急性支气管肺炎患儿EOS%、CCR3、Eotaxin与病情严重程度的关系

doi:10.3969/j.issn.1673-8640.2023.03.005

摘要/Abstract

摘要： 目的探究急性支气管肺炎患儿嗜酸性粒细胞百分比（EOS%）和血清CC趋化因子受体3（CCR3）、嗜酸性粒细胞趋化因子（Eotaxin）水平与疾病严重程度的关系。方法选取急性支气管肺炎患儿126例（支气管肺炎组），根据患儿入院时临床肺部感染评分（CPIS）细分为轻症组（81例，CPIS评分≤6分）和重症组（45例，CPIS评分>6分）；以同期体检健康儿童60名作为正常对照组。检测所有研究对象EOS%和血清CCR3、Eotaxin水平；检测所有患儿肺功能[潮气量（VT）、呼吸频率（RR）、达峰容积比（VPTEF/VE）、达峰时间比（TPTEF/TE）]。采用Pearson相关分析评估各项指标之间的相关性，采用受试者工作特征（ROC）曲线评估EOS%和血清CCR3、Eotaxin水平诊断重症急性支气管肺炎的效能。结果支气管肺炎组EOS%和血清CCR3、Eotaxin水平均显著高于正常对照组（P=0.000）。与轻症组比较，重症组血清CCR3、Eotaxin水平和EOS%、RR显著升高（P<0.01），VT、VPTEF/VE、TPTEF/TE显著降低（P<0.01）。急性支气管肺炎患儿EOS%、CCR3、Eotaxin与RR呈正相关（P<0.05），与VPTEF/VE、TPTEF/TE呈负相关（P<0.05），与VT无相关性（P>0.05）。ROC曲线分析结果显示，EOS%和血清CCR3、Eotaxin水平单项检测和联合检测诊断重症急性支气管肺炎的曲线下面积（AUC）分别为0.861、0.762、0.826、0.931。结论血清CCR3、Eotaxin和EOS%与急性支气管肺炎患儿病情严重程度密切相关，可在一定程度上反映肺功能状态，或可作为临床判断急性支气管肺炎病情发展的血清学指标。

关键词: 嗜酸性粒细胞百分比, CC趋化因子受体3, 嗜酸性粒细胞趋化因子, 急性支气管肺炎, 儿童

Abstract: Objective To investigate eosinophil percentage（EOS%），serum CC chemokine receptor 3（CCR3） and eotaxin of children with acute bronchopneumonia and their relationship with disease severity. Methods A total of 126 children with acute bronchopneumonia（bronchopneumonia group） were enrolled. According to the clinical pulmonary infection score（CPIS）of children with acute bronchopneumonia on admission，they were classified into mild group（81 cases，CPIS≤6）and severe group（45 cases，CPIS>6）. Totally，60 healthy children were enrolled as healthy control group. The EOS% and serum CCR3 and eotaxin levels of all the subjects were determined，the lung function indicators [tidal volume（VT），respiratory rate（RR），the ratio of volume to peak expiratory flow to total expiratory volume（VPTEF/VE）and the ratio of time to peak tidal expiratory flow to total expiratory time（TPTEF/TE）] of children with acute bronchopneumonia were determined. Pearson correlation analysis was used to evaluate the correlation between various indicators，and receiver operating characteristic（ROC） curve was used to evaluate the diagnostic values of EOS%，serum CCR3 and eotaxin levels in children with severe acute bronchopneumonia. Results The levels of EOS%，serum CCR3 and eotaxin in bronchopneumonia group were higher than those in healthy control group（P=0.000）. Compared with mild group，the levels of serum CCR3，eotaxin，EOS% and RR in severe group were higher（P<0.01），and VT，VPTEF/VE，TPTEF/TE were lower（P<0.01）. The levels of EOS%，serum CCR3 and eotaxin in children with acute bronchopneumonia were positively correlated with RR（P<0.05），and they were negatively correlated with VPTEF/VE and TPTEF/TE（P<0.05），but without VT（P>0.05）. ROC curve analysis results showed that the areas under curves（AUC）of single determinations and combined determination of EOS%，serum CCR3 and eotaxin levels for the diagnosis of severe acute bronchopneumonia were 0.861，0.762，0.826 and 0.931，respectively. Conclusions Serum CCR3，eotaxin and EOS% are related to the severity of acute bronchopneumonia in children，and they can reflect the status of lung function to a certain extent，or they can be used as serological indicators for clinical judgment of the development of acute bronchopneumonia.

Key words: Eosinophil percentage, CC chemokine receptor 3, Eotaxin, Acute bronchopneumonia in children

中图分类号:

R446.1

王雅玲, 黄运丽, 田密, 王顺兰, 肖莉. 急性支气管肺炎患儿EOS%、CCR3、Eotaxin与病情严重程度的关系[J]. 检验医学, 2023, 38(3): 230-234.

WANG Yaling, HUANG Yunli, TIAN Mi, WANG Shunlan, XIAO Li. Relationship between EOS%，CCR3，eotaxin and disease severity in children with acute bronchopneumonia[J]. Laboratory Medicine, 2023, 38(3): 230-234.

图/表 5

参考文献 17

[1]	高伟霞, 秦小菀, 刘阳, 等. 支气管哮喘患儿诱导痰中炎性细胞类型及炎症相关细胞因子的临床价值研究[J]. 检验医学, 2021, 36(1):69-74.
[2]	LEE E A, JOHNSON L R, JOHNSON E G, et al. Clinical features and radiographic findings in cats with eosinophilic,neutrophilic,and mixed airway inflammation(2011-2018)[J]. J Vet Intern Med, 2020, 34(3):1291-1299. DOI URL
[3]	AGHASAFARI P, GEORGE U, PIDAPARTI R. A review of inflammatory mechanism in airway diseases[J]. Inflamm Res, 2019, 68(1):59-74. DOI PMID
[4]	李小波, 张蓉映, 王斌梁, 等. 哮喘小鼠CD34-+祖细胞和嗜酸性粒细胞的动态变化及其与CCR3/eotaxin表达的关系[J]. 中华全科医学, 2019, 17(8):1261-1264.
[5]	李军文, 周芳. 婴幼儿喘息性疾病呼出气一氧化氮浓度与EOS、FEV1关系[J]. 临床肺科杂志, 2018, 23(5):794-797.
[6]	杨希, 焦蓉, 张闯. 哮喘患儿血清中IgE、Eotaxin含量检测及其临床意义[J]. 海南医学院学报, 2018, 24(23):2058-2061.
[7]	胡亚美, 江载芳, 申昆玲, 等. 诸福棠实用儿科学[M]. 8版. 北京: 人民卫生出版社, 2015.
[8]	CHEN C, YAN M, HU C, et al. Diagnostic efficacy of serum procalcitonin,C-reactive protein concentration and clinical pulmonary infection score in ventilator-associated pneumonia[J]. Med Sci(Paris), 2018, 34(F1):26-32.
[9]	DE GIACOMI F, VASSALLO R, YI E S, et al. Acute eosinophilic pneumonia. Causes,diagnosis,and management[J]. Am J Respir Crit Care Med, 2018, 197(6):728-736. DOI URL
[10]	MARTINEZ-GARCIA M A, FANER R, OSCULLO G, et al. Inhaled steroids,circulating eosinophils,chronic airway infection,and pneumonia risk in chronic obstructive pulmonary disease. A network analysis[J]. Am J Respir Crit Care Med, 2020, 201(9):1078-1085. DOI URL
[11]	SUZUKI Y, SUDA T. Eosinophilic pneumonia:a review of the previous literature,causes,diagnosis,and management[J]. Allergol Int, 2019, 68(4):413-419. DOI URL
[12]	YANG G, LIU J Q, MO L H, et al. Bcl 2 like protine-12(Bcl2L12) facilitates experimental airway allergic inflammation by inducing autocrine eotaxin in eosinophils[J]. Immunol Lett, 2020, 228:93-102. DOI URL
[13]	SATO H, NAKAJIMA N, HASEGAWA G, et al. Immunohistochemical differentiation of eosinophilic esophageal myositis from eosinophilic esophagitis[J]. J Gastroenterol Hepatol, 2017, 32(1):106-113.
[14]	徐凌云, 夏敏, 李亚琴, 等. 支气管哮喘患儿血清中的IL-10、IL-12、IFN-γ、Eotaxin水平检测及其临床意义[J]. 贵州医药, 2019, 43(11):1711-1713.
[15]	吴丙美, 杨雪冰, 李丹, 等. 呼出气一氧化氮外周血嗜酸性粒细胞及血清总IgE在儿童喘息性疾病诊断中的意义[J]. 西部医学, 2020, 32(1):65-68.
[16]	李春芳, 陈先红, 王珂. 探讨不同时期喘息性支气管肺炎患儿潮气呼吸功能检查的临床价值[J]. 吉林医学, 2020, 41(4):946-948.
[17]	张蕾, 艾涛, 廖惠玲, 等. 离线FeNO及潮气肺功能量化指标在<5岁儿童哮喘管理中的应用研究[J]. 国际呼吸杂志, 2021, 41(1):1-5.

组别	例数	EOS%/%	CCR3/（pg/mL）	Eotaxin/（pg/mL）
正常对照组	60	1.62±0.94	17.56±7.32	106.02±26.48
支气管肺炎组	126	4.17±0.76	32.84±9.37	194.81±43.76
t值		19.777	11.114	14.492
P值		0.000	0.000	0.000

组别	例数	EOS%/%	CCR3/（pg/mL）	Eotaxin/（pg/mL）
正常对照组	60	1.62±0.94	17.56±7.32	106.02±26.48
支气管肺炎组	126	4.17±0.76	32.84±9.37	194.81±43.76
t值		19.777	11.114	14.492
P值		0.000	0.000	0.000

组别	例数	EOS%/%	CCR3/ （pg/mL）	Eotaxin/ （pg/mL）	VT/ （mL/kg）	RR/ （次/min）	VPTEF/VE/%	TPTEF/ TE/%
轻症组	81	3.74±0.69	29.53±8.92	176.34±41.46	7.36±2.07	26.34±5.13	38.06±8.27	37.68±9.26
重症组	45	4.92±0.83	38.74±9.56	228.16±47.82	6.25±1.89	29.42±6.77	32.52±7.14	30.42±9.30
t值		8.545	5.412	6.360	2.973	2.873	3.778	4.210
P值		0.000	0.000	0.000	0.004	0.005	0.000	0.000

组别	例数	EOS%/%	CCR3/ （pg/mL）	Eotaxin/ （pg/mL）	VT/ （mL/kg）	RR/ （次/min）	VPTEF/VE/%	TPTEF/ TE/%
轻症组	81	3.74±0.69	29.53±8.92	176.34±41.46	7.36±2.07	26.34±5.13	38.06±8.27	37.68±9.26
重症组	45	4.92±0.83	38.74±9.56	228.16±47.82	6.25±1.89	29.42±6.77	32.52±7.14	30.42±9.30
t值		8.545	5.412	6.360	2.973	2.873	3.778	4.210
P值		0.000	0.000	0.000	0.004	0.005	0.000	0.000

指标	EOS%		CCR3		Eotaxin
指标	r值	P值	r值	P值	r值	P值
VT	-0.174	0.643	-0.234	0.481	-0.209	0.514
RR	0.416	0.000	0.449	0.000	0.431	0.000
VPTEF/VE	-0.462	0.000	-0.471	0.000	-0.439	0.000
TPTEF/TE	-0.397	0.000	-0.418	0.000	-0.477	0.000