目的: 探讨毛细支气管炎患儿血清黏蛋白5AC(mucin 5AC, MUC5AC)、半胱氨酰白三烯(cysteinyl leukotrienes, CysLTs)、白细胞介素-35(interleukin-35, IL-35)水平的变化及临床意义,为临床早期制定干预治疗方案提供参考依据。方法: 选取2022年4月-2024年6月本院就诊的82例毛细支气管炎患儿作为研究组,另选取82例同期健康体检儿童作为对照组,比较两组及研究组中不同病情患儿血清MUC5AC、CysLTs、IL-35水平,分析血清MUC5AC、CysLTs、IL-35水平与病情相关性,并比较研究组中继发哮喘患儿入院时的血清MUC5AC、CysLTs、IL-35水平,分析血清MUC5AC、CysLTs、IL-35水平对毛细支气管炎患儿继发哮喘的影响及诊断价值。结果: 与对照组比较,研究组入院时血清MUC5AC、CysLTs水平较高,血清IL-35水平较低(P＜0.05);不同病情患儿入院时血清MUC5AC、CysLTs水平轻度组＜中度组＜重度组;血清IL-35水平轻度组＞中度组＞重度组(P＜0.05);经Spearman相关性分析结果显示,入院时血清MUC5AC、CysLTs水平与毛细支气管炎病情呈正相关(r=0.756、0.783,P＜0.05),血清IL-35水平与毛细支气管炎病情呈负相关(r=-0.725,P＜0.05);与未继发哮喘患儿比较,继发哮喘患儿入院时血清MUC5AC、CysLTs水平较高,IL-35水平较低(P＜0.05);血清MUC5AC、CysLTs水平均为毛细支气管炎患儿继发哮喘的危险因素,血清IL-35为毛细支气管炎患儿继发哮喘的保护因素(P＜0.05);入院时血清MUC5AC、CysLTs、IL-35水平对毛细支气管炎患儿继发哮喘的诊断AUC分别为0.795、0.832、0.856,联合诊断AUC为0.927。结论: 血清MUC5AC、CysLTs、IL-35水平与毛细支气管炎患儿病情程度密切相关,为临床早期评估病情及继发哮喘提供参考依据,以制定相应干预治疗方案,改善预后。

Objective: To explore the changes and clinical significance of serum mucin 5AC (MUC5AC), cysteinyl leukotrienes (CysLTs), and interleukin-35 (IL-35) levels in children with bronchiolitis, in order to provide reference for early clinical intervention. Methods: A total of 82 children with bronchiolitis who were treated in our hospital from April 2022 to June 2024 were selected as the study group, and 82 healthy children were selected as the control group. The levels of serum MUC5AC, CysLTs and IL-35 in the two groups and children with different disease severity were compared. The correlation between the levels of serum MUC5AC, CysLTs and IL-35 and the disease severity was analyzed. The levels of serum MUC5 AC, CysLTs and IL-35 in children with secondary asthma were compared. The effects and diagnostic value of serum MUC5AC, CysLTs and IL-35 levels on secondary asthma in children with bronchiolitis were analyzed. Results: Compared with the control group, the levels of serum MUC5AC and CysLTs in the study group were higher, and the level of serum IL-35 was lower (P＜0.05). Comparison of serum MUC5AC and CysLTs levels at admission in children with different disease severity: mild group＜moderate group＜severe group; comparison of serum IL-35 level: mild group>moderate group>severe group (P＜0.05). Spearman correlation analysis showed that the levels of serum MUC5AC and CysLTs at admission were positively correlated with the severity of bronchiolitis (r=0.756, 0.783, P＜0.05), and the level of serum IL-35 was negatively correlated with the severity of bronchiolitis (r=-0.725, P＜0.05). Compared with children without secondary asthma, the levels of serum MUC5AC and CysLTs were higher and the level of IL-35 was lower in children with secondary asthma on admission (P＜0.05). Serum MUC5AC and CysLTs levels were risk factors for secondary asthma in children with bronchiolitis, and serum IL-35 was a protective factor for secondary asthma in children with bronchiolitis (P＜0.05). The diagnostic AUC of serum MUC5AC, CysLTs and IL-35 levels at admission for secondary asthma in children with bronchiolitis was 0.795, 0.832 and 0.856, respectively, and the combined diagnostic AUC was 0.927. Conclusion: The levels of serum MUC5 AC, CysLTs and IL-35 are closely related to the severity of bronchiolitis in children, which provides a reference for early clinical evaluation of the disease and secondary asthma, so as to formulate corresponding intervention treatment plans and improve the prognosis.