Clinical diagnostic value of interleukin-17,interleukin-27 and exhaled nitric oxide alone or combination in children with bronchial asthma
- LIU Yang, GAO Wei-xia, SONG Zhe, ZHU Yong-jie
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Objective To detect the correlation between fractional exhaled nitric oxide(FeNO),interleukin-17(IL-17),interleukin-27(IL-27)and lung function indexes,and to analyze the clinical diagnostic value for bronchial asthma in children. Methods A total of 84 children diagnosed with bronchial asthma in Nanyang Central Hospital were prospectively enrolled in this study from January 2019 to April 2020,meanwhile 56 healthy children were selected as control group.IL-17,IL-27 and FeNO levels of peripheral blood were tested,and pulmonary function-related indicators were recorded,including forced expiratory volume in one second(FEV1),forced expiratory volume in one second and vital capacity ratio(FEV1/FVC),peak expiratory flow rate(PEF),and ratio of residual volume to total lung volume(RV/TLC).Pearson correlation analysis was used to detect the correlation between IL-17,IL-27 and FeNO with lung function indexes.The ROC working curve was used to evaluate the diagnostic value of FeNO combined with IL-17 and IL-27 detection in childhood asthma. Results The differences of IL-17,IL-27,FeNO,FEV1,FEV1,FEV1/FVC,PEF and RV/TLC among the control group,stable phase and acute exacerbation phase groups were statistically significant(F=137.241,92.074,94.296,16.325,174.263,31.174,115.207,P<0.001).In children with asthma,IL-17 level was negatively correlated with FEV1,FEV1/FVC and PEF(r=-0.690,-0.576,-0.613),and positively correlated with RV/TLC(r=0.581).IL-27 level was negatively related to FEV1,FEV1/FVC and PEF(r=-0.786,-0.818,-0.549),and positively related to RV/TLC(r=0.513).FeNO level was negatively correlated with FEV1,FEV1/FVC and PEF(r=-0.667,-0.662,-0.637),and was positively correlated with RV/TLC(r=0.543).The sensitivity of IL-17,IL-27 and FeNO in the diagnosis of childhood asthma was 52.4%,68.5% and 70.6%,the specificity was 76.2%,63.2% and 65.3%,and the area under the curve was 0.684(95%CI:0.614—0.725),0.768(95%CI:0.710—0.805),0.792(95%CI:0.723—0.840),respectively.The sensitivity of the combined test for diagnosis of childhood asthma was 86.9%,the specificity was 81.4%,the area under the curve was 0.905(95%CI:0.802～0.941),and the difference was statistically significant compared with the single test(P<0.05). Conclusions The levels of IL-17,IL-27 and FeNO are correlated with lung function indexes.Joint detection can significantly improve the sensitivity and specificity of the diagnosis of bronchial asthma in children.