过敏性鼻炎患儿变应原特异性免疫治疗前后炎症因子表达谱变化及其意义

尚虹; 邵磊; 胡崇伟

doi:10.16766/j.cnki.issn.1674-4152.003681

过敏性鼻炎患儿变应原特异性免疫治疗前后炎症因子表达谱变化及其意义

doi: 10.16766/j.cnki.issn.1674-4152.003681

浙江省人民医院淳安分院儿科，浙江杭州 311700

基金项目:

浙江省医药卫生科技计划项目 2023XY014

详细信息

通讯作者:
邵磊，E-mail：493274791@qq.com

中图分类号: R729
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- 被引次数: 0
出版历程
- 收稿日期: 2024-01-02

Changes in inflammatory factors in children with allergic rhinitis before and after allergen-specific immunotherapy: expression spectrum and clinical significance

Department of Pediatrics, Chun'an Branch of Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 311700, China

摘要

摘要: 目的检测过敏性鼻炎患儿变应原皮下特异性免疫治疗(SCIT)前后炎症因子表达水平，并分析这些炎症因子在评估SCIT疗效中的应用价值。方法纳入2021年2月—2023年7月于浙江省人民医院淳安分院儿科接受标准SCIT的80例过敏性鼻炎(AR)患儿，根据疗效情况将其分为应答组(48例)和无应答组(32例)。对比2组患儿基线炎症因子水平，选取P＜0.05的变量构建单因素logistic回归模型，并绘制ROC曲线分析其预测SCIT应用于AR患儿的疗效。结果治疗后，80例患儿C反应蛋白(CRP)、白细胞介素(IL)-1β、IL-6及IL-13水平降低，肿瘤坏死因子-β(TNF-β)、IL-10及IL-33水平升高(P＜0.05)。应答组患儿基线IL-10及IL-33水平低于无应答组(P＜0.05)。单因素logistic回归分析显示，IL-10(OR=0.344)、IL-33(OR=0.963)是SCIT疗效的影响因素(P＜0.05)。ROC曲线结果显示，IL-10(AUC=0.836)、IL-33(AUC=0.833)预测SCIT疗效的价值较高。结论 AR患儿经SCIT治疗后, TNF-β、IL-10、IL-33水平上升，CRP、IL-1β、IL-6及IL-13水平下降；基线IL-10及IL-33水平对SCIT疗效有较好的预测价值。
- 过敏性鼻炎 /
- 变应原特异性免疫治疗 /
- 炎症因子 /
- 儿童
Abstract: Objective To detect the expression levels of inflammatory factors in children with allergic rhinitis before and after subcutaneous specific immunotherapy (SCIT) and to analyze the application value of these inflammatory factors in evaluating the efficacy of SCIT. Methods Eighty children with allergic rhinitis (AR) who received standard SCIT at the pediatric department of Chun'an Branch of Zhejiang Provincial People's Hospital from February 2021 to July 2023 were divided into a response group (n=48) and a non-response group (n=32) according to the curative effect. The baseline levels of inflammatory factors were compared between the two groups. The variables with P < 0.05 were selected for univariate logistic regression model, and the ROC curves were drawn to analyze the predictive effect of SCIT on AR children. Results After treatment, the levels of C-reactive protein (CRP), interleukin (IL)-1β, IL-6, and IL-13 decreased, while the levels of tumor necrosis factor-β (TNF-β), IL-10, and IL-33 increased (P < 0.05).The baseline levels of IL-10 and IL-33 in children in the response group were lower than those in the non-response group (P < 0.05). Univariate logistic regression analysis showed that IL-10 (OR=0.344) and IL-33 (OR=0.963) significantly affected SCIT outcomes (P < 0.05). ROC curve showed that IL-10 (AUC=0.836) and IL-33 (AUC=0.833) have good predictive value for SCIT efficacy. Conclusion After SCIT treatment, the levels of TNF-β, IL-10, and IL-33 increased, while the levels of CRP, IL-1β, IL-6, and IL-13 decreased. Baseline levels of IL-10 and IL-33 are valuable predictors of efficacy.
- Allergic rhinitis /
- Subcutaneous specific immunotherapy /
- Inflammatory factors /
- Children
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图 1 基线IL-10及IL-33水平预测SCIT疗效的ROC曲线

Figure 1. ROC curve of baseline IL-10 and IL-33 levels in predicting the efficacy of SCIT

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表 1 80例AR患儿治疗前后炎症因子水平比较(x±s)

Table 1. Comparison of levels of inflammatory factors before and after treatment in 80 children(x±s)

时间	CRP (mg/L)	TNF-β (pg/mL)	IL-1β (ng/L)	IL-6 (ng/L)	IL-10 (pg/mL)	IL-13 (ng/L)	IL-33 (ng/mL)
治疗前	22.76±2.03	14.26±3.20	14.69±2.16	17.66±2.19	6.72±1.85	45.20±7.69	97.65±13.24
治疗后	12.65±1.78	21.23±3.28	6.33±1.05	7.32±1.65	10.51±1.76	24.15±6.42	154.30±20.34
t值	35.576	13.907	32.573	36.822	13.307	20.071	21.243
P值	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

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表 2 应答组与无应答组AR患儿一般资料比较

Table 2. Comparison of general data of children in the response group and the non-response group

组别	例数		性别[例(%)]	年龄(x±s，岁)	病程(x±s，年)	BMI (x±s)	基线TNSS (x±s，分)	VAS (x±s，分)
组别	男	女	性别[例(%)]	年龄(x±s，岁)	病程(x±s，年)	BMI (x±s)	基线TNSS (x±s，分)	VAS (x±s，分)
应答组	48	22(45.83)	26(54.17)	9.20±2.75	2.14±0.97	20.14±2.06	9.32±3.05	7.12±2.05
无应答组	32	17(53.12)	15(46.88)	9.26±2.64	2.16±0.95	20.08±2.12	9.28±314	7.09±2.01
统计量		0.409^a		0.098^b	0.091^b	0.125^b	0.001^b	0.065^b
P值		0.523		0.922	0.927	0.901	0.999	0.948
注：^a为χ²值，^b为t值。

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表 3 应答组与无应答组AR患儿基线炎症因子水平比较(x±s)

Table 3. Comparison of baseline inflammatory factors between children in the response group and the non-response group(x±s)

组别	例数	CRP (mg/L)	TNF-β (pg/mL)	IL-1β (ng/L)	IL-6 (ng/L)	IL-10 (pg/mL)	IL-13 (ng/L)	IL-33 (ng/mL)
应答组	48	23.23±2.45	15.02±3.05	15.03±2.14	17.26±2.22	6.54±1.66	43.69±7.52	90.23±20.13
无应答组	32	22.43±2.18	14.01±2.97	14.26±2.14	17.81±2.25	8.23±2.02	46.23±7.41	116.20±22.30
t值		1.530	1.474	1.577	1.077	3.930	1.493	5.303
P值		0.131	0.145	0.120	0.286	＜0.001	0.140	＜0.001

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表 4 AR患儿SCITL疗效影响因素的单因素logistic回归分析

Table 4. Univariate logistic regression analysis of factors influencing SCITL efficacy in children with AR

变量	B	SE	Waldχ²	P值	OR值	95%CI
IL-10	-1.067	0.267	15.974	0.000	0.344	0.204~0.581
IL-33	-0.038	0.013	8.580	0.003	0.963	0.939~0.988

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表 5 基线IL-10及IL-33水平的准确性与预测值

Table 5. Accuracy and predictive value of baseline levels of IL-10 and IL-33

指标	AUC	95% CI	灵敏度(%)	特异度(%)
IL-10	0.836	0.737~0.910	72.92	87.50
IL-33	0.833	0.733~0.907	97.92	62.50

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