摘要
目的探讨血清转化生长因子-β1(TGF-β1)、叉头框蛋白M1(FOXM1)mRNA表达水平与支气管哮喘(BA)患儿气道重塑的影响。方法选取2020年8月至2021年9月我院收治的110例BA患儿作为本次研究对象,依据《儿童支气管哮喘诊断与防治指南(2016年版)》将110例BA患儿分为急性发作组(n=56)和临床缓解组(n=54)。对两组的血清TGF-β1、FOXM1 mRNA、气道重塑相关指标(T/D、WA)、肺功能相关指标(FEV1、FEV1/FVC)水平进行检测并比较。采用Pearson分析急性发作期BA患儿血清TGF-β1、FOXM1 mRNA水平和肺功能及气道重塑指标的相关性。通过多因素Logistic回归分析方法分析影响BA患儿急性发作的因素,建立风险评估模型,经受试者工作特征曲线(ROC)评估模型诊断效能。结果与临床缓解组相比较,急性发作组血清TGF-β1、FOXM1 mRNA水平和T/D、WA水平较高,FEV1、FEV1/FVC水平较低(P<0.05);Pearson分析结果表明,急性发作期BA患儿血清TGF-β1、FOXM1 mRNA水平和FEV1、FEV1/FVC水平呈负相关(r=-0.527、r=-0.496,r=-0.492,r=-0.486,P<0.05),与T/D、WA呈正相关(r=0.434,r=0.511,r=0.515,r=0.524,P<0.05);多因素Logistic回归分析结果显示,血清TGF-β1(P=0.029,OR=11.382)、FOXM1 mRNA(P=0.007,OR=3.200)、T/D(P=0.001,OR=3.019)、WA(P=0.004,OR=2.489)水平是BA患儿急性发作的独立影响因素;ROC曲线分析结果表明,上述四种指标联合检测的AUC值最高,为0.997,灵敏度、特异度分别为96.42%、92.85%。结论BA患儿的血清TGF-β1、FOXM1 mRNA表达水平和气道重塑有紧密关联,血清TGF-β1、FOXM1 mRNA水平的提升可在一定程度上引发气道重塑。同时血清TGF-β1、FOXM1 mRNA水平在评估BA患儿病情严重程度方面具有一定的临床应用价值。
Objective To investigate the serum transforming growth factor-β1(TGF-β1),fork head box protein M1(FOXM1)mRNA expression and airway remodeling in children with bronchial asthma(BA).Methods One hundred and ten children with BA admitted to our hospital from August 2020 to September 2021 were selected as the subjects of this study.According to the Guidelines for Diagnosis and Prevention of Children's Bronchial Asthma(2016 Edition),110 children with BA were divided into acute attack group(n=56)and clinical remission group(n=54).The levels of serum TGF-β1,FOXM1 mRNA,airway remodeling indexes(T/D,WA),and pulmonary function related indicators(FEV1,FEV1/FVC)were detected and compared between the two groups.Pearson was used to analyze the correlation between serum TGF-β1 and FOXM1 mRNA levels and lung function and airway remodeling indexes in children with acute exacerbation BA.The factors affecting the acute onset of children with BA were analyzed by multivariate Logistic regression analysis,a risk assessment model was established,and the diagnostic efficacy of the model was evaluated by the working characteristic curve(ROC)of the subject.Results Compared with the clinical remission group,in the acute attack group the serum TGF-β1,FOXM1 mRNA level and T/D,WA level were higher,FEV1,FEV1/FVC levels were lower(P<0.05);Pearson analysis showed that in children with BA during acute attack serum TGF-β1,FOXM1 mRNA level was negatively correlated with FEV1 and FEV1/FVC levels(r=-0.527,r=-0.496,r=-0.492,r=-0.486,P<0.05),and positively correlated with T/D and WA(r=0.434,r=0.511,r=0.515,r=0.524,P<0.05);Multivariate Logistic regression analysis showed that serum TGF-β1(P=0.029,OR=11.382),FOXM1 mRNA(P=0.007,OR=3.200),T/D(P=0.001,OR=3.019),and WA(P=0.004,OR=2.489)were independent influencing factors of acute attack in children with BA;The ROC curve analysis results showed that the AUC value of the above four indicators was the highest(0.997),and the sensitivity and specificity were 96.42%and 92.85%respectively.Conclusion Serum TG
作者
戴红霞
DAI Hongxia(Department of Pediatrics,Jiangsu Taizhou Third People's Hospital,Taizhou 225321,China)
出处
《中国医药指南》
2023年第15期45-48,共4页
Guide of China Medicine
