目的 檢測哮喘患兒白細(xì)胞介素-17（IL-17）、白細(xì)胞介素-27（IL-27）和呼出氣一氧化氮（FeNO）水平的變化，探討這些指標(biāo)與肺功能指標(biāo)的相關(guān)性、診斷哮喘的臨床價值。方法 收集2019年5月-2020年5月在漯河市中心醫(yī)院兒科接受治療的64例哮喘患兒作為哮喘組，同期體檢的30例健康兒童作為對照組。記錄患者入院時的一般資料、外周血清中白細(xì)胞介素-17（IL-17）、白細(xì)胞介素-27（IL-27）、FeNO水平和肺功能檢測結(jié)果。比較治療前后哮喘患者IL-17、IL-27、FeNO和肺功能指標(biāo)的變化，分析IL-17、IL-27、FeNO與肺功能指標(biāo)的相關(guān)性。繪制ROC曲線，估測IL-17、IL-27、FeNO單獨及聯(lián)合檢測對哮喘的診斷價值。結(jié)果 入院時，哮喘組用力肺活量（FVC）、1秒用力呼氣量（FEV1）、75%呼氣中期流量（MEF75%）、50%呼氣中期流量（MEF50%）、25%呼氣中期流量（MEF25%）和最大呼氣峰值流速（PEF）水平均明顯低于對照組（P<0.05）。治療后哮喘組FVC、FEV1、MEF75%、MEF50%、MEF25%和PEF均有所增加，差異具有統(tǒng)計學(xué)意義（P<0.05）。入院時哮喘組IL-17和FeNO水平高于對照組，IL-27低于對照組（P<0.05）。治療后哮喘組IL-17和FeNO水平降低，IL-27水平增加，差異有統(tǒng)計學(xué)意義（P<0.05）。IL-17與肺功能指標(biāo)FVC、FEV1和PEF均呈負(fù)相關(guān)（r=-0.660、-0.742、-0.889，P<0.05），IL-27與肺功能指標(biāo)FVC、FEV1和PEF均呈正相關(guān)（r=0.664、0.712、0.726，P<0.05），F(xiàn)eNO與肺功能指標(biāo)FVC、FEV1和PEF均呈負(fù)相關(guān)（r=-0.874、-0.817、-0.696，P<0.05）。IL-17、IL-27和FeNO單獨檢測均可診斷哮喘，但靈敏度和特異度均較低，三者聯(lián)合檢測后診斷哮喘的靈敏度和特異度均有所提高。結(jié)論 哮喘患兒中IL-17、FeNO水平升高，IL-27水平降低，聯(lián)合檢測可提高診斷哮喘的靈敏度和特異度。

Objective To detect the level changes of interleukin-17 (IL-17), interleukin-27 (IL-27) and exhaled nitric oxide (FeNO) levels in children with asthma and their correlation with pulmonary function indexes and the clinical value of diagnosis of asthma. Methods Children (64 cases) with asthma in the Department of Paediatrics of Luohe Central Hospital from May 2019 to May 2020 were selected as the asthma group, and 30 healthy children for physical examination during the same period were selected as the control group. Children's general information at the time of admission and the levels of IL-17 and IL-27 in the peripheral serum, the level of FeNO and the results of lung function tests were Recorded. Changes of IL-17, IL-27, FeNO, and lung function indexes in children with asthma before and after treatment were compare, and the correlations between IL-17, IL-27, FeNO, and lung function indexes were analyze. ROC curve was drawn to estimate the diagnostic value of IL-17, IL-27, FeNO alone and combined detection for asthma. Results On admission. pulmonary function test indicators forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), 75% mid-expiratory flow (MEF75%), 50% mid-expiratory flow (MEF50%), 25% mid-expiratory flow (MEF25%) and maximum peak expiratory flow rate (PEF) in the asthma group were lower than those in the control group (P<0.05). After treatment, the levels of FVC, FEV1, MEF75%, MEF50%, MEF25%, and PEF in the asthma group was increased, and the difference was statistically significant in the same group (P<0.05). On admission, the levels of IL-17 and FeNO in the asthma group were higher than those in the control group, but the levels of IL-27 were lower than those in the control group (P<0.05). After treatment, the levels of IL-17 and FeNO in the asthma group were decreased, but the levels of IL-27were increased, and the difference was statistically significant (P<0.05). There was negative correlation between IL-17 levels and lung function indexes FVC, FEV1, and PEF (r=-0.660, -0.742, and -0.889, P<0.05), and IL-27 was positively correlated with FVC, FEV1, and PEF (r=0.664, 0.712, and 0.726, P<0.05), and FeNO was negatively correlated with FVC, FEV1, and PEF (r=-0.874, -0.817, and -0.696, P<0.05). The detection of IL-17, IL-27, and FeNO alone could be used to diagnose asthma, but the sensitivity and specificity were low. The combined detection of IL-17, IL-27, and FeNO could improve the sensitivity and specificity of the diagnosis of asthma. Conclusion The levels of IL-17 and FeNO are increased in children with asthma, but the level of IL-27 is decreased, and combined detection can improve the sensitivity and specificity of the diagnosis of asthma.

R979.1