现代中西医结合杂志2025，Vol.34Issue(11)：1468-1474,7.DOI:10.3969/j.issn.1008-8849.2025.11.002
痰液IL-37、RAMP-1、TSLP水平与支气管哮喘急性发作关系及联合预测重度发作效能研究
Relationship between sputum IL-37,RAMP-1,TSLP and acute asthma exacerbation and combined efficacy in predicting severe exacerbation
摘要
Abstract
Objective It is to investigate the relationship between sputum interleukin-37(IL-37),receptor activity modifying protein-1(RAMP-1),and thymic stromal lymphopoietin(TSLP)and acute asthma exacerbations and the com-bined predictive efficacy on severe exacerbations.Methods A total of 109 patients in clinical remission of asthma admitted to our hospital from July 2023 to December 2023 were selected and divided into exacerbation group and non-exacerbation group according to whether they had an acute exacerbation within 3 months,the baseline data,and sputum levels of IL-37,RAMP-1,TSLP of patient were compared between the two groups,and the sputum levels of IL-37,RAMP-1,TSLP were compared among patients with different exacerbation degrees.The correlations between sputum levels of IL-37,RAMP-1 and TSLP and the severity of asthma attacks were analyzed,the importances of variables associated with asthma acute exac-erbations were ranged and relevant variables were screened by random forest model,the efficacy of sputum levels of IL-37,RAMP-1 and TSLP in predicting moderate and severe acute exacerbations of asthma was analyzed by receiver operating characteristic(ROC)curve.Results There were 37 patients in the exacerbation group and 72 patiens in the non-exacerba-tion group.The proportions of patients hospitalized for acute exacerbation,and those complicating with allergic rhinitis,chronic obstructive pulmonary disease,sinusitis and nasal polyps in the past one year were significantly higher in the exac-erbation group than those in the non-exacerbation group(all P<0.05),the sputum level of IL-37 was significantly lower,while the sputum levels of RAMP-1 and TSLP were significantly higher than those in the non-exacerbation group(all P<0.05).The sputum level of IL-37 in severe patients was significantly lower than that in mild and moderate patients in the exacerbation group(all P<0.05),and the level in moderate patients was significantly lower than that in mild patients(P<0.05);the sputum levels of RAMP-1 and TSLP were significantly higher in severe patients than those in mild and moder-ate patients,and the levels were significantly higher in moderate patients than those in mild patients(all P<0.05).Corre-lation analysis showed that sputum IL-37 was negatively correlated with the severity of asthma attacks,and sputum RAMP-1 and TSLP were positively correlated with severity of asthma attacks(all P<0.05).Random forest model analysis showed that the ranked importance of the variables characterizing acute exacerbations of asthma were TSLP,IL-37,RAMP-1,hos-pitalization for acute exacerbations in the past one year,chronic obstructive pulmonary disease,allergic rhinitis,sinusitis and nasal polyps in that order,and the lowest out-of-bag data error rate was observed when the number of variables was 3.Therefore,mtry=3 was fixed to filter the top 3 variables in importance:TSLP,IL-37,and RAMP-1;the AUC of sputum IL-37,RAMP-1,and TSLP combined to predict moderate and severe exacerbations of asthma was greater than that of the corresponding individual indexes,with predictive sensitivities of 83.33%and 80.00%and predictive specificities of 98.61%and98.61%,respectively(all P<0.05).Conclusion Decreased sputum IL-37 and elevated RAMP-1 and TSLP are associated with acute asthma exacerbation and exacerbation severity,and the combined test can be used as an effective protocol for predicting moderate to severe acute asthma exacerbation,providing objective guidance information for clinical management and treatment decisions.关键词
支气管哮喘/痰液/白细胞介素-37/受体活性修饰蛋白-1/胸腺基质淋巴生成素/急性发作/预测效能Key words
asthma/sputum/IL-37/RAMP-1/TSLP/acute attack/predictive efficacy分类
医药卫生引用本文复制引用
曹敬,王伯丽,赫坤,徐海博,晁灵善,阎锡新..痰液IL-37、RAMP-1、TSLP水平与支气管哮喘急性发作关系及联合预测重度发作效能研究[J].现代中西医结合杂志,2025,34(11):1468-1474,7.基金项目
2024年度河北省医学科学研究课题计划项目(20240129) （20240129）
