反复肺炎患儿血清YKL-40与体液免疫功能的变化及意义

Changes in serum YKL-40 level and humoral immune function and their significance in children with recurrent pneumonia

摘要:

目的 研究反复肺炎患儿血清YKL-40与体液免疫功能的变化及意义。方法 收集30例反复肺炎患儿（反复肺炎组）、30例急性肺炎患儿（急性肺炎组）、30例健康体检儿童（对照组）的血标本，采用酶联免疫吸附法检测各组血清YKL-40浓度。并进行血清YKL-40与体液免疫相关实验室指标的相关性分析。利用受试者工作特征（ROC）曲线分析血清YKL-40对反复肺炎的诊断价值。结果 反复肺炎组血清YKL-40浓度高于急性肺炎组及对照组（P < 0.05），急性肺炎组血清YKL-40浓度高于对照组（P < 0.05）。反复肺炎组血清IgG和补体C4水平均低于急性肺炎组（P < 0.05）。血清YKL-40浓度与IgG水平呈负相关（r_s=-0.309，P=0.047），与补体C4水平亦呈负相关（r=-0.324，P=0.039）。血清YKL-40诊断反复肺炎的ROC曲线下面积为0.958（95% CI：0.921~0.994）。结论 反复肺炎患儿体液免疫功能降低；血清YKL-40可能参与了反复肺炎的发生，并可作为反复肺炎诊断的参考指标。

Abstract:

Objective To investigate the changes in serum YKL-40 level and humoral immune function and their significance in children with recurrent pneumonia. Methods Blood samples were collected from 30 children with recurrent pneumonia (recurrent pneumonia group), 30 children with acute pneumonia (acute pneumonia group), and 30 healthy children (control group). Serum YKL-40 levels were measured by enzyme-linked immunosorbent assay. The correlation between serum YKL-40 level and laboratory indices related to humoral immune function was analyzed. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of serum YKL-40 level for recurrent pneumonia. Results The recurrent pneumonia group had a significantly higher serum YKL-40 level than the acute pneumonia and control groups (P < 0.05). The acute pneumonia group had a significantly higher serum YKL-40 level than the control group (P < 0.05). Serum levels of IgG and complement 4 in the recurrent pneumonia group were significantly lower than in the acute pneumonia group (P < 0.05). Serum YKL-40 level was negatively correlated with serum IgG level (r_s=-0.309, P=0.047) and serum complement 4 level (r=-0.324, P=0.039). The area under the ROC curve of serum YKL-40 level for diagnosing recurrent pneumonia was 0.958 (95%CI:0.921-0.994). Conclusions Humoral immune function is low in children with recurrent pneumonia. Serum YKL-40 may be involved in the occurrence of recurrent pneumonia and can be used as a reference index for diagnosing recurrent pneumonia.