Clinical significance of asthma predictive index, Etoaxin, interleukin-4, interferon-γ in infants with recurrent wheezing / 中华实用儿科临床杂志

ABSTRACT

Objective@#To investigate the clinical significance of asthma prediction index (API), Eotaxin(Eot), interleukin-4 (IL-4), interferon-γ (IFN-γ), eosinophil (Eos) in predicting recurrent wheezing in infants.@*Methods@#Ninety-six infants with first wheezing attack due to bronchiolitis from April 2015 to April 2016 at the Department of Pediatrics, the Second Hospital of Tianjin Medical University were selected.The medical history and other clinical data were collected, and the peripheral blood samples were collected to detect Eot, IL-4, IFN-γ, Eos count and serum specific immunoglobulin E(sIgE). Then all infants were followed up by telephone until 2-year-old to find whether recurrent wheezing attack occurred and then API was calculated.According to the recurrent wheezing times during the follow-up, they were divided into 2 groups the observation group (recurrent attacks≥2 times, 33 cases) and the control group (no recurrent wheezing during follow-up, 60 cases). The infants in the observation group were divided into the API positive group (18 cases) and the API negative group (14 cases) according to API.The differences in clinical data and peripheral blood indexes were analyzed by independent sample t test for measuring data and χ2 test for counting data.@*Results@#Thirty-three cases (35.48%) infants in the study had recurrent wheezing attacks within 2 years followed by bronchiolitis.The average age of the recurrent wheezing attack was (13.59±5.89) months.Compared with the control group, the levels of serum Eot[(135.45±44.45) ng/L vs.(110.91±22.50) ng/L, t=3.44, P<0.05], IL-4[(58.56±43.55) ng/L vs.(34.91±12.18) ng/L, t=3.78, P<0.05] and peripheral blood Eos proportion(0.034 0±0.025 6 vs.0.003 3±0.006 4, t=4.56, P<0.05) increased in the observation group, and the differences were statistically significant.The food allergy history [18.18%(6/33 cases) vs.5.00%(3/60 cases), χ2=4.23, P<0.05]and the positive proportion of sIgE allergens[38.46%(10/26 cases) vs.9.09%(2/22 cases), χ2=5.48, P<0.05] increased, and the differences were statistically significant.There was no difference between the 2 groups in IFN-γ level (P>0.05). The level of serum Eot [(146.59±59.35) ng/L vs.(114.14±13.60) ng/L, t=3.71, P<0.05], airway sIgE[45.00%(9/20 cases) vs.0(0/6 case), χ2=4.13, P<0.05]and food allergens sIgE [50.0%(10/20 cases) vs.0(0/6 case), χ2=4.88, P<0.05)] in the API positive group was higher than that in the API negative group, and the differences were statistically significant.@*Conclusions@#The elevated serum Eot levels during the first asthmatic attack of bronchiolitis in infants and food sIgE positive levels suggest an increased risk of recurrent wheezing, and the elevated serum Eot levels and sIgE positive levels are associated with API positive levels.