急性上呼吸道感染性疾病患儿血清中PU.1、IL-4表达及其临床诊断价值

doi:10.11958/20212783

摘要/Abstract

摘要：

目的分析急性上呼吸道感染性疾病患儿血清中转录因子PU.1、白细胞介素4（IL-4）表达，并探究其临床诊断价值。方法选取在本院接受治疗的急性上呼吸道感染疾病患儿78例作为疾病组，选取同期体检健康儿童78例作为对照组。分别以荧光定量PCR和酶联免疫吸附试验（ELISA）检测患儿血清中转录因子PU.1和IL-4表达水平，以受试者工作特征（ROC）曲线分析其临床诊断价值，多因素Logistic回归分析急性上呼吸道感染性疾病发生的影响因素。结果疾病组患儿血清IL-6、C-反应蛋白（CRP）、降钙素原（PCT）、肿瘤坏死因子α（TNF-α）、IL-4水平及PU.1相对表达量明显高于对照组（P<0.05）。血清IL-4水平及PU.1相对表达量及其联合检测用于诊断上呼吸道感染性疾病患儿的ROC曲线下面积分别为0.752、0.855和0.984，相应的敏感度分别为58.97%、78.21%和94.87%，特异度分别为83.33%、78.21%和97.44%。多因素Logistic回归结果显示，血清IL-4、PU.1、IL-6、CRP、TNF-α水平升高为影响上呼吸道感染性疾病发生的独立危险因素（P<0.05）。结论急性上呼吸道感染性疾病患儿血清中PU.1、IL-4表达水平较高，具有一定的诊断价值。

关键词: 呼吸道感染, 急性病, 转录因子, 白细胞介素4, 诊断, 儿童, PU.1

Abstract:

Objective To analyze the expression levels of serum transcription factor PU.1 and interleukin-4 (IL-4) in children with acute upper respiratory tract infectious diseases and explore their clinical diagnostic values. Methods A total of 78 children with acute upper respiratory tract infection treated in our hospital were selected as the disease group, and 78 healthy children with physical examination during the same period were selected as the normal control group. Fluorescence quantitative method and enzyme linked immunosorbent assay (ELISA) were used to detect the expression levels of serum transcription factors PU.1 and IL-4 in children respectively. The receiver operating characteristic (ROC) curve was used to analyze its clinical diagnostic value. Multivariate Logistic regression was used to analyze the independent risk factors affecting the occurrence of acute upper respiratory tract infectious diseases. Results The serum levels of interleukin-6 (IL-6), C reactive protein (CRP), procalcitonin (PCT), tumor necrosis factor alpha (TNF-α), IL-4 and the relative expression of PU.1 were significantly higher in the disease group than those in the normal control group (P<0.05). The areas under the ROC curve of serum IL-4 level and the relative expression of PU.1 and their combined detection for diagnosing the upper respiratory tract infectious diseases in children were 0.752, 0.855 and 0.984, respectively, the corresponding sensitivities were 58.97%, 78.21%, 94.87%, respectively, and the specificities were 83.33%, 78.21% and 97.44%, respectively. A multivariate Logistic regression analysis was performed, and the results showed that higher serum IL-4, PU.1, IL-6, CRP and TNF-α expression levels were independent risk factors affecting the occurrence of upper respiratory tract infectious diseases (P<0.05). Conclusion The serum levels of PU.1 and IL-4 in children with acute upper respiratory tract infectious diseases are relatively high, which have certain diagnostic value.

Key words: respiratory tract infections, acute disease, transcription factors, interleukin-4, diagnosis, child, PU.1

中图分类号:

R725.6

图/表 5

参考文献 20

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组别	年龄（岁）	男/女	IL-6 （ng/L）	CRP （mg/L）	PCT （ng/L）	TNF-α （pmol/L）
对照组	5.62±1.62	36/42	7.82±1.07	3.15±0.58	0.12±0.03	6.78±0.90
疾病组	5.78±1.55	40/38	9.14±2.27	4.16±1.42	0.14±0.07	8.14±2.27
t或χ²	0.630	0.411	4.651^＊＊	5.807^＊＊	2.438^＊＊	4.910^＊＊

组别	年龄（岁）	男/女	IL-6 （ng/L）	CRP （mg/L）	PCT （ng/L）	TNF-α （pmol/L）
对照组	5.62±1.62	36/42	7.82±1.07	3.15±0.58	0.12±0.03	6.78±0.90
疾病组	5.78±1.55	40/38	9.14±2.27	4.16±1.42	0.14±0.07	8.14±2.27
t或χ²	0.630	0.411	4.651^＊＊	5.807^＊＊	2.438^＊＊	4.910^＊＊

组别	n	IL-4（ng/L）	PU.1
对照组	78	6.74±1.78	0.74±0.12
疾病组	78	8.43±1.78	0.82±0.18
t		5.937^＊＊	3.127^＊＊

组别	n	IL-4（ng/L）	PU.1
对照组	78	6.74±1.78	0.74±0.12
疾病组	78	8.43±1.78	0.82±0.18
t		5.937^＊＊	3.127^＊＊

指标	截断值	AUC（95%CI）	敏感度（%）	特异度（%）	约登指数
IL-4	8.17 ng/L	0.752（0.676~0.817）	58.97	83.33	0.423
PU.1	0.84	0.855（0.790~0.906）	78.21	78.21	0.564
IL-4+PU.1	-	0.984（0.949~0.997）	94.87	97.44	0.923