摘要
目的探讨细菌性肺炎(BP)患儿的血清可溶性尿激酶型纤溶酶原激活物受体(suPAR)、肺表面活性蛋白A(SPA)、可溶性细胞间黏附分子-1(sICAM-1)水平,并分析其与患儿病情的相关性及对患儿预后的预测价值。方法选取BP患儿124例作为BP组,根据患儿临床表现分为轻度组(70例)和重度组(54例)两个亚组。选取同期78例支原体肺炎患儿作为支原体组,同期健康体检患儿64例作为对照组。分别检测各组血清suPAR、SPA、sICAM-1水平。采用急性生理和慢性健康状况评分(APACHEⅡ)评估病情,记录患儿治疗后7 d的预后情况,分析血清suPAR、SPA、sICAM-1水平与患儿病情的相关性及对患儿预后的预测价值。结果BP组与支原体组血清suPAR、SPA、sICAM-1水平均高于对照组,且BP组血清suPAR、SPA、sICAM-1水平均高于支原体组(t分别=13.45、27.15、20.79、9.13、19.37、17.94、5.08、8.40、8.10,P均<0.05)。重度组血清suPAR、SPA、sICAM-1水平均高于轻度组(t分别=4.26、6.50、4.98,P均<0.05)。BP患儿血清suPAR、SPA、sICAM-1水平均与APACHEⅡ评分呈正相关(r分别=0.84、0.87、0.86,P均<0.05)。血清suPAR预测BP患儿预后的AUC为0.81(95%CI 0.72~0.90),灵敏度为87.90%,特异度为61.20%;血清SPA预测BP患儿预后的AUC为0.85(95%CI 0.77~0.93),灵敏度为69.70%,特异度为92.50%;血清sICAM-1预测BP患儿预后的AUC为0.82(95%CI 0.74~0.90),灵敏度为72.70%,特异度为76.10%;三者联合预测BP患儿预后的AUC为0.93(95%CI 0.88~0.98),灵敏度为81.80%,特异度为95.50%。结论BP患儿血清suPAR、SPA、sICAM-1水平均升高,患儿血清suPAR、SPA、sICAM-1水平均与病情程度密切相关。血清suPAR、SPA、sICAM-1三者联合预测患儿预后情况的价值更高。
Objective To investigate the levels of soluble urokinase-type plasminogen activator receptor(suPAR),surfactant protein A(SPA)and soluble intercellular adhesion molecule-1(sICAM-1)in serum of children with bacterial pneumonia(BP),and to analyze the correlation between them and the severity of children and their predictive value in prognosis.Methods Totally 124 children with BP were divided into two subgroups:mild group(n=70)and severe group(n=54)according to their severity.At meanwhile,78 children with mycoplasma pneumonia during the same period were selected as the mycoplasma group,and 64 children with healthy physical examination during the same period were selected as the control group.The levels of serum suPAR,SPA and sICAM-1 were detected in each group.The acute physiology and chronic health status score(APACHEⅡ)was used to assess the child’s condition,and the prognosis of the child at 7 days after treatment was recorded.The correlation between serum suPAR,SPA,sICAM-1 levels and severity was analyzed,and the prognosis of the child value was analyzed by ROC.Results The levels of serum suPAR,SPA,and sICAM-1 in the BP group and the mycoplasma group were higher than those in the control group,and the levels of serum suPAR,SPA,and sICAM-1 in the BP group were higher than those in the mycoplasma group,the differences were statistically significant(t=13.45,27.15,20.79,9.13,19.37,17.94,5.08,8.40,8.10,P<0.05).The levels of serum suPAR,SPA and sICAM-1 in the severe group were higher than those in the mild group,the differences were statistically significant(t=4.26,6.50,4.98,P<0.05).Pearson correlation analysis showed that serum levels of suPAR,SPA,and sICAM-1 in children with BP were positively correlated with the APACHEⅡ score(r=0.84,0.87,0.86,P<0.05).The AUC of serum suPAR for predicting the prognosis of children with BP was 0.81(95%CI 0.72-0.90),the sensitivity was 87.90%,and the specificity was 61.20%.The AUC of serum SPA for predicting the prognosis of children with BP was 0.85(95%CI 0.77-0.93),the sensitivi
作者
李蓉蓉
俞培锋
LI Rongrong;YU Peifeng(Department of Pediatrics,Zhuji People’s Hospital,Zhuji 311800,China)
出处
《全科医学临床与教育》
2021年第5期424-427,共4页
Clinical Education of General Practice
