支氣管哮喘患兒血清Sema7a、Activin A與氣道重塑的相關性

Doi：10.3969/j.issn.1673—5293.2025.08.009

[摘要]目的分析支氣管哮喘患兒血清信號素7a（Sema7a）、激活素A（ActivinA）與氣道重塑的相關性。方法選取2022年5月至2024年5月于華北醫療健康集團峰峰總醫院治療的118例哮喘患兒為研究組（氣道重塑組56例，非氣道重塑組62例），79例同期健康兒童為對照組。檢測并收集兩組患兒肺功能和氣道重塑指標，使用ELISA法檢測血清 Sema7a和Activin A水平，Pearson法分析氣道重塑組哮喘患兒血清 Sema7a和ActivinA水平之間及與肺功能和氣道重塑指標的關系，Logistic 回歸分析哮喘患兒氣道重塑發生的影響因素，受試者工作特征（ROC）曲線評估血清 Sema7a和ActivinA水平診斷哮喘患兒氣道重塑的效能。結果研究組患兒血清Sema7a和ActivinA水平顯著高于對照組 （t=15.648，17.357，Plt;0.05） ，中、重度組哮喘患兒顯著高于輕度組，重度組哮喘患兒顯著高于中度組 （F=47.312，30.019，Plt;0.05） 。氣道重塑組哮喘患兒的氣道壁厚度與氣道腔外徑比 （T/D） 、氣道管壁面積（WA）占氣道總面積百分比（ ΔWA% ）、Sema7a和ActivinA水平顯著高于非氣道重塑組 （t=6.955 、4.142，8.722，7.327，Plt;0.05） ，呼氣流量峰值（PEF）和用力呼氣容積與用力肺活量之比 ΔFEV₁/FVC） 顯著低于氣道重塑組（ t= 3.609，5.041，Plt;0.05） 。Pearson結果顯示，氣道重塑組哮喘患兒血清Sema7a和ActivinA水平呈正相關 （r=0.516，Plt;0.05） ，二者與PEF和 FEV₁ /FVC呈負相關 （r=-0.502，-0.469，-0.432，-0.540，Plt;0.05） ，與 T/D 和 ΔWA% 呈正相關 （r=0.488 、（2 0.354，0.421，0.378，Plt;0.05） 。Logistic回歸表明，PEF、 FEV₁/FVC.T/D.WA% 、Sema7a和ActivinA為哮喘患兒氣道重塑的影響因素 （OR=0.667，0.551，1.492，1.935，1.589，2.367，Plt;0.05） 。ROC曲線表明，血清Sema7a和ActivinA水平診斷哮喘患兒氣道重塑的ROC 曲線下面積（AUC）分別為0.861和0.833，二者聯合診斷的AUC為0.941，顯著高于各自單獨診斷 （Z=???ac≈?Sema7a= 。結論哮喘氣道重塑患兒血清Sema7a和ActivinA水平顯著升高，與肺功能和氣道重塑指標相關，二者聯合檢測診斷哮喘患兒氣道重塑效能良好。

[中圖分類號]R179 [文獻標識碼]A [文章編號]1673—5293（2025）08—0054—07

Correlation between serum Sema7a，Activin A and airway remodeling in children with bronchial asthma

MA Xiaolong，LI Ranran，DAI Lisha，ZHOU Suxiang （DepartmentofPediatrics，FengfengGeneral Hospital，NorthChinaMedical and HealthGroup，HebeiHandanO562OO，China）

[Abstract]ObjetiveToanalyzecorelationsofserumsemaphorin7a（Sema7a）andActivinAwithairwayremodelinginchildren withbronchialasthma.MethodsFromMay2O22toMay2024，118childrenwithasthmatreatedinourhospitalwereselectedas studygroup.According toseverityofasthma，49childrenwithasthma weredividedintomildasthma group，38childrenwithasthma weredivided into moderate asthma group and31children withasthma weredivided into severe asthma group.Further，accordingto whetherthechild presentedwithairwayremodelinginpathological examination，56childrenwithasthma whopresentedwith airway remodelingwere dividedintoairwayremodeling groupand62children with asthmawho didn’t present withairway remodeling were dividedintonon-airwayremodelinggroup.79healthychildren inthesameperiod wereselectedasthecontrol group.Thelungfunctionandairwayremodeling indexesofallchildren inthetwogroups weretestedandrecorded.Enzyme-linked immunosorbentassay（ELISA）wasaplied todetectserum Sema7aandActivinAlevelsofallchildren.Pearsoncorrelationanalysis wasaplied toanalyzerelationshipsofserum Sema7aandActivinAlevelswithclinicaldataofasthmaticchildrenwithairway remodeling.LogisticregresionwasappliedtoanalyzeinfluencingfactorsofairwayremodelinginchildrenwithasthmaReceiver operating characteristic（ROC）curve was applied toevaluate eficacyofserum Sema7a and Activin Alevels fordiagnosing airway remodeling ofthechildren withasthma.ResultsTheserumlevelsofSema7aandActivinAofthechildreninthestudy groupwere significantly higher than those in the control group（ Δt=15.648 and 17.357 respectively，both Plt;0.05） .And the serum levels of Sema7aandActivinAof thechildreninthe moderate orsevereasthma groupsweresignificantly higher thanthoseinthemild asthmagroup，also，theserumlevelsofSema7aandActivinAofthechildren inthesevereasthmaweresignificantly higherhan those in the moderate asthma group （ F=47.312 and 30.019 respectively，both Plt;0.05 .Compared with the non-airway remodeling group，asthmaticchildrenintheairwayremodeling grouphadsignificantlyincreasedairwaywalthicknesstiraylumendiameter ratio（T/D），airway wall area（WA）as a percentage of total airway area（ WA% ），serum Sema7a and Activin A levels，whilein lungfunctionindexes，theyhadsignificantlydecreasedpeak expiratoryflow（PEF）andforcedexpiratoryvolumetoforcedvital capacityratio （ FEV₁ /FVC） （t=6.955，4.142，8.722，7.327，3.609 and5.041 respectively，all Plt;0.05 ）.Pearson correlation analysis showed thatserum Sema7a levelwaspositivelycorrelatedwithserum ActivinAlevelinasthmaticchildrenintheairway remodeling group （ r=0.516，Plt;0.05 ，the serum Sema7a level and the serum Activin A level were negatively correlated with PEF and FEV/FVC r=-0.502，-0.469，-0.432 and -0.540 respectively，all Plt;0.05 ），and they were positively correlated with T/D and WA% （ r=0.488，0.354，0.421 and 0.378 respectively，all Plt;0.05 ）.Logisticregression analysis showed that PEF，FEV ¹ / FVC，T/D， WA% ，Sema7a and Activin A were allinfluencing factors of airway remodeling in children with asthma （ OR=0.667 ， 0.551，1.492，1.935，1.589 and 2.367 respectively，all Plt;0.05） .ROC analysis showed that areas under the curve （AUCs）of serum Sema7aandActivinAlevels fordiagnosing ocurenceofairwayremodelinginchildren withasthmawereO.861and0.833 respectively.TheAUCofthecombineddiagnosisofthetwoindexes was O.941，whichwassignificantlyhigherthanthoseof single serum Sema7a and single serum Activin A alone （Z_{combination?Sema7a}=2.028，P=0.043;Z_{combination?ActivinA}=2.568，P=0.010） . Conclusion Serum Sema7aand Activin Alevels greatly elevate in asthmatic children withairway remodeling，and theyarecorrelated withlung functionandairwayremodelingindexes.Thecombineddetectionofthetwoindexeshasgooddiagnosticeficacyforairway remodeling in children with asthma.

[Key words] children; bronchial asthma;semaphorin 7a;Activin A;airway remodeling

支氣管哮……