目的:探讨血清中性粒细胞胞外诱捕网(neutrophil extracellular traps, NETs)、白细胞介素-13(interleukin-13, IL-13)、辅助T细胞17/调节T细胞(T-helper 17 cells /regulatory T cells , Th17/Treg)与儿童哮喘急性发作的关系及临床意义。方法:选取西华县人民医院2019年9月-2021年7月就诊的哮喘患儿128例作为研究对象,根据疾病发作时期分为2个亚组(急性发作组75例、缓解期组53例),另选取64例同期健康体检儿童作为参照组,比较入院时三组NETs、IL-13、Th17/Treg水平及气道炎症指标如血清总免疫球蛋白E(IgE)、呼出气一氧化氮(fractional exhaled nitric ox, FeNO)、痰嗜酸粒细胞(phlegm eosinophils, PEOS)、血嗜酸粒细胞(blood eosinophils, BEOS),并分析血清NETs、IL-13、Th17/Treg与气道炎症的相关性及对哮喘患儿急性发作的预测价值。结果:入院时NETs、IL-13、Th17/Treg水平比较:急性发作组＞缓解期组＞参照组(P＜0.05);入院时IgE、FeNO、PEOS、BEOS水平比较:急性发作组＞缓解期组＞参照组(P＜0.05);经Pearson相关性分析可知,入院时血清NETs、IL-13、Th17/Treg水平变化与IgE、FeNO、PEOS、BEOS呈正相关(P＜0.05);入院时NETs、IL-13、Th17/Treg水平对哮喘患儿急性发作期预测AUC分别为0.864、0.838、0.789,联合预测AUC为0.928(P＜0.05)。结论:NETs、IL-13、Th17/Treg可用于评估预测哮喘患儿急性发作,为临床评估患儿病情、气道炎症状态提供依据,以制定相应干预措施。

Objective: To investigate the relationship between serum neutrophil extracellular traps (NETs), interleukin-13 (IL-13), T-helper 17 cells /regulatory T cells (Th17/Treg) and acute asthma exacerbation in children. Methods: A total of 128 children with asthma who were treated in Xihua County People's Hospital from September 2019 to July 2021 were selected as the research objects. All selected children were divided into two groups (75 cases in the acute attack group and 53 cases in the remission group) according to the period of asthma attack. 64 healthy children who underwent physical examination during the same period were selected as the reference group. The levels of NETs,IL-13,Th17/Treg and airway inflammation indexes (serum total immunoglobulin E, IgE), fractional exhaled nitric ox (FeNO), sputum eosinophils (EOS) and blood eosinophils (BEOSs) of the three groups were recorded and compared, and the correlation between serum NETs, IL-13, Th17/Treg and airway inflammation and their predictive value for acute exacerbation in children with asthma were analyzed. Results: Comparison of NETs, IL-13, Th17/Treg levels at admission showed that acute attack group ＞remission group ＞ reference group (P＜0.05). Comparison of IgE, FeNO, EOS, BEOS levels at admission showed that acute attack group ＞remission group ＞reference group (P＜0.05). Pearson correlation analysis showed that the changes of serum NETs, IL-13, Th17/Treg levels at admission were positively correlated with IgE, FeNO, EOS, and BEOS (P＜0.05). The predicted AUCs of IL-13 and Th17/Treg levels in the acute exacerbation period of children with asthma were 0.864, 0.838,and 0.789 respectively, and the combined predicted AUC was 0.928 (P＜0.05). Conclusion: NETs, IL-13 and Th17/Treg could be used to evaluate and predict acute exacerbation in children with asthma, which could provide a basis for clinical evaluation of children's disease and airway inflammation, and help clinicians make effective intervention measures.