血浆骨膜蛋白、核因子E2相关因子2与咳嗽变异性哮喘患儿气道炎症和哮喘控制的关系OA

Objective To investigate the relationships of plasma periostin(POSTN),nuclear factor E2-related factor 2(Nrf2)with airway inflammation and asthma control in children with cough variant asthma(CVA).Methods A total of 185 children with CVA(CVA group)and 185 healthy children undergoing physical examinations during the same period(control group)were retrospective-ly selected as the study subjects.Enzyme-linked immunosorbent assay was used to detect the plasma levels of POSTN and Nrf2 in both groups,and airway inflammation indicators[eosinophil(EOS)count and fractional exhaled nitric oxide(FeNO)]were also measured.Spearman correlation analysis was employed to explore the correlations of plasma POSTN and Nrf2 levels with disease severity with airway inflammation in children with CVA.Multivariate logistic regression analysis and receiver operating characteristic(ROC)curve analysis were used to analyze the influencing factors of poor asthma control in children with CVA and the predictive efficacy of plasma POSTN and Nrf2 levels.Results Compared with the control group,the CVA group showed increased plasma POSTN levels,EOS counts,and FeNO levels,and decreased plasma Nrf2 levels,with statistically significant differ-ences(P＜0.05).Among children with mild,moderate,and severe CVA,the plasma POSTN lev-els,EOS counts,and FeNO levels increased successively,while the plasma Nrf2 levels decreased successively,with statistically significant differences(P＜0.017).In children with CVA,plasma POSTN levels were positively correlated with disease severity,EOS count,and FeNO(r=0.707,0.651,0.668,respectively;P＜0.001),while plasma Nrf2 levels were negatively correlated with disease severity,EOS count,and FeNO(r=-0.705,-0.603,-0.656,respectively;P＜0.001).Multivariate logistic regression analysis revealed that increased EOS count,increased FeNO,and increased POSTN were independent risk factors for poor asthma control in children with CVA,while increased Nrf2 was an independent protective factor(P＜0.05).The ROC curve showed that the area under the curve for the combined prediction of poor asthma control in children with CVA by plasma POSTN and Nrf2 was 0.912,and the predictive efficacy was better than that of individual prediction.After internal validation using 1 000 Bootstrap resamplings,the C-index of the combined prediction was 0.912(95％CI,0.906 to 0.918).Conclusion Increased plasma POSTN levels and decreased plasma Nrf2 levels in children with CVA are associated with disease ex-acerbation,aggravated airway inflammation,and poor asthma control.Plasma POSTN and Nrf2 may serve as auxiliary predictive indicators for poor asthma control,and their combination has higher pre-dictive efficacy.