Analysis of the relationship between serum Endocan,complement C3a,with the disease condition and prognosis in children with severe pneumonia
Objective To investigate the relationship between serum endothelium cell specific molecule(Endocan)-1,complement C3a with the disease condition and prognosis in children with severe pneumonia.Methods A study was conducted on 190 children with severe pneumonia(pneumonia group)and 95 healthy children matched for age and sex(control group)admitted to 961 Hospital of the Joint Logistics Support Force of the People's Liberation Army and the First Hospital of Qiqihar from March 2018 to March 2023.The children with severe pneumonia were devided into a low-risk subgroup(59 cases),a moderate-to-high-risk subgroup(76 cases),and a very high-risk subgroup(55 cases)based on the modified predisposition,infection,response,and organ dysfunction(PIRO)score.Measure serum levels of Endocan and complement C3a,record adverse clinical outcomes in children with severe pneumonia,analyze factors influencing prognosis in these children,and the value of Endocan and complement C3a in predicting developmental outcomes of severe pneumonia in children.Results In the pneumonia group,serum levels of Endocan and complement C3a were higher compared to the control group,with statistically significant differences(t=40.775 and 37.808,respectively,P＜0.05).Within the pneumonia group,the very high-risk subgroup exhibited higher levels of serum Endocan and complement C3a compared to the moderate-to-high-risk and low-risk subgroups.The moderate-to-high-risk subgroup also showed higher levels compared to the low-risk subgroup,with statistically significant differences(F=109.352 and 78.293,respectively,P＜0.05).Among patients with poor prognosis,the modified very high-risk category,admission to the intensive care unit,and respiratory failure were higher than that in good prognosis group,and the serum Endocan and complement C3a levels were higher compared to the good prognosis group,with statistically significant differences(t/x2=5.435-33.346,P＜0.05).Multivariable logistic regression analysis showed that very high-risk according to the modified PIRO scale,high level of Endocan and high level of complement C3a were risk factors for poor prognosis children with severe pneumonia,with OR and 95％CI of 2.186(1.177-4.061),1.868(1.092-3.196),and 1.667(1.120-2.482),all P＜0.05.Combining Endocan,complement C3a,and modified PIRO score to predict the outcomes of severe pneumonia children yielded an area under the curve(AUC)of 0.900,which was higher than the prediction using each individual indicator alone(Z=3.542,6.317,and 2.627,all P＜0.05).Conclusion Elevated serum levels of Endocan and complement C3a in children with severe pneumonia are associated with disease severity worsening and poor prognosis,and can be used as potential indicators for assessing the severity and prognosis of severe pneumonia.
endothelial cell specific molecule-1complement C3asevere pneumoniaprognosis
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