分析毛细支气管炎患者胸腺基质淋巴细胞生成素的表达水平与发生复发性喘息的相关性。

选择2015年1月至2017年1月我院收治的151例毛细支气管炎患儿，根据治疗后1年内是否发生复发性喘息分为复发性喘息组(45例)，及对照组(106例)，并对两组患者的一般资料、呼吸窘迫评估工具(RDAI评分)及脉氧饱和度、细胞间黏附分子-1(ICAM-1)、尿白细胞三烯E4(尿LTE4)、血嗜酸性细胞阳离子蛋白(血ECP)及胸腺基质淋巴细胞生成素(TSLP)指标进行比较，并采用COX多因素分析对上述影响复发性喘息的危险因素进行分析，并应用受试者工作曲线(ROC)评估相关危险因素预测复发性喘息的诊断价值及诊断效能。

两组患者性别相比较无明显差异；复发性喘息组患者的年龄、出生体重及脉氧饱和度均明显低于对照组，住院天数、合并先天性心脏病患者的人数、RDAI评分、ICAM-1、尿LTE4、血ECP及TSLP均明显高于对照组(均P<0.05)；Cox回归分析示高RDAI评分及高ICAM-1、尿LTE4、血ECP、TSLP水平是复发性喘息的独立危险因素(HR＝1.323，1.008，1.003，1.051，1.125；均P<0.05)，而未合并先天性心脏病是保护因素(HR＝0.117；P<0.05)；ROC曲线示TSLP在预测复发性喘息方面具有较高的诊断效能(AUC＝0.844)，明显高于ECP、ICAM-1、尿LTE4、RDAI评分及合并先心病(Z＝3.143，2.683，3.173，3.251，5.532，均P<0.05)，其中，TSLP诊断的最佳截点为>54 ng/ml，此时其预测复发性喘息的敏感性为75.6%，特异性为84.0%。

患儿体内的TSLP水平在预测患儿是否出现复发性喘息方面，具有较高的诊断价值及诊断效能。

To analyze the correlation between the expression level of thymic stromal lymphopoietin and the recurrent wheezing in the children with bronchiolitis.

A total of 151 patients with bronchiolitis treated in our hospital from January 2015 to January 2017 were divided into a recurrent wheezing group (n=45 cases) and a control group (n=106 cases) based on whether recurrent wheezing occurred within 1 year after treatment. For all the patients, the general information, the respiratory distress assessment tool (RDAI score) and the pulse oxygen saturation, the intercellular adhesion molecule-1 (ICAM-1), urine leukotriene E4 (LTE4), the blood eosinophils cell cationic protein (blood ECP) and thymic stromal lymphopoietin (TSLP) were measured and compared. And Cox multivariate analysis was used to analyze the above-mentioned risk factors affecting recurrent wheezing, and the receiver operating characteristic curve (ROC curve) was applied to assess the diagnostic value and diagnostic efficacy of the related risk factors in predicting recurrent wheezing.

There was no significant difference in gender between the two groups. The age, birth weight, and pulse oxygen saturation of the patients with recurrent wheezing were significantly lower than those of the control group. The length of hospital stay, the number of patients with congenital heart disease, RDAI score, ICAM-1, urine LTE4, blood ECP and TSLP were significantly higher in the recurrent wheezing group than the control group (all P<0.05). Cox regression analysis showed that the higher RDAI score and the higher levels of ICAM-1, urine LTE4, blood ECP and TSLP levels were independent risk factors of recurrent wheezing (HR=1.323, 1.008, 1.003, 1.051, and 1.125, respectively, all P<0.05), and the uncomplicated congenital heart disease was a retaliatory factor (HR=0.117, P<0.05). The ROC curve showed that TSLP had a higher diagnostic efficacy in predicting relapse asthma (AUC=0.844), which was significantly higher than ECP, ICAM-1, urine LTE4, RDAI score and congenital heart disease (Z=3.143, 2.683, 3.173, 3.251, 5.532, respectively, all P<0.05). Among them, the optimal cut-off point for TSLP diagnosis was>54, and at this time point, the sensitivity of TSLP diagnosis in predicting recurrent wheezing was 75.6% and the specificity was 84.0%.

The TSLP level in children has a high diagnostic value and a predictive power in predicting whether children have recurrent wheezing.