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中华肺部疾病杂志(电子版)

中华肺部疾病杂志(电子版) ›› 2025, Vol. 18 ›› Issue (06) : 996 -1001. doi: 10.3877/cma.j.issn.1674-6902.2025.06.024

论著

过敏性哮喘患儿C-ACT、骨膜蛋白和TSLP及ECP与病情严重程度的相关性
魏晓琼, 刘青, 于丽娟, 谭志红, 和岚, 常艳美, 和勇†()   
  1. 100089　北京，北京市海淀医院儿科
  • 收稿日期:2025-07-10 出版日期:2025-12-25
  • 通信作者: 和勇
  • 基金资助:
    北京市海淀医院青年项目(KYQ2022017)

Correlation between asthma control test, periostin, thymic matrix lymphoietin and eosinophilic cationic protein and the severity of the disease in children with allergic asthma

Xiaoqiong Wei, Qing Liu, Lijuan Yu, Zhihong Tan, Lan He, Yanmei Chang, Yong He†()   

  1. Pediatrics Department, Haidian Hospital, Beijing 100089, China
  • Received:2025-07-10 Published:2025-12-25
  • Corresponding author: Yong He
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魏晓琼, 刘青, 于丽娟, 谭志红, 和岚, 常艳美, 和勇. 过敏性哮喘患儿C-ACT、骨膜蛋白和TSLP及ECP与病情严重程度的相关性[J/OL]. 中华肺部疾病杂志(电子版), 2025, 18(06): 996-1001.

Xiaoqiong Wei, Qing Liu, Lijuan Yu, Zhihong Tan, Lan He, Yanmei Chang, Yong He. Correlation between asthma control test, periostin, thymic matrix lymphoietin and eosinophilic cationic protein and the severity of the disease in children with allergic asthma[J/OL]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(06): 996-1001.

目的

探讨过敏性哮喘患儿儿童哮喘控制测试(children′s asthma control test, C-ACT)评分、血清骨膜蛋白、胸腺基质淋巴生成素(thymic stromal lymphopoietin, TSLP)及嗜酸细胞阳离子蛋白(eosinophil cationic protein, ECP)水平与病情严重程度的相关性。

方法

选取2023年3月至2025年4月我院收治的过敏性哮喘患儿105例为对象。根据第1秒用力呼气容积占预计值百分比(percentage of forced expiratory volume in the first second, FEV1%)分为对照组70例(FEV1%≥60%)和观察组35例(FEV1%<60%)。对比两组临床特征、病情及呼吸功能特征、C-ACT评分、血清学指标，通过Pearson及多因素Logistic回归分析相关性。

结果

观察组合并过敏史28例(80.00%)、呼吸频率(29.74±1.39)次/min、血清骨膜蛋白(19.49±6.46)ng/ml、TSLP(42.59±9.48)pg/ml、ECP(19.08±6.08)μg/L高于对照组合并过敏史35例(50.00%)、呼吸频率(29.33±1.31)次/min、血清骨膜蛋白(16.81±4.84)ng/ml、TSLP (37.53±10.04)pg/ml、ECP (16.80±4.11)μg/L(P<0.05)；观察组FEV1%(50.49±2.91)、C-ACT评分(18.79±2.19)分低于对照组FEV1%(76.99±4.75)、C-ACT评分(19.98±2.36)分(P<0.05)。Pearson分析显示，两组FEV1%与C-ACT评分呈正相关(r＝0.634、0.586、0.721，P<0.001)，与血清骨膜蛋白(r＝－0.578、－0.509、－0.614)、TSLP(r＝－0.592、－0.531、－0.663)、ECP(r＝－0.601、－0.527、－0.756)呈负相关(P<0.001)。多因素Logistic回归显示，C-ACT评分较低(OR＝0.755，95%CI：0.653~0.873)、血清骨膜蛋白(OR＝1.083，95%CI：1.016~1.153)、TSLP(OR＝1.065，95%CI：1.029~1.102)、ECP(OR＝1.091，95%CI：1.016~1.171)水平较高与病情严重密切相关(P<0.05)。

结论

过敏性哮喘患儿C-ACT评分与病情严重程度呈负相关，血清骨膜蛋白、TSLP、ECP水平与病情严重程度呈正相关。

关键词: 过敏性哮喘, 儿童哮喘控制测试, 骨膜蛋白, 胸腺基质淋巴生成素, 嗜酸细胞阳离子蛋白
Objective

To investigate the correlation of the Children′s Asthma Control Test (C-ACT) score, serum periostin, thymic stromal lymphopoietin (TSLP), eosinophil cationic protein (ECP) levels and the severity of illness in children with allergic asthma.

Methods

A total of 105 children with allergic asthma admitted to our hospital from March 2023 to April 2025 were selected as subjects. They were divided into a control group (70 cases, FEV1% ≥ 60%) and an observation group (35 cases, FEV1%<60%) based on the percentage of forced expiratory volume in the first second (FEV1%) of predicted value. The basic clinical characteristics, disease and respiratory function characteristics, C-ACT scores, and serological indicators were compared between the two groups. Correlation was analyzed using Pearson correlation and multivariate logistic regression.

Results

The observation group had higher proportions of combined allergy history (82.9% vs. 34.3%), respiratory rate (29.74±1.39) breaths/min vs. (29.33±1.31) breaths/min, serum periostin (19.49±6.46) ng/ml vs. (16.81±4.84) ng/ml, TSLP(42.59±9.48) pg/ml vs. (37.53±10.04) pg/ml, and ECP (19.08±6.08) μg/L vs. (16.80±4.11) μg/L compared to the control group (P<0.05). The observation group had lower FEV1% (50.49±2.91) vs. (76.99±4.75) and C-ACT scores (18.79±2.19) vs. (19.98±2.36) than the control group (P<0.05). Pearson analysis showed that FEV1% was positively correlated with C-ACT score (r=0.634, 0.586, 0.721, P<0.001) and negatively correlated with serum periostin (r=-0.578, -0.509, -0.614), TSLP (r=-0.592, -0.531, -0.663), and ECP (r=-0.601, -0.527, -0.756) in both groups (P<0.001). Multivariate logistic regression showed that lower C-ACT score (OR=0.755, 95%CI: 0.653~0.873) and higher serum periostin (OR=1.083, 95%CI: 1.016~1.153), TSLP (OR=1.065, 95%CI: 1.029~1.102), and ECP (OR=1.091, 95%CI: 1.016~1.171) levels were closely associated with disease severity (P<0.05).

Conclusion

In children with allergic asthma, the C-ACT score is negatively correlated with disease severity, while serum periostin, TSLP, and ECP levels are positively correlated with disease severity.

Key words: Allergic asthma, Children′s asthma control test, Periostin, Thymic stromal lymphopoietin, Eosinophil cationic protein
表1 两组过敏性哮喘患儿临床资料结果比较
临床资料 观察组(n＝35) 对照组(n＝70) t/χ2/Z值 P值
首次发作年龄[岁，M(Q1，Q3)] 4(4，4) 4(3，4) 0.026 0.979
发作频率[次/年，M(Q1，Q3)] 5(5，6) 5(5，6) 0.719 0.472
发病至就诊时间[d，M(Q1，Q3)] 3(2，3) 3(2，3) 0.183 0.855
典型症状[n(%)]        
喘息 32(91.43) 60(85.72) 0.274 0.600
咳嗽 32(91.43) 61(87.14) 0.106 0.745
气促 31(88.57) 52(74.29) 2.875 0.090
胸闷 22(62.86) 43(61.43) 0.732 0.392
典型体征[n(%)]        
双肺哮鸣音 34(97.14) 61(87.14) 1.672 0.196
呼气相延长 31(88.57) 56(80.00) 1.207 0.272
呼吸频率[次/min，(±s)] 29.74±1.39 29.33±1.31 2.121 0.035
心率[次/min，(±s)] 113.17±2.84 112.75±3.15 0.943 0.347
FEV1%(±s) 50.49±2.91 76.99±4.75 42.827 0.000
表2 两组过敏性哮喘患儿C-ACT评分及血清指标结果比较
临床指标 观察组(n＝35) 对照组(n＝70) t值 P值
C-ACT评分[分，(±s)] 18.79±2.19 19.98±2.36 3.539 0.000
C-ACT分级[n(%)]     8.379 0.015
未控制 22(62.86) 28(40.00)    
部分控制 13(37.14) 36(51.43)    
完全控制 0 6(8.57)    
血清骨膜蛋白[ng/ml，(±s)] 19.49±6.46 16.81±4.84 3.377 0.001
TSLP[ng/ml，(±s)] 42.59±9.48 37.53±10.04 3.502 0.001
ECP[μg/L，(±s)] 19.08±6.08 16.80±4.11 3.214 0.002
图1 过敏性哮喘患儿典型胸部X线摄片。图A为对照组轻中度哮喘患儿；图B为观察组重度哮喘患儿
表3 过敏性哮喘患儿C-ACT评分及血清指标水平与FEV1%相关性
组　别 例数 相关性系数 C-ACT评分 血清骨膜蛋白 TSLP ECP
观察组 35 r值 0.721 －0.614 －0.663 －0.756
    P值 0.000 0.000 0.000 0.000
对照组 70 r值 0.586 －0.509 －0.531 －0.527
    P值 0.000 0.000 0.000 0.000
表4 过敏性哮喘患儿病情严重程度多因素Logistic回归分析
自变量 B SE Wald卡方值 P值 OR 95%CI下限 95%CI上限
C-ACT评分 －0.281 0.074 14.420 0.000 0.755 0.653 0.873
血清骨膜蛋白 0.079 0.032 6.062 0.014 1.083 1.016 1.153
TSLP 0.063 0.017 13.018 0.000 1.065 1.029 1.102
ECP 0.087 0.036 5.801 0.016 1.091 1.016 1.171
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