).ROC curve analysis indicated that the area under curve of the IFN-γwas 0.796,greater than that of the VCAM-1,RBP and TARC,and the sensitivity and specificity were respectively 81.25%and 55.00%when the cutoff value of RBP was more than 36.25.CONCLUSION The BA children complicated with MP infection show abnormal levels of serum VCAM-1,RBP,IFN-γand TARC,which is closely associated with the severity of infection and may provide data support for clinical differential diagnosis and assessment of illness condition.