vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v18i2.2014vsp-2077Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESДиагностика бронхиальной астмы у детей в возрасте 3–6 лет с применением сывороточного периостина и суррогатных маркеров эозинофильного воспаления (эозинофилы крови и уровень общего IgE): одномоментное исследованиеDiagnosis of Bronchial Asthma in Children 3–6 Years Old by Using Serum Periostin and Surrogate Markers of Eosinophilic Inflammation (Blood Eosinophils and Total IgE): a Cross-Sectional Studyhttps://orcid.org/0000-0002-7143-8259ШаховаН. В.ShakhovaNatalia V.

доцент кафедры пропедевтики детских болезней АГМУ, врач аллерголог-иммунолог

656043, Барнаул, пр. Ленина, д. 40, тел.:+7 (385) 261-91-82

Barnaul

Natalia.shakhova@mail.ruhttps://orcid.org/0000-0002-2234-5355КамалтыноваЕ. М.KamaltynovaElena M.

Томск

Tomsk

https://orcid.org/0000-0001-8184-9230КашинскаяТ. С.KashinskayaTatyana S.

Барнаул

Barnaul

Алтайский государственный медицинский университетРоссияAltai State Medical UniversityRussian FederationСибирский государственный медицинский университетРоссияSiberian State Medical UniversityRussian Federation201923062019182118124Copyright © Шахова Н.В., Камалтынова Е.М., Кашинская Т.С., 20192019Шахова Н.В., Камалтынова Е.М., Кашинская Т.С.Shakhova N.V., Kamaltynova E.M., Kashinskaya T.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/2077

Диагностика бронхиальной астмы (БА) у детей в возрасте до 6 лет сложна в связи с ограниченной возможностью исследования функции внешнего дыхания. В этих условиях актуален поиск диагностических маркеров БА, определение которых не потребует активного участия ребенка.

Цель исследования — изучить диагностическую ценность сывороточного периостина в сравнении с суррогатными маркерами эозинофильного воспаления (общим IgE и эозинофилами крови) для установления БА у детей дошкольного возраста.

Методы

Методы. В одномоментное исследование включали детей в возрасте 3–6 лет с БА и здоровых сверстников. Определяли уровень сывороточного периостина (ELISA), общего IgE (хемилюминесцентным методом), число эозинофилов крови (на гематологическом анализаторе). Для изучения диагностической ценности показателей периферической крови использовали ROC-анализ.

Результаты

Результаты. У детей с БА (n = 56) в сравнении с группой здоровых (n = 29) отмечены более высокие уровни сывороточного периостина (медиана и квартили) — 5,7 (3,4; 8,0) и 2,7 (1,7; 3,6) нг/мл (p < 0,001), общего IgE — 180 (122; 622) и 55 (45; 87) ME/мл (p < 0,001), эозинофилов крови — 6,1 (3,8; 8,0) и 3,6% (2,7; 4,1) (p < 0,001). Площадь под ROC-кривой (AUC) для сывороточного периостина составила 0,81 (95% ДИ 0,73–0,89), для обще-го IgE — 0,86 (95% ДИ 0,77–0,92), для эозинофилов крови — 0,77 (95% ДИ 0,67–0,86). Независимыми предиктора-ми сывороточного периостина были общий IgE и количество обострений БА за прошедшие 12 мес > 2 (R2 = 0,527).

Заключение

Заключение. Уровень сывороточного периостина у детей дошкольного возраста с БА выше, чем у их здоровых сверстников. Диагностическая ценность сывороточного периостина при БА находится в диапазоне от средней до хорошей и сопоставима с таковой для эозинофилов крови и уровня общего IgE.

Background

Background. It is difficult to diagnose bronchial asthma (BA) in children under the age of 6 due to the limited ability to study respiratory function. Therefore, it is relevant to search for such diagnostic markers of BA that do not require the active participation of a child.

Objective

Objective. Our aim was to assess the diagnostic value of serum periostin levels in comparison with surrogate markers of eosinophilic inflammation (total IgE and blood eosinophils) for the diagnosis of BA in preschool children.

Methods

Methods. A cross-sectional study included children 3–6 years of age with BA and healthy peers. The levels of serum periostin (ELISA), total IgE (chemiluminescent method), blood eosinophils (counted on a hematological analyzer) were determined. To study the diagnostic value of peripheral blood parameters ROC-analysis was used.

Results

Results. Children with BA (n = 56) compared with the healthy group (n = 29) showed higher levels of serum periostin (median and quartile) — 5.7 (3.4, 8.0) and 2.7 (1, 7; 3.6) ng/ml (p < 0.001), total IgE — 180 (122; 622) and 55 (45; 87) IU/ml (p < 0.001), blood eosinophils — 6.1% (3.8; 8.0) and 3.6% (2.7; 4.1) (p < 0.001). The area under the ROC curve (AUC) for serum periostin was 0.81 (95% CI 0.73–0.89), for total IgE — 0.86 (95% CI 0.77–0.92), for blood eosinophils — 0.77 (95% CI 0.67–0.86). Independent predictors of serum periostin were total IgE and the number of exacerbations of BA over the past 12 months > 2 (R2 = 0.527).

Conclusion

Conclusion. The level of serum periostin in preschool children with BA is higher than in their healthy peers. The diagnostic value of serum periostin in BA is in the range from moderate to good and is comparable to that for the levels of blood eosinophils and total IgE.

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The authors declare that there are no conflicts of interest present.