[1]蒋筠斐,须　静,钟政荣.支气管哮喘患者外周血TIM4，IgG4及EOS水平表达与其肺功能、哮喘发病严重程度及预后的相关性研究[J].现代检验医学杂志,2021,36(05):148-152.[doi:10.3969/j.issn.1671-7414.2021.05.033]
　JIANG Yun-fei,XU Jing,ZHONG Zheng-rong.Correlation of Peripheral Blood TIM4, IgG4 and EOS ExpressionLevels with the Prognosis in Bronchial Asthma Patients[J].Journal of Modern Laboratory Medicine,2021,36(05):148-152.[doi:10.3969/j.issn.1671-7414.2021.05.033]
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支气管哮喘患者外周血TIM4，IgG4及EOS水平表达与其肺功能、哮喘发病严重程度及预后的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年05期
页码:
148-152
栏目:
检验与临床
出版日期:
2021-10-14

文章信息/Info

Title:
Correlation of Peripheral Blood TIM4, IgG4 and EOS ExpressionLevels with the Prognosis in Bronchial Asthma Patients
文章编号:
1671-7414（2021）05-148-05
作者:
蒋筠斐; 须　静; 钟政荣
( 上海交通大学医学院附属第九人民医院检验科，上海 201999)
Author(s):
JIANG Yun-fei;  XU Jing;  ZHONG Zheng-rong
（Department of Clinical Laboratory, the Ninth People’s Hospital of Shanghai City, Shanghai 201999, China）
关键词:
支气管哮喘; T细胞免疫球蛋白域及黏蛋白域蛋白4; 血清免疫球蛋白G4; 嗜酸性粒细胞
分类号:
R562.25；R392.11
DOI:
10.3969/j.issn.1671-7414.2021.05.033
文献标志码:
A
摘要:
目的　研究外周血T细胞免疫球蛋白域及黏蛋白域蛋白4（T cells immunoglobulin domain and mucin domain protein 4， TIM4）、血清免疫球蛋白G4（IgG4）及嗜酸性粒细胞（EOS）在支气管哮喘患者中的表达水平及其与患者预后的关系。方法　选取上海交通大学医学院附属第九人民医院2019.01~2020.06间收治的103例支气管哮喘患者纳为研究对象，分为急性组（急性发作期，n=66）和缓解组（哮喘缓解期，n=37），同时将30例健康志愿者纳为对照组。根据急性发作严重程度，将66例急性发作患者分为重度组、中度组及轻度组。分别比较急性组、缓解组、对照组及急性发作不同严重程度患者外周血TIM4，血清IgG4及EOS水平。分析外周血TIM4，血清IgG4及EOS水平与患者肺功能指标间的相关性。急性发作期患者出院后随访1年，统计急性组哮喘再次疾病发作情况，绘制ROC曲线，分析外周血TIM4，血清IgG4及EOS在预测哮喘急性发作患者预后中的价值。结果　对照组、缓解组及急性组外周血TIM4，血清IgG4及EOS水平呈依次升高趋势，且组间差异有统计学意义（F=309.753, 149.528和155.106，均P<0.001）；相关性分析提示，哮喘患者外周血TIM4，EOS与肺功能指标FEV1%pred间均呈负相关（r=-0.36,-0.33, 均P<0.05），IgG4与FEV1%pred及FEV1/FVC呈负相关（r=0.41, 0.46, 均P<0.05）；急性哮喘发作轻度组、中度组及重度组患者外周血TIM4及血清IgG4，EOS水平均呈依次上升趋势，组间差异均有显著统计学意义（F=39.175, 73.200, 25.564, P<0.001）；66例哮喘急性发作者中11例1年内再次急性复发，将其纳为预后不良组，统计发现，预后不良组外周血TIM4及血清IgG4，EOS 水平分别为1.49±0.26 ng/ml，1.33±0.35 g/L和（0.55±0.16）×109/L，均显著高于预后良好组[1.02±0.37 ng/ml，0.86±0.22 g/L和（0.38±0.17）×109/L]，差异均有统计学意义（t=4.008, 5.810和3.055, 均P<0.05）。绘制ROC曲线发现，外周血TIM4，IgG4及EOS在预测哮喘急性发作者预后中均具有一定价值，各指标单独应用时，TIM4预测效能最高（AUC=0.802，95%CI：0.635~0.975），预测灵敏度及特异度分别为72.7%，85.5%。联合预测因子预测效能最高（AUC=0.944，95%CI：0.890~0.998），预测灵敏度及特异度分别为90.9%和89.1% 。结论　哮喘患者外周血TIM4，IgG4及EOS浓度异常升高，外周血TIM4，IgG4及EOS浓度不仅可有效反映哮喘患者病情，还可预测患者后期急性复发风险。
Abstract:
Objective　To investigate the correlation of peripheral blood TIM4, serum immunoglobulin G4 (IgG4) andeosinophils (EOS) expression levels with the prognosis in bronchial asthma patients. Methods　A total of 103 patients withbronchial asthma in the Ninth People’s of Shanghai City from January 2019 to June 2020 were enrolled, and divided into twogroups according to the different disease stages, acute group (n=66) and remission group (n=37). Meanwhile, another 30 healthyindividuals were set as control group. Based on the severity of the acute attack, acute group was further divided into threesubgroups, severe group, moderate group and mild group. Levels of peripheral blood TIM4, serum IgG4 and EOS were comparedwithin groups and subgroups. Correlation between the levels of three indicators and lung function indicators was analyzed.Patients in acute group were followed up for 1 year after discharge, and the recurrence rate of asthma in acute group wasrecorded. ROC curve was used to analyze the value of peripheral blood TIM4, serum IgG4 and EOS in predicting the prognosisof patients with acute asthma attacks. Results　Peripheral blood TIM4, serum IgG4 and EOS levels among three groups were thehighest in acute group, followed by remission group, and were the lowest in control group, the differences were statisticallysignificant (F=309.753,149.528 and 155.106, all P<0.001). Correlation analysis showed that peripheral blood TIM4 and EOS were negatively correlated lung function index FEV1%pred (r=-0.36, -0.33, all P<0.05), and IgG4 was negatively correlatedwith FEV1%pred and FEV1/FVC (r=0.41, 0.46, all P<0.05). Peripheral blood TIM4, serum IgG4 and EOS levels showedsignificant difference among three subgroups, which were the highest in severe group, followed by moderate group, and were thelowest in mild group, the differences were statistically significant (F=39.175, 73.200 and 25.564, all P<0.001). One-year followupresults found that a total of 11 patients in acute group relapsed and were classified into poor prognosis group. The levels ofTIM4, IgG4 and EOS in peripheral blood of poor prognosis group were 1.49±0.26 ng/ml, 1.33±0.35g/L and (0.55±0.16)×109/L, which significantly higher than 1.02±0.37 ng/ml, 0.86±0.22 g/L and (0.38±0.17)×109/L of good prognosis group,thedifferences were statistically signnificant (t=4.008, 5.810 and 3.055, all P<0.05). ROC curve found that peripheral blood TIM4,IgG4 and EOS had certain efficacy in predicting the prognosis of acute asthma. In the single detection of three indicators, TIM4had the highest diagnostic efficacy, with AUC, sensitivity and specificity of 0.802, 95%CI:0.635~0.975, 72.7% and 85.5%respectively. Meanwhile, the diagnostic efficacy of combined detection was significantly higher than that of single detection, withAUC, sensitivity and specificity of 0.944, 95%CI: 0.890~0.998, 90.9% and 89.1%, respectively. Conclusion　Levels of TIM4,IgG4 and EOS in peripheral blood of asthma patients are abnormally increased, and the three indicators can be used to reflect thecondition of asthma patients, and predict the risk of recurrence after discharge.

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备注/Memo

备注/Memo:
作者简介：蒋筠斐（1980-），女，本科，主管技师，研究方向：临床生物化学检验，E-mail:snailsky1980@163.com。
通讯作者：钟政荣（1972-），男，博士研究生，副主任技师，研究方向：病原微生物感染与免疫。
更新日期/Last Update: 1900-01-01