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1、咳嗽变异性哮喘患儿血清气道炎症介质水平测定的临床意义1.江苏省苏州市立医院本部儿科；2.核医学科江苏苏州215002【摘要】目的探讨咳嗽变异性哮喘(coughvariantasthma,CVA)患儿血淸气道炎症介质水平测定的临床意义。方法放射免疫分析测定了76例咳嗽变异性哮喘患儿和60例正常儿血清气道炎症介质【血管活性肠肽(vasoactiveintestinalpeptide,VIP)、胰岛素样生长因子-2(likegrowthfactor-II,IGF-II)、肿瘤坏死因子-
2、(tumornecrosisfactor-,TNF-)】水平并进行丫比较性研究。采用受试者工作特征曲线(receiveroperatingcharacteristiccurve,ROCcurve)分析评估了CVA患儿综合治疗后的预后价值。结果76例CVA患儿治疗前血淸VIP水平较之60例正常儿明显降低(P<0.01),而血清IGF-II和TNF-明显增高(P分别为<0.01和<0.001)。ROC曲线表明：血清评估CVA患儿综合治
3、疗预价值的曲线卜*面釈(areaundercurve,AUC)VIP分别是86.11%,临界值是26.34ng/ml，灵敏度是85.22%,特异度是92.93%;IGF-II分别是85.61%,0.56ng/ml,84.77%和91.56%;TNF-分别是86.14%,8.35ng/ml,87.16%和85.06°/。。结论气道炎症介质参与CVA疾病的发生和发展，血淸VIPJGF-II和TNF-水平是评估CVA患儿综合治疗后的有价值指标。【关键词】咳嗽变异性哮喘(
4、CVA)；气道炎症介质；综合治疗；受试者工作特征曲线(ROCcurve)；有价值指标ClinicalsignificanceofdeterminingserumairwayinflammatorymatterlevelsinpediatricpatientswithcoughvariantasthmaGANlu，ZHOUjian-xin,YANGyong-qingDepartmentofPediatrics,SuzhouMunicipalHospital,Suzhou,Jiangsu215002
5、，China[Abstract]ObjectiveToexploreclinicalsignificanceofdeterminingserumairwayinflammtorymatterlevelsinpediatricpatientswithcoughvariantasthma(CVA).MethodstheserumVIP,IGF-IIandTNF-levelsweredeterminedin76pediatricpatientswithCVAand60normalchi
6、ldrenbyradioimmunoassay，andweredonecomparativestudy.UsingROCcurveanalysistoevaluatethepredictvalueaftergeneraltreatmentinpediatricpatientswithCVA.ResultsTheserumVIPlevelwassignificantlylowerthanthoseof60normalchildren(P<0.01)，butIGF-HandTNF-᠉
7、7;weresignificantlyhigher(P<0.01and<0.001,respectively).ROCcurveanalysisshower：TheserumVIPtoassessAUCwas86.11%predictvaluetoevaluateaftergeneraltreatmentinpediatricpatientswithCVA,thecutoffvaluewas26.34ng/ml，thesensitivitywas85.22%,thespecifici
8、tywas92.93%；IGF-IIwere85.61%,0.56ng/ml，84.77%and91.56%respectively；TNF-were86.14%,8.35ng/ml,87.16%and85.06%respectively.ConclusionTheairwayinflammatorymattermightbeplayimportantrolesindevelopmentandprogressionofCVAdisease.TheserumVIP，IGF-IIan
