Abstract: Objective To explore the relationship between serum high mobility group box-1 protein (HMGB1), soluble cluster differentiation 163(sCD163) levels andfractional exhaled nitric oxide(FeNO) concentration and disease severity in children with bronchiolitis, and to analyze the diagnostic value of serum HMGB1 and sCD163 for bronchiolitis in children. Methods A total of 76 children with bronchiolitis for the first time in the First Affiliated Hospital of Shaoyang University from September 2018 to September 2019 were selected into the study group, including mild group(n=23), moderate group(n=31) and severe group (n=22).At the same time, 50 healthy children at the same age were selected into the control group.Serum levels of HMGB1 and sCD163 were detected by enzyme linked immunosorbent assay, FeNO concentration was measured by off-line tidal exhalation.Pearson method was used to analyze the correlation between serum HMGB1, sCD163 levels and FeNO concentration in children with bronchiolitis.Receiver operating characteristic curve(ROC) was used to evaluate the predictive value of serum HMGB1 and sCD163 levels in children with bronchiolitis. Results The levels of HMGB1 and sCD163 in the study group were significantly higher than those in the control group (t=8.927, 8.442, P<0.001).With the severity of bronchiolitis aggravating, the levels of serum HMGB1, sCD163 and FeNO became higher (F=67.908, 96.412, 23.390, P<0.001).Pearson results showed that serum HMGB1 and sCD163 levels were positively correlated with FeNO concentration in children with bronchiolitis (r=0.674,0.680, P<0.001).ROC results showed that the area under the curve (AUC) of serum HMGB1 and sCD163 in the diagnosis of bronchiolitis was 0.849 (95%CI:0.775 - 0.897) and 0.863 (95%CI:0.802—0.906), respectively.The AUC of combined diagnosis was 0.925 (95% CI:0.870 - 0.968).Serum HMGB1 and sCD163 levels were positively correlated with the number of wheezing during follow-up (r=0.614, 0.672, P<0.001). Conclusion The levels of serum HMGB1 and sCD163 in children with bronchiolitis are positively correlated with FeNO concentration and severity of disease, which may be used as potential biological indicators to predict the occurrence, development and prognosis of bronchiolitis.

Key words: children with bronchiolitis, high mobility group box-1 protein(HMGB1), soluble cluster differentiation 163, fractional exhaled nitric oxide(FeNO), severity

摘要： 目的 探究毛细支气管炎患儿血清高迁移率族蛋白B1(HMGB1)、可溶性清道夫受体163(sCD163)水平与呼出气一氧化氮(FeNO)浓度及病情严重程度的关系,分析血清HMGB1、sCD163对毛细支气管炎患儿的诊断价值,初步讨论其临床意义。方法 收集2018年9月-2019年9月在邵阳学院附属第一医院普儿科院住院治疗的76例首次发生毛细支气管炎的患儿为研究组,其中轻度组23例、中度组31例和重度组22例,同期选取在本院体检的同年龄段健康幼儿50例为对照组。采用酶联免疫吸附法检测血清HMGB1、sCD163水平,采用离线潮气呼气检测FeNO浓度,Pearson法分析患儿血清HMGB1、sCD163水平与FeNO浓度的相关性,受试者工作特征曲线(ROC)评价血清HMGB1、sCD163水平对毛细支气管炎患儿疾病严重程度的预测价值。结果 研究组患儿血清HMGB1、sCD163水平均明显高于对照组(t=8.927、8.442,P＜0.001);随着毛细支气管炎患儿严重程度加重,血清HMGB1、sCD163水平及FeNO浓度均呈上升趋势(F=67.908、96.412、23.390,P＜0.001);Pearson结果显示,毛细支气管炎患儿血清HMGB1、sCD163水平与FeNO浓度均呈正相关(r=0.674、0.680,P＜0.001);ROC结果显示,血清HMGB1、sCD163水平诊断毛细支气管炎患儿的曲线下面积(AUC)分别为0.849(95%CI:0.775~0.897)、0.863(95%CI:0.802~0.906),二者联合诊断的AUC为0.925(95%CI:0.870~0.968);血清HMGB1、sCD163水平与随访中患儿喘息次数均呈正相关(r=0.614、0.672,P＜0.001)。结论 毛细支气管炎患儿血清HMGB1、sCD163水平与患儿FeNO浓度及病情严重程度呈正相关,可能作为指示毛细支气管炎发生发展及预后的潜在生物指标。

关键词: 毛细支气管炎患儿, 高迁移率族蛋白B1, 可溶性清道夫受体163, 呼出气一氧化氮, 严重程度