血清14-3-3β蛋白联合呼出气一氧化氮及常规通气肺功能参数对儿童支气管哮喘的诊断效能

Diagnostic efficacy of serum 14-3-3β protein combined with fractional exhaled nitric oxide and conventional ventilatory lung function parameters for bronchial asthma in children

摘要:

目的 探讨血清14-3-3β蛋白联合呼出气一氧化氮（fractional exhaled nitric oxide, FeNO）及常规通气肺功能参数对儿童支气管哮喘（简称“哮喘”）的诊断效能。方法 前瞻性纳入136例初次诊断为哮喘且处于急性发作期的儿童为哮喘组，选择同期85例健康体检儿童为健康对照组，比较两组血清14-3-3β蛋白浓度的差异，分析血清14-3-3β蛋白与临床指标的相关性，评估14-3-3β蛋白联合FeNO及常规通气肺功能参数对儿童哮喘的诊断效能。结果 哮喘组血清14-3-3β蛋白浓度高于健康对照组（P<0.001）。血清14-3-3β蛋白与中性粒细胞百分比、血清总免疫球蛋白E呈正相关，与常规通气肺功能参数呈负相关（P<0.05）。联合指标交叉验证显示14-3-3β蛋白+FeNO+用力呼出75%肺活量的呼气流量占预测值百分比预测哮喘的曲线下面积为0.948，灵敏度和特异度分别为88.9%和93.7%，具有较好的诊断效能（P<0.001），模型的外推性最好。结论 血清14-3-3β蛋白联合FeNO、用力呼出75%肺活量的呼气流量占预测值百分比可以显著提高儿童哮喘的诊断效能。

Abstract:

Objective To explore the diagnostic efficacy of serum 14-3-3β protein combined with fractional exhaled nitric oxide (FeNO) and conventional ventilatory lung function parameters in diagnosing bronchial asthma (referred to as "asthma") in children.Methods A prospective study included 136 children initially diagnosed with asthma during an acute episode as the asthma group, and 85 healthy children undergoing routine health checks as the control group. The study compared the differences in serum 14-3-3β protein concentrations between the two groups, analyzed the correlation of serum 14-3-3β protein with clinical indices, and evaluated the diagnostic efficacy of combining 14-3-3β protein, FeNO, and conventional ventilatory lung function parameters for asthma in children.Results The concentration of serum 14-3-3β protein was higher in the asthma group than in the control group (P<0.001). Serum 14-3-3β protein showed a positive correlation with the percentage of neutrophils and total serum immunoglobulin E, and a negative correlation with conventional ventilatory lung function parameters (P<0.05). Cross-validation of combined indices showed that the combination of 14-3-3β protein, FeNO, and the percentage of predicted value of forced expiratory flow at 75% of lung volume had an area under the curve of 0.948 for predicting asthma, with a sensitivity and specificity of 88.9% and 93.7%, respectively, demonstrating good diagnostic efficacy (P<0.001). The model had the best extrapolation.Conclusions The combination of serum 14-3-3β protein, FeNO, and the percentage of predicted value of forced expiratory flow at 75% of lung volume can significantly improve the diagnostic efficacy for asthma in children. Citation:Chinese Journal of Contemporary Pediatrics, 2024, 26(7): 723-729