摘要
目的探讨抗中性粒细胞胞浆抗体(ANCA)对儿童闭塞性细支气管炎(BO)的临床意义。方法本研究为前瞻性研究。选取2009年6月至2014年10月在广州医科大学附属第一医院儿科住院诊断为BO的患儿59例(BO组)、同期的轻症支气管肺炎患儿43例(轻症肺炎组)、重症支气管肺炎患儿18例(重症肺炎组)以及正常体检儿童15名(正常对照组)。于患儿住院首日(入院时)及最后一日(出院时)(正常对照组于体检当天)使用酶联免疫吸附法检测其血清中髓过氧化物酶(MPO)-ANCA及蛋白酶3(PR3)-ANCA的抗体浓度,并计算其阳性率。结果入院时BO组的MPO-ANCA、PR3-ANCA的阳性率及滴度水平均明显高于轻症肺炎组、重症肺炎组及正常对照组(P值均<0.05),而轻症肺炎组、重症肺炎组与正常对照组的组间比较差异均无统计学意义。出院时BO组的MPO-ANCA、PR3-ANCA的阳性率及滴度水平仍明显高于轻症肺炎组与重症肺炎组(P值均<0.05),而轻症肺炎组与重症肺炎组的组间比较差异均无统计学意义。BO组、轻症肺炎组、重症肺炎组患儿入院时与出院时MPO-ANCA、PR3-ANCA阳性率与滴度水平的组内比较差异均无统计学意义。结论 BO患儿的MPO-ANCA及PR3-ANCA表达水平明显升高,提示ANCA的检测可能有助于儿童BO的诊断。
Objective To investigate the clinical significance of antineutrophil cytoplasmic antibody(ANCA)in children with bronchiolitis obliterans(BO).Methods In this prospective study,59 children with BO(BO group),43 children with mild bronchopneumonia(mild pneumonia group),18 children with severe bronchopneumonia(severe pneumonia group)and 15 children with normal physical examination(normal control group)in Department of Pediatrics,the First Affiliated Hospital of Guangzhou Medical University from June 2009 to October 2014 were included.Serum myeloperoxidase(MPO)-ANCA and proteinase-3(PR3)-ANCA levels were measured on the first day(at the time of admission)(the day of physical examination as to normal control group)and the last day of hospitalization(on discharge)by enzyme-linked immunosorbent assay,the positive rate was calculated.Results At the time of admission,the positive rates and titers of both MPO-ANCA and PR3-ANCA in the BO group were significantly higher than those in the mild pneumonia group,severe pneumonia group,and normal control group(all P<0.05),whereas there was no significant difference among the mild pneumonia group,the severe pneumonia group and the normal control group.The positive rates and titers of both MPO-ANCA and PR3-ANCA in the BO group on discharge were still significantly higher than those in the mild pneumonia group and the severe pneumonia group(all P<0.05),whereas there were no significant difference between the mild pneumonia group and the severe pneumonia group.The positive rates and titers of both MPO-ANCA and PR3-ANCA in all the patients were not significantly different between admission and discharge.Conclusions The expression levels of both MPO-ANCA and PR3-ANCA in the BO group are higher,suggesting that the detection of ANCA may be helpful in the diagnosis of children with BO.
作者
陈晓雯
吴上志
谢娜
刘文宽
林育能
陈涛
牛学锋
蔡勇
张亚文
陈德晖
Chen Xiaowen;Wu Shangzhi;Xie Na;Liu Wenkuan;Lin Yuneng;Chen Tao;Niu Xuefeng;Cai Yong;Zhang Yawen;Chen Dehui(Department of Pediatrics,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China;Hunan Provincial Meternal and Child Health Care Hospital,Changsha 410008,China;Guangzhou Institute of Respiratory Health,Guangzhou 510120,China)
出处
《国际呼吸杂志》
2021年第9期655-659,共5页
International Journal of Respiration
基金
国家自然科学基金面上项目(81770063)
广东省自然科学基金(S2012010008784)
广东省公益研究与能力建设专项资金项目(2014A020212356)
广州市科技创新项目(201504281719217)
呼吸疾病国家重点实验室开放课题(SKLRD2016OP005)。
关键词
抗体
抗中性白细胞胞质
细支气管炎
闭塞性
儿童
Antibodies,antineutrophil cytoplasmic
Bronchiolitis obliterans
Children
