2020 年第 5 期 第 15 卷

过敏性哮喘患儿外周血T细胞免疫球蛋白及黏蛋白域4和血清免疫球蛋白G4的水平变化及意义

Peripheral blood T cell immunoglobulin, mucin domains 4 and serum immunoglobulin G4 level in children with allergic asthma

作者：刘英贤;谢燕丕;李惠怡;孟琼

英文作者：Liu Yingxian Xie Yanpi Li Huiyi Meng Qiong

单位：广东省第二人民医院儿科,广州510000

英文单位：Department of Pediatrics Guangdong Second Provincial General Hospital Guangzhou 510000 China

关键词：过敏性哮喘；T细胞免疫球蛋白及黏蛋白域4；免疫球蛋白G4；诊断价值

英文关键词：Allergicasthma；Tcellimmunoglobulinandmucindomains4；ImmunoglobulinG4；Diagnosticvalue

• 摘要：

• 目的 研究过敏性哮喘患儿外周血T细胞免疫球蛋白及黏蛋白域4（TIM4）、血清免疫球蛋白G4（IgG4）的水平变化及诊断价值。方法 选取2016年12月至2019年2月广东省第二人民医院收治的过敏性哮喘患儿80例，按照病情严重程度将入选患者分为轻度哮喘组（24例）、中度哮喘组（29例）和重度哮喘组（27例）。另取同期于我院进行体检的健康儿童30例作为对照组。比较4组儿童治疗前后外周血TIM4和血清IgG4水平，分析外周血TIM4、血清IgG4水平与过敏性哮喘患儿病情严重程度的相关性，探讨外周血TIM4、血清IgG4对过敏性哮喘的诊断价值。结果 治疗前，轻、中、重度哮喘组患儿外周血TIM4、血清IgG4水平均高于对照组，重度哮喘组患儿外周血TIM4、血清IgG4水平高于轻、中度哮喘组（均P＜0.05）。治疗后中、重度哮喘组患儿外周血TIM4、IgG4水平明显低于治疗前，且高于轻度哮喘组，重度哮喘组外周血TIM4、血清IgG4水平高于中度哮喘组（均P＜0.05）。Pearson相关性分析结果 显示，外周血TIM4、血清IgG4水平与过敏性哮喘患儿病情严重程度均呈正相关（r=0.481、0.475，P=0.032、0.029）。外周血TIM4、血清IgG4对过敏性哮喘诊断的曲线下面积分别为0.723、0.791，理论诊断阈值为1.5%、0.8 g/L，敏感度为0.721、0.784，特异度为0.706、0.765。二者联合检测诊断过敏性哮喘患儿的敏感度为0.841，特异度为0.812，均高于上述两项指标单独检测。结论过敏性哮喘患儿外周血TIM4、血清IgG4水平存在明显高表达，且随着病情不断加重，上述两项指标表达水平随之升高，临床工作中联合检测外周血TIM4、血清IgG4水平有助于过敏性哮喘的诊断。

• Objective To investigate the changes of peripheral blood T cell immunoglobulin and mucin domains 4 (TIM4), serum immunoglobulin G4 (IgG4) levels in children with allergic asthma. Methods Totally 80 children with allergic asthma admitted to Guangdong Second Provincial General Hospital from December 2016 to February 2019 were selected and divided into mild asthma group (24 cases), moderate asthma group (29 cases) and severe asthma group (27 cases). Other 30 healthy children who underwent physical examination during the same period were taken as control group. The levels of TIM4 in peripheral blood and IgG4 in serum of four groups before and after treatment were compared. The correlation among peripheral blood TIM4, serum IgG4 levels and severity of allergic asthma was analyzed. The diagnostic value of peripheral blood TIM4 and serum IgG4 was discussed. Results Before treatment, the levels of peripheral blood TIM4 and serum IgG4 of children with mild, moderate and severe asthma were higher than those in control group; in severe asthma group, the levels of peripheral blood TIM4 and serum IgG4 were higher than those in mild and moderate asthma group (all P＜0.05). After treatment, the levels of peripheral blood TIM4 and serum IgG4 of children with moderate and severe asthma were significantly lower than those before treatment, and higher than those in mild asthma group; in severe asthma group, the levels of peripheral blood TIM4 and serum IgG4 were higher than those in moderate asthma group (all P＜0.05). Pearson correlation analysis showed that the levels of peripheral blood TIM4 and serum IgG4 were positively correlated with the severity of allergic asthma in children (r=0.481, 0.475, P=0.032, 0.029). The area under the curve of peripheral blood TIM4 and serum IgG4 was 0.723 and 0.791, respectively. The theoretical diagnostic threshold was 1.5% and 0.8 g/L. The sensitivity was 0.721 and 0.784; the specificity was 0.706 and 0.765. The sensitivity and specificity of the combined test for the diagnosis of allergic asthma in children were 0.841 and 0.812, respectively.ConclusionThe level of peripheral blood TIM4 and serum IgG4 of children with allergic asthma is highly expressed; the expression of the two indicators increases with aggravation of the disease. The detection of both peripheral blood TIM4 and serum IgG4 is helpful for the diagnosis of allergic asthma.