Expression of serum eosinophil cationic protein in children with respiratory syncytial viruses pneumonia and its clinical significance / 中国医师进修杂志

ABSTRACT

Objective:To investigate the expression of serum eosinophil cationic protein (ECP) in children with respiratory syncytial viruses (RSV) pneumonia and its clinical significance.Method:One hundred and six children with RSV pneumonia (RSV pneumonia group) and 70 healthy children (control group) from January 2017 to October 2019 in the Affiliated Suzhou Science & Technology Town Hospital of Nanjing Medical University were selected. Among children with RSV pneumonia, low risk was in 68 cases, intermediate risk was in 25 cases and high risk was in 13 cases. The serum ECP level was measured by enzyme-linked immunosorbent assay. The lung function indexes were measured, including the forced expiratory volume in one second as a percentage of predicted value (FEV 1%), forced expiratory volume in one second (FEV 1)/forced vital capacity (FVC) and fractional exhaled nitric oxide (FeNO). Risk factors of severity in children with RSV pneumonia were analyzed by multivariate Logistic regression analysis. The area under the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of serum ECP for RSV pneumonia. Results:The FEV 1% and FEV 1/FVC in RSV pneumonia group were significantly lower than those in control group (81.47 ± 14.08)% vs. (96.80 ± 17.10)% vs. (72.17 ± 21.63)% and (93.46 ± 26.57)%, the FeNO and ECP were significantly higher than those in control group (17.88 ± 2.55) ppb vs. (9.79 ± 2.35) ppb and (64.00 ± 20.05) μg/L vs. (41.59 ± 16.99) μg/L, and there were statistical differences ( P<0.01). The serum ECP in RSV pneumonia children with intermediate risk and high risk were significantly higher than that in RSV pneumonia children with low risk (70.82 ± 20.84), (90.71 ± 19.75) μg/L vs. (58.05 ± 14.72) μg/L, the serum ECP in high risk children was significantly higher than that in intermediate risk children, and there were statistical differences ( P<0.05). Multivariate Logistic regression analysis result showed that FEV 1%, FEV 1/FVC, FeNO and ECP were independent risk factors of severity in children with RSV pneumonia ( OR=12.913, 17.845, 0.002 and 0.126; 95% CI 2.641 to 63.139, 2.972 to 107.139, 0.000 to 0.017 and 0.028 to 0.566; P<0.01). ROC curve analysis result showed that the optimal cut-off value of serum ECP for the diagnosis of RSV pneumonia was 51.84 μg/L, AUC was 0.809, and the sensitivity and specificity were 78.57% and 75.47%; the optimal cut-off value of serum ECP for early diagnosis of RSV pneumonia was 43.17 μg/L, AUC was 0.714, and the sensitivity and specificity were 58.57% and 82.35%. Pearson correlation analysis result showed that serum ECP was negatively correlated with FEV 1% and FEV 1/FVC ( r=-0.632 and-0.604, P<0.01), and it was positively correlated with FeNO ( r=0.707, P<0.01). Conclusions:Serum ECP level in children with RSV pneumonia is significantly increased, which is negatively correlated with FEV 1% and FEV 1/FVC, and positively correlated with FeNO. Serum ECP can be used as one of the reference indicators for the diagnosis and severity assessment of children with RSV pneumonia.