摘要
目的 探讨血清可溶性晚期糖基化终末产物受体(sRAGE)、高迁移率族蛋白B1(HMGB1)和肺泡表面活性蛋白A(SP-A)在新生儿急性呼吸窘迫综合征(ARDS)诊断及预后评估中的应用价值。方法 选择2018年10月至2020年10月于该院确诊ARDS的新生儿80例作为ARDS组,同期选择健康新生儿50例作为对照组,ARDS患儿根据治疗结局分为存活组和死亡组。采用酶联免疫吸附试验(ELISA)检测新生儿入院时的血清sRAGE、HMGB1和SP-A水平,比较ARDS不同分级患儿血清sRAGE、HMGB1和SP-A水平;采用多因素Logistic回归分析筛选死亡的独立预测因子;采用受试者工作特征(ROC)曲线分析血清sRAGE、HMGB1和SP-A水平预测死亡的效能。结果 ARDS组比对照组,死亡患儿比存活患儿,ARDSⅢ~Ⅳ级患儿比ARDSⅠ~Ⅱ级患儿血清sRAGE、HMGB1和SP-A水平明显升高(P<0.05)。多因素Logistic回归分析结果显示,ARDSⅢ~Ⅳ级及血清sRAGE、HMGB1和SP-A水平升高是死亡的危险因素(P<0.05)。ROC曲线分析结果显示,血清sRAGE、HMGB1、SP-A水平及联合诊断预测ARDS新生儿死亡的曲线下面积分别为0.834、0.855、0.869和0.899(P<0.05)。结论 ARDS新生儿血清sRAGE、HMGB1和SP-A水平明显升高与疾病严重程度和生存预后密切相关,联合诊断可提高预测死亡结局的准确性。
Objective To investigate the application value of serum soluble advanced glycation end product receptor(sRAGE),high mobility group protein B1(HMGB1)and pulmonary surfactant protein A(SP-A)in the diagnosis and prognosis evaluation of neonatal acute respiratory distress syndrome(ARDS).Methods A total of 80 neonates with ARDS diagnosed in the hospital from October 2018 to October 2020 were selected as the ARDS group,and 50 healthy neonates were selected as the control group during the same period.Children with ARD were divided into a survival group and a death group according to the treatment outcome.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of sRAGE,HMGB1 and SP-A in admission serum,and the levels of sRAGE,HMGB1 and SP-A in children with different grades of ARDS were analyzed.Multivariate Logistic regression analysis was used to screen independent predictors of death;receiver operating characteristic(ROC)curves were used to analyze the efficacy of serum sRAGE,HMGB1 and SP-A levels in predicting death.Results The serum levels of sRAGE,HMGB1 and SP-A in ARDS group were significantly higher than those in control group(P<0.05).The serum levels of sRAGE,HMGB1 and SP-A were significantly higher in the dead children than in the surviving children(P<0.05).The serum levels of sRAGE,HMGB1 and SP-A in children with ARDSⅢ-Ⅳgrades were significantly higher than those in children with ARDSⅠ-Ⅱgrades(P<0.05).Multivariate Logistic regression analysis showed that ARDSⅢ-Ⅳgrades and serum levels of sRAGE,HMGB1 and SP-A were risk factors for death(P<0.05).The results of ROC curve analysis showed that the serum sRAGE,HMGB1,SP-A levels and the area under the curve of combined diagnosis to predict ARDS neonatal death were 0.834,0.855,0.869 and 0.899 respectively(P<0.05).Conclusion Significantly elevated serum sRAGE,HMGB1 and SP-A levels in neonates with ARDS are closely related to disease severity and survival prognosis.Combined diagnosis can improve the accuracy of predicting death outcomes.
作者
金少娟
茅红英
JIN Shaojuan;MAO Hongying(Department of Neonatology,Zhangjiagang Hospital Affiliated to Soochow University/Zhangjiagang First People's Hospital,Suzhou,Jiangsu 215600,China)
出处
《国际检验医学杂志》
CAS
2022年第10期1221-1225,1233,共6页
International Journal of Laboratory Medicine
