| 刘慧慧,徐佳琛.支气管哮喘患儿血清CCN1和SEMA7A水平与气道炎症及哮喘控制情况的关系[J].安徽医药,待发表. |
| 支气管哮喘患儿血清CCN1和SEMA7A水平与气道炎症及哮喘控制情况的关系 |
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| 投稿时间：2026-06-29 录用日期：2026-08-21 |
| DOI： |
| 中文关键词: 支气管哮喘 儿童 CCN1 SEMA7A 气道炎症 哮喘控制 |
| 英文关键词: |
| 基金项目:河北省医学科学研究课题(20201311)；秦皇岛市科学技术研究与发展计划(202301A143) |
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| 中文摘要: |
| 目的 探讨支气管哮喘患儿血清细胞通讯网络因子1(CCN1)和信号素7A(SEMA7A)水平与气道炎症指标及哮喘控制状态的相关性,评估二者联合检测对哮喘控制不良的预测价值。方法 采用前瞻性队列研究设计,纳入2024年4月至2026年2月于秦皇岛市第一医院就诊的支气管哮喘患儿408例,同期招募健康体检儿童150例作为对照。所有患儿依据GINA 2023指南接受规范化治疗,4周后根据儿童哮喘控制测试(C-ACT)评分分为控制良好组(n=326)和控制不良组(n=82)。采用ELISA法检测血清CCN1和SEMA7A水平,同步检测外周血嗜酸性粒细胞(EOS)计数、血清总IgE、呼出气一氧化氮(FeNO)及肺功能指标。采用Spearman相关分析评估指标间相关性,多因素Logistic回归分析筛选控制不良的独立影响因素,受试者工作特征(ROC)曲线评估预测效能。结果 哮喘组血清CCN1和SEMA7A水平均显著高于对照组(均P<0.05)。控制不良组血清CCN1和SEMA7A水平均显著高于控制良好组(均P<0.05)。相关性分析显示,CCN1和SEMA7A与EOS计数、血清总IgE、FeNO均呈显著正相关(均P<0.001)。多因素Logistic回归分析显示,CCN1(OR=1.078,95%CI：1.044~1.112)和SEMA7A(OR=1.307,95%CI：1.181~1.446)升高是哮喘控制不良的独立危险因素。ROC曲线分析显示,CCN1和SEMA7A单独预测哮喘控制不良的AUC分别为0.730和0.750,二者联合预测的AUC为0.897(95%CI：0.863~0.931),显著优于单独预测。结论 血清CCN1和SEMA7A在支气管哮喘患儿中显著升高,与气道炎症指标呈正相关,是哮喘控制不良的独立危险因素。 |
| 英文摘要: |
| Objective To investigate the correlations of serum cellular communication network factor 1 (CCN1) and semaphorin 7A (SEMA7A) levels with airway inflammation indices and asthma control status in children with bronchial asthma, and to evaluate the predictive value of their combined detection for poor asthma control. Methods A prospective cohort study design was adopted. A total of 408 children with bronchial asthma who visited Qinhuangdao No.1 Hospital from April 2024 to February 2026 were enrolled as the case group, and 150 healthy children who underwent routine physical examination during the same period were recruited as the control group. All children received standardized treatment according to the Global Initiative for Asthma (GINA) 2023 guidelines. After 4 weeks of treatment, they were divided into the well-controlled group (n=326) and the poorly controlled group (n=82) based on Childhood Asthma Control Test (C-ACT) scores. Serum CCN1 and SEMA7A levels were detected by enzyme-linked immunosorbent assay (ELISA). Peripheral blood eosinophil (EOS) count, serum total IgE, fractional exhaled nitric oxide (FeNO), and lung function indices were simultaneously measured. Spearman correlation analysis was used to evaluate the correlations between indices. Multivariate Logistic regression analysis was performed to screen independent influencing factors for poor control. Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy. Results Serum CCN1 and SEMA7A levels in the asthma group were significantly higher than those in the control group (both P<0.05). Serum CCN1 and SEMA7A levels in the poorly controlled group were significantly higher than those in the well-controlled group (both P<0.05). Correlation analysis showed that CCN1 and SEMA7A were significantly positively correlated with peripheral blood EOS count, serum total IgE, and FeNO (all P<0.001). Multivariate Logistic regression analysis showed that elevated CCN1 (OR=1.078, 95%CI: 1.044-1.112) and SEMA7A (OR=1.307, 95%CI: 1.181-1.446) were independent risk factors for poor asthma control. ROC curve analysis showed that the area under the curve (AUC) of CCN1 and SEMA7A alone for predicting poor asthma control was 0.730 and 0.750, respectively. The AUC of their combined prediction was 0.897 (95%CI: 0.863-0.931), which was significantly better than single prediction. Conclusion Serum CCN1 and SEMA7A are significantly elevated in children with bronchial asthma, positively correlated with airway inflammation indices, and are independent risk factors for poor asthma control. Combined detection of CCN1 and SEMA7A has high clinical value for predicting poor asthma control, providing novel serological evidence for precise management and inflammation monitoring of asthma. |
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