支气管哮喘患儿血清Rac1水平变化及临床意义

王亚南; 戴倩倩; 茹凉

doi:10.16766/j.cnki.issn.1674-4152.002971

支气管哮喘患儿血清Rac1水平变化及临床意义

doi: 10.16766/j.cnki.issn.1674-4152.002971

新疆医科大学第一附属医院儿科，新疆乌鲁木齐 830000

基金项目:

新疆维吾尔自治区自然科学基金项目 2019D01C310

详细信息

通讯作者:
茹凉，E-mail: 18997953070@163.com

中图分类号: R562.25 R725.6
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出版历程
- 收稿日期: 2022-11-17

The changes and clinical significance of serum Rac1 levels in children with bronchial asthma

Department of Pediatrics of the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830000, China

摘要

摘要: 目的通过检测支气管哮喘患儿血清Ras相关的C3肉毒素底物1(Rac1)水平变化，探讨其与患儿病情严重程度及预后的关系。方法选择2019年1月—2022年1月新疆医科大学第一附属医院收治的支气管哮喘患儿150例为观察组，根据病情严重程度分为轻度组(49例)、中度组(59例)、重度组(42例)，以健康儿童80例为对照组，采用RT-PCR法检测受检者血清单个核细胞Rac1 mRNA水平，采用Pearson分析Rac1 mRNA与患儿气道炎症反应及肺功能的相关性，采用logistic回归分析研究支气管哮喘患儿预后的危险因素。结果轻度组(0.14±0.03)、中度组(0.07±0.02)、重度组(0.06±0.03)的Rac1 mRNA均低于对照组(0.16±0.03)，t=3.675、19.990、17.493，均P＜0.05；Rac1 mRNA与哮喘患儿白介素-25(IL-25)、白介素-33(IL-33)、呼出气一氧化氮(FeNO)、免疫球蛋白E(IgE)呈明显负相关关系(r=-0.620、-0.691、-0.660、-0.634，均P＜0.01)，与第1秒用力呼气流量(FEV₁)、FEV₁/用力肺活量(FVC)、呼气流量峰值(PEF)呈明显正相关关系(r=0.648、0.582、0.522，均P＜0.01)。Rac1 mRNA高水平为影响哮喘患儿预后的保护因素(OR=0.753, 95% CI：0.647~0.877，P＜0.001)。结论支气管哮喘患儿血清Rac1水平较低，与气道炎症反应、肺功能下降相关。
- 支气管哮喘 /
- 气道炎症反应 /
- 肺功能 /
- C3肉毒素底物1 /
- 相关性
Abstract: Objective Through detecting the changes of serum Ras-related C3 botulinum toxin substrate 1 (Rac1) levels in children with bronchial asthma, the relationship between them and the severity and prognosis of the children ' s disease was investigated. Methods One hundred and fifty children with bronchial asthma admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2019 to January 2022 were selected as the observation group and divided into mild (49 cases), moderate (59 cases) and severe (42 cases) groups according to the severity of disease. Another 80 healthy children were selected as the control group. The Rac1 mRNA of serum monocyte cells was detected by RT-PCR. The correlation between Rac1 mRNA and the airway inflammatory response and lung function of the children was analyzed by Pearson, and the risk factors for the prognosis of children with bronchial asthma were analyzed by logistic regression. Results The Rac1 mRNA was lower in the mild (0.14±0.03), moderate (0.07±0.02) and severe (0.06±0.03) groups than that in the control group (0.16±0.03), t=3.675, 19.990, 17.493, all P < 0.05; Rac1 mRNA was significantly negatively correlated with IL-25, IL-33, fractional exhaled nitric oxide (FeNO), IgE (r=-0.620, -0.691, -0.660, -0.634, all P < 0.01) and positively correlated with the forced expiratory volume in one second (FEV₁), FEV₁/forced vital capacity (FVC), peak expiratory flow (PEF) in children with asthma (r=0.648, 0.582, 0.522, all P < 0.01). High level of Rac1 mRNA was a protective factor affecting the prognosis of children with asthma (OR=0.753, 95%CI: 0.647-0.877, P < 0.001). Conclusion Lower serum Rac1 levels in children with bronchial asthma are associated with airway inflammatory response and decreased lung function.
- Bronchial asthma /
- Airway inflammatory response /
- Lung function /
- C3 botulinum toxin substrate 1 /
- Correlation
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表 1 不同病情严重程度哮喘患儿血清学指标比较(x ±s)

Table 1. Comparison of serological indexes in children with asthma of different severities(x ±s)

组别	例数	Rac1 mRNA	IL-25(ng/L)	IL-33(ng/L)	FeNO(μg/m³)	IgE(ng/mL)	FEV₁(%)	FVC(%)	FEV₁/FVC	PEF(%)
对照组	80	0.16±0.03	39.13±10.82	382.42±65.33	17.82±4.33	87.25±9.93	86.26±3.45	95.68±3.28	90.15±6.35	87.45±15.63
轻度组	49	0.14±0.03^a	51.23±10.56^a	403.65±75.13^a	26.25±6.18^a	109.26±11.45^a	78.26±5.23^a	93.00±4.35^a	84.15±3.88^a	68.41±5.23^a
中度组	59	0.07±0.02^ab	66.32±7.40^ab	625.23±80.15^ab	36.26±5.74^ab	133.52±12.16^ab	67.25±3.41^ab	88.85±2.58^ab	75.69±4.20^ab	57.26±6.02^ab
重度组	42	0.06±0.03^abc	77.16±11.42^abc	806.45±142.06^abc	41.72±5.79^abc	176.32±18.45^abc	53.51±3.50^abc	85.80±4.25^abc	62.36±6.45^abc	45.52±3.98^abc
F值		130.850	82.390	185.620	81.950	263.410	109.170	71.460	230.610	214.510
P值		＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001
注：与对照组比较，^aP＜0.05；与轻度组比较，^bP＜0.05；与中度组比较，^cP＜0.05。

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表 2 Rac1 mRNA与哮喘患儿气道炎症反应及肺功能指标相关性分析

Table 2. Correlation analysis of Rac1 mRNA with airway inflammatory reaction and lung function index in children with asthma

指标		Rac1 mRNA
指标		r值	P值
气道炎症反应	IL-25	-0.620	＜0.001
	IL-33	-0.691	＜0.001
	FeNO	-0.660	＜0.001
	IgE	-0.634	＜0.001
肺功能指标	FEV₁	0.648	＜0.001
	FVC	0.574	＜0.001
	FEV₁/FVC	0.582	＜0.001
	PEF	0.522	＜0.001

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表 3 不同预后哮喘患儿血清学指标比较(x ±s)

Table 3. Comparison of serological indexes in children with different prognosis(x ±s)

组别	例数	Rac1 mRNA	IL-25(ng/L)	IL-33(ng/L)	FeNO(μg/m³)	IgE(ng/mL)
完全控制组	63	0.15±0.04	48.26±12.33	415.23±79.49	32.62±7.80	105.62±13.52
部分控制组	46	0.09±0.03^a	66.25±7.10^a	643.20±71.26^a	40.85±6.09^a	140.20±11.59^a
未控制组	41	0.05±0.02^ab	82.33±11.58^ab	852.36±105.14^ab	45.26±6.20^ab	170.38±20.49^ab
F值		123.620	127.080	335.150	45.330	229.660
P值		＜0.001	＜0.001	＜0.001	＜0.001	＜0.001
注：与完全控制组比较，^aP＜0.05；与部分控制组比较，^bP＜0.05。

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表 4 变量赋值情况

Table 4. Assignment of independent variables

变量	赋值方法
Rac1 mRNA	≥0.14=1, ＜0.14=2
IL-25	＜53.26 ng/L=1, ≥53.26 ng/L=2
IL-33	＜498.74 ng/L=1, ≥498.74 ng/L=2
FeNO	＜40.59 μg/m³=1, ≥40.59 μg/m³=2
IgE	＜119.25 ng/mL=1, ≥119.25 ng/mL=2
预后	完全控制=1，未完全控制=2

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表 5 影响哮喘患儿预后的多因素logistic回归分析

Table 5. Multivariate logistic regression analysis of risk factors affecting the prognosis of children with asthma

变量	B	SE	Wald χ²	P值	OR值	95% CI
Rac1 mRNA	-0.283	0.078	13.241	＜0.001	0.753	0.647~0.877
IL-25	0.720	0.263	7.337	0.007	2.054	1.125~3.456
IL-33	0.528	0.156	11.407	0.001	1.696	1.248~2.340
FeNO	0.836	0.277	9.108	0.003	2.308	1.341~3.972
IgE	0.339	0.151	5.052	0.025	1.403	1.032~1.889

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