目的:分析支气管哮喘(bronchial asthma,BA)患儿外周血清中血清协同刺激因子B7-H3(costimlatory molecules B7-H3)水平变化,及其与Th17型细胞因子白介素17(inerleukin 17,IL-17)表达水平的相关性,探讨B7-H3在儿童BA中的临床意义。方法:选取2021年6月至2022年12月就诊的BA患儿72例,其中急性发作期(acute attack,AA)组患儿32例、临床缓解期(clinical remission,CR)组患儿40例,同时随机选取接受健康体检的儿童33例为健康对照(healthy controls,HC)组,检测3组儿童的血清共刺激因子B7-H3、IL-17的表达水平。结果:3组儿童的一般资料比较,差异无统计学意义(P＞0.05);3组间血清B7-H3、IL-17表达水平差异具有统计学意义(P＜0.05),将各组进行两两比较发现,BA组B7-H3及IL-17水平均高于HC组,AA组高于CR组(P＜0.05);BA组患儿外周血清中B7-H3、IL-17呈正相关(r=0.843,P＜0.05);从所绘制的ROC曲线得知,B7-H3 AUC为0.710,最佳截断值为20.67 ng/mL,诊断BA的敏感度及特异度分别为70.80 %、63.60 %,95 % CI为(0.609-0.811);IL-17 AUC为0.756,最佳截断值为47.40 pg/mL,敏感度及特异度分别为72.20 %、69.70 %,95 % CI为(0.663,0.849);两因子联合检测的AUC为0.754,灵敏度及特异度分别为80.60 %、63.60 %,95 % CI为(0.661-0.847)。结论:B7-H3及IL-17参与BA的发生发展,亦与BA的严重程度相关,他们可能共同参与了BA的炎症反应、气道重塑与肺功能损伤,B7-H3、IL-17及两者联合检测均对BA具有较好的诊断效能,对儿童BA的识别及治疗指导具有一定的临床价值。
Objective: To analyze the changes of serum co-stimulatory molecules B7-H3 level in peripheral serum of children with bronchial asthma (BA) and its correlation with the expression level of Th17 cytokine interleukin 17 (IL-17), and to explore the clinical significance of B7-H3 in children with BA. Methods: From June 2021 to December 2022, 72 children with BA were selected, including 32 children in acute attack (AA) group and 40 children in clinical remission (CR) group. At the same time, 33 children who received physical examination were randomly selected as healthy controls ( HC ) group. The expression levels of serum co-stimulatory factors B7-H3 and IL-17 in the three groups were detected. Results: There was no significant difference in the general data among the three groups (P＞0.05). There were significant differences in the expression levels of serum B7-H3 and IL-17 among the three groups (P＜0.05), while the levels of B7-H3 and IL-17 in BA group were higher than those in HC group, and those in AA group were higher than those in CR group (P＜0.05). There was a positive correlation between B7-H3 and IL-17 in peripheral serum of BA group (r=0.843, P＜0.05). According to the ROC curve drawn, the AUC of B7-H3 was 0.710, the optimal cut-off value was 20.67 ng/mL, the sensitivity and specificity for the diagnosis of BA were 70.80 % and 63.60 %, respectively, and the 95 % CI was (0.609-0.811). The AUC of IL-17 was 0.756, the optimal cut-off value was 47.40 pg/mL, the sensitivity and specificity were 72.20 % and 69.70 %, 95 %CI was (0.663,0.849). The AUC of the combined detection of the two factors was 0.754, the sensitivity and specificity were 80.60 % and 63.60 %, respectively, and the 95 %CI was (0.661-0.847). Conclusion: B7-H3 and IL-17 are involved in the occurrence and development of BA, and are also related to the severity of BA.They may be involved in the inflammatory response, airway remodeling and lung function injury of BA.B7-H3, IL-17 and their combined detection have good diagnostic efficacy for BA, and have certain clinical value for the identification and treatment guidance of BA in children.
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