哮喘患儿体重指数与血清炎性因子水平对哮喘控制的影响

Effects of body mass index and serum inflammatory cytokines on asthma control in children with asthma

摘要:

目的 探讨哮喘患儿体重指数(BMI)及血清炎性因子水平对哮喘控制的影响。方法 依据BMI 结果将2013 年1 月至2014 年5 月收治的116 例哮喘患儿分为正常组(n=59)、消瘦组(n=31)与肥胖组(n=26),ELISA 法检测各组患儿白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平,免疫比浊法检测各组高敏C 反应蛋白(hs-CRP)水平。治疗4 周后采用儿童哮喘控制测试(C-ACT)评价各组患儿哮喘控制情况。结果 IL-6、hs-CRP 及TNF-α 在正常组、消瘦组及肥胖组水平依次增加(P<0.05),C-ACT 评分在正常组、消瘦组及肥胖组逐渐降低(P<0.05);正常组完全控制率、部分控制率与未控制率均显著优于消瘦组与肥胖组(P<0.05),但消瘦组与肥胖组间比较差异均无统计学意义(P>0.05);IL-6、hs-CRP 及TNF-α 与C-ACT 评分均呈负相关(P<0.05),C-ACT 评分、IL-6、hs-CRP、TNF-α 与BMI 均无相关性(P>0.05)。结论 BMI 过高或过低时,血清炎性因子水平均升高,不利于哮喘控制,哮喘患儿维持正常体重有利于降低血清炎性因子水平,提高哮喘控制率。

Abstract:

Objective To explore the effects of body mass index (BMI) and the levels of serum inflammatory cytokines on asthma control in children with asthma. Methods One hundred and sixteen children with asthma were divided into three groups: normal (n=59), thin (n=31), and obesity (n=26) based on their BMI. The levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were determined using ELISA, and the level of high-sensitivity C-reactive protein (hs-CRP) was measured by immunoturbidimetric assays. Asthma control status in each group was evaluated by the Childhood Asthma Control Test (C-ACT) after 4 weeks of treatment. Results The serum levels of IL-6, hs-CRP, and TNF-α were highest in the obesity group, followed by the thin group and the normal group (P<0.05), while the C-ACT score was highest in the normal group, followed by the thin group and obesity group (P<0.05). The normal group had significantly higher complete controlled and partially controlled rates than the thin and obesity groups (P<0.05); however, there were no significant differences between the thin and obesity groups (P>0.05). The levels of IL-6, hs-CRP, and TNF-α were negatively correlated with the C-ACT score (P<0.05). There were no significant correlations of BMI with the C-ACT score and levels of IL-6, hs-CRP, and TNF-α (P>0.05). Conclusions When BMI is too high or too low, the levels of serum inflammatory cytokines are all increased, which is harmful to asthma control. Maintaining a healthy weight in children with asthma may reduce the levels of serum inflammatory cytokines and improve the asthma control rate.