Evaluation of High-Sensitivity Serum CRP Levels Compared to Markers of Airway Inflammation and Allergy as Predictors of Methacholine Bronchial Hyper-Responsiveness in Children
Evaluation of High-Sensitivity Serum CRP Levels Compared to Markers of Airway Inflammation and Allergy as Predictors of Methacholine Bronchial Hyper-Responsiveness in Children
复制标题
评估高敏血清 CRP 水平与气道炎症和过敏标志物相比作为儿童乙酰甲胆碱支气管高反应性的预测因子
作者：
G. Livnat;Ronen Bar Yoseph;V. Nir;F. Hakim;M. Yigla;L. Bentur
背景甲基胆碱激发试验（MCT）评估支气管高反应性可能有助于哮喘的诊断，而MCT阴性则有助于排除哮喘的诊断。预测MCT结果的实验室措施有望减少程序的数量。我们评估了血清高敏c反应蛋白（hs-CRP）预测学龄儿童MCT阳性或阴性的能力，并将其与气道炎症标志物、分数呼气一氧化氮（FeNO）、过敏致敏标志物、免疫球蛋白E （IgE）和外周血嗜酸性粒细胞进行了比较。患者和方法6-18岁的儿童接受MCT治疗。将MCT结果与hs-CRP水平、FeNO水平、IgE和外周血嗜酸性粒细胞计数进行比较。结果131例患儿中，63例（48%）mct阳性（I组），68例（52%）mct阴性（II组）。通过受体工作特征曲线预测MCT阳性的最佳临界值为：FeNO为23 ppb， IgE为120 IU/mL，嗜酸性粒细胞为500/mL；hs-CRP未见临界值。上述截断点MCT阳性的比值比为：FeNO为2.43 (1.05-5.61)，IgE为2.4(1.01-5.74)，嗜酸性粒细胞为3.32 (1.13-9.75)，hs-CRP为NS。hs-CRP与FeNO、IgE或嗜酸性粒细胞水平无相关性。结论crp水平对预测本组患儿甲胆碱支气管高反应性无帮助，而FeNO、IgE、嗜酸性粒细胞对预测患儿甲胆碱支气管高反应性有帮助。
BackgroundBronchial hyper-responsiveness assessed by the methacholine challenge test (MCT) may aid in the diagnosis of asthma, while a negative MCT can help in excluding the diagnosis. Laboratory measures that predict the results of MCT are expected to reduce the number of procedures. We evaluated the capacity of serum high-sensitivity C-reactive protein (hs-CRP) to predict positive or negative MCT in school-aged children and compared it to a marker of airway inflammation, fractional exhaled nitric oxide (FeNO), and markers of allergic sensitization, immune globulin E (IgE) and peripheral blood eosinophils.Patients and MethodsChildren aged 6–18 years referred for MCT were included in the study. The results of the MCT were compared to hs-CRP levels and FeNO levels, IgE, and peripheral blood eosinophil counts.ResultsOf the 131 children assessed, 63 (48 %) patients had positive MCTs (Group I), and 68 (52 %) had negative MCTs (Group II). The best cut-off values to predict a positive MCT by receiver-operating characteristic curves were: 23 ppb for FeNO, 120 IU/mL for IgE, and 500/mL for eosinophils; no cut-off value was found for hs-CRP. The odds ratio for a positive MCT with the above cut-off points were 2.43 (1.05–5.61) for FeNO, 2.4 (1.01–5.74) for IgE, 3.32 (1.13–9.75) for eosinophils, and NS for hs-CRP. No correlation was found between hs-CRP and FeNO, IgE, or eosinophil levels.Conclusionshs-CRP levels were not helpful, while FeNO, IgE, and eosinophils were useful in the prediction of methacholine bronchial hyper-responsiveness in our group of children.