广西医学

目的探讨过敏性鼻炎患儿血清可溶性生长刺激表达基因2蛋白（sST2)水平及其与病情严重程度及粉尘螨滴剂治疗反应性的相关性。方法选取100例过敏性鼻炎患儿设为观察组，另选取100例健康儿童设为对照组。比较两组研究对象血清IgE、白细胞介素（IL）-33、sST2水平。给予观察组患儿为期1年的粉尘螨滴剂舌下含服治疗，根据疗效将其分为有效组和无效组，比较有效组和无效组患儿治疗前后的血清sST2、IL-33水平。分析过敏性鼻炎患儿治疗前血清sST2水平与鼻部症状总评分（TNSS）、视觉模拟量表（VAS）评分、血清IgE水平的相关性。绘制受试者工作特征性（ROC）曲线，分析治疗前血清sST2水平预测过敏性鼻炎患儿对粉尘螨滴剂治疗反应性的价值。结果观察组治疗前的血清IgE、IL-33、sST2水平高于对照组（P＜0.05）。治疗前后有效组的血清sST2、IL-33水平低于无效组，且治疗后有效组的血清sST2、IL-33水平低于治疗前（P＜0.05），而无效组治疗前后血清sST2、IL-33水平差异无统计学意义（P＞0.05）。过敏性鼻炎患儿治疗前血清sST2 水平与TNSS、VAS评分、血清IgE水平呈正相关（P＜0.05）。ROC曲线分析显示，治疗前血清sST2水平预测过敏性鼻炎患儿对粉尘螨滴剂治疗反应性的曲线下面积为0.834，敏感性为89.23%，特异性为62.86%，截值为28.74 ng/mL。结论过敏性鼻炎患儿的血清 sST2 水平升高，其与患儿病情严重程度密切相关，且可作为预测过敏性鼻炎患儿对粉尘螨滴剂治疗反应性的生物学标志物。

ObjectiveTo investigate the level of serum soluble growth stimulation expressed gene 2 (sST2) in children with allergic rhinitis, and its correlation with severity and therapeutic responsiveness to Dermatophagoides Farinae Drops. MethodsA total of 100 children with allergic rhinitis were selected and set as observation group, and another 100 healthy children as control group. The levels of serum IgE, interleukin (IL)-33, and sST2 were compared between research subjects of the two groups. Children in the observation group received sublingual administration of Dermatophagoides Farinae Drops for 1 year, and they were assigned to effective group or ineffective group according to efficacy. The pre- and post-treatment serum sST2 and IL-33 levels were compared between children of the effective group and the ineffective group. The correlation of pre-treatment serum sST2 level with Total Nose Symptom Score (TNSS), Visual Analogue Scale (VAS) score, and serum IgE level in children with allergic rhinitis was analyzed. The receiver operating characteristic (ROC) curve was drawn to analyze the value of pre-treatment serum sST2 level for predicting therapeutic responsiveness to Dermatophagoides Farinae Drops in children with allergic rhinitis. ResultsThe pre-treatment levels of serum IgE, IL-33, sST2 in the observation group were higher than those in the control group (P＜0.05). The pre- and post-treatment levels of serum sST2, IL-33 in the effective group were lower than those in the ineffective group, and the effective group exhibited lower post-treatment levels of serum sST2 and IL-33 as compared with before treatment (P＜0.05), whereas no statistically significant difference in levels of serum sST2 and IL-33 in the ineffective group was found between before and after treatment (P>0.05). Serum sST2 level before treatment positively correlated with TNSS, VAS score, and serum IgE level in children with allergic rhinitis (P＜0.05). The ROC curve analysis revealed that area under the curve of pre-treatment serum sST2 level for predicting therapeutic responsiveness to Dermatophagoides Farinae Drops in children with allergic rhinitis was 0.834, the sensitivity was 89.23%, the specificity was 62.86%, and the cut-off value was 28.74 ng/mL. ConclusionSerum sST2 level is elevated in children with allergic rhinitis, it is closely related with severity of children, and it can be regarded as a biological marker for predicting therapeutic responsiveness to Dermatophagoides Farinae Drops in children with allergic rhinitis.