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14-3-3β 在儿童急性哮喘中的作用及哮喘加重的危险因素分析。

The role of 14-3-3β in acute asthma in children and analysis of the risk factors for asthma exacerbation.

机构信息

Department of Pediatrics, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Henan Pediatric Clinical Research Center, Zhengzhou, China.

出版信息

J Asthma. 2024 Nov;61(11):1422-1431. doi: 10.1080/02770903.2024.2355238. Epub 2024 Jun 5.

Abstract

OBJECTIVE

To investigate the role of 14-3-3β in acute asthma exacerbations in children and analyze the risk factors for asthma exacerbations.

METHODS

This study recruited 101 children with acute asthma exacerbations, 101 children with stable asthma, and 65 healthy children. Serum 14-3-3β was compared among the three groups. Factors such as asthma family history, skin prick test, serum-specific IgE test, coinfections, and clinical indicators (FeNO, FEV1, white blood cells, eosinophils, and serum IgE level) were compared between the asthma groups. Risk factors associated with acute asthma exacerbations were identified using multivariate logistic regression models. ROC curve was drawn to determine the diagnostic sensitivity and specificity of 14-3-3β.

RESULTS

Serum 14-3-3β was significantly greater in the acute asthma group than in the stable asthma and control groups. Serum 14-3-3β was higher in severe acute asthma group than in mild-moderate asthma group. There were no significant differences in serum 14-3-3β levels between stable asthma and control groups ( > .05). Multivariate logistic regression analysis revealed that serum 14-3-3β level, FeNO, coinfection, and FEV1 z-score significantly increased the odds of acute asthma exacerbations in children. The optimal 14-3-3β cutoff value (39.79 ng/mL), had a sensitivity of 69.3% and specificity of 94.1% for predicting acute asthma exacerbations.

CONCLUSIONS

14-3-3β is elevated in children with acute exacerbations of asthma, and increases with exacerbation severity. 14-3-3β, FeNO, FEV1, and coinfection could be independent risk factors for predicting asthma exacerbations. The optimal 14-3-3β cutoff value for predicting asthma exacerbations was 39.79 ng/mL.

摘要

目的

探讨 14-3-3β 在儿童急性哮喘发作中的作用,并分析哮喘发作的危险因素。

方法

本研究纳入了 101 例急性哮喘发作患儿、101 例稳定期哮喘患儿和 65 例健康儿童。比较三组血清 14-3-3β。比较哮喘组哮喘家族史、皮肤点刺试验、血清特异性 IgE 检测、合并感染和临床指标(FeNO、FEV1、白细胞、嗜酸性粒细胞和血清 IgE 水平)。采用多因素 logistic 回归模型识别与急性哮喘发作相关的危险因素。绘制 ROC 曲线以确定 14-3-3β 的诊断灵敏度和特异性。

结果

急性哮喘组血清 14-3-3β 显著高于稳定期哮喘组和对照组。重度急性哮喘组血清 14-3-3β 高于轻中度哮喘组。稳定期哮喘组与对照组血清 14-3-3β 水平无差异( > .05)。多因素 logistic 回归分析显示,血清 14-3-3β 水平、FeNO、合并感染和 FEV1 z 评分显著增加儿童急性哮喘发作的几率。最佳 14-3-3β 截断值(39.79 ng/mL)预测急性哮喘发作的灵敏度为 69.3%,特异度为 94.1%。

结论

儿童急性哮喘发作时 14-3-3β 升高,且随病情加重而升高。14-3-3β、FeNO、FEV1 和合并感染可能是预测哮喘发作的独立危险因素。预测哮喘发作的最佳 14-3-3β 截断值为 39.79 ng/mL。

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