Objective To investigate the expression of 5 extracellular nucleotidase(CD73)and hypoxia-inducing factor 1α(HIF-1α)in peripheral blood mononuclear cells(PBMCs)in children with severe acute respiratory distress syndrome(ARDS)and their clinical signifi-cance.Methods One hundred and seventeen children with ARDS aduitted to Guang'an Peoples Hospital from February 2022 to April 2023 were selected as the study subjects and divided into mild group(n=27),moderate group(n=38)and severe group(n=52)according to the se-verity of the disease.The expression levels of CD73 and HIF-1α in PBMCs and pulmonary infection index(CPIS)scores of the three groups were compared.Pearson correlation coefficient was used to analyze the correlation between CD73 and HIF-1α expression levels and CPIS score.After 3 months of follow-up after treatment,the children were divided into survival group(n=34)and death group(n=83)according to their sur-vival status,and the expression levels of CD73 and HIF-1α in PBMCs were compared between the two groups.The value expression levels of CD73 and HIF-1α in PBMCs in prognosis of ARDS children were evaluated by receiver operating characteristic(ROC)curve.Results The ex-pression levels of CD73 and HIF-1α in PBMCs in mild group were 0.44±0.06,0.60±0.11,(4.82±0.81)points,respectively,which were significantly lower than those in moderate group[0.53±0.10,0.76±0.14,(6.33±1.02)points]and severe group[0.62±0.07,0.89±0.08,(7.03±1.14)points],the expression levels of CD73 and HIF-1α in PBMCs in moderate group were significantly lower than those in severe group,and the differences were statistically significant(P＜0.05).Pearson correlation coefficient analysis showed that the relative expression levels of CD73 and HIF-1α were significantly positively correlated with CPIS scores(r=0.623,0.687,P＜0.05).The expression levels of CD73 and HIF-1α in PBMCs in survival group were significantly lower than those in death group(P＜0.05).ROC curve analysis showed that the sensitivity of CD73 and HIF-1α alone and combined to predict the prognosis of ARDS children were 79.41％,85.29％and 94.12％,and the area under the curve(AUC)was 0.746,0.801 and 0.843,respectively.The combined prediction value was higher.Conclusion The ex-pression levels of CD73 and HIF-1α in PBMCs are increased with the increase of disease severity,and are significantly correlated with pulmonary infection in children with ARDS.They have high diagnostic value for the prognosis of children with ARDS.
维普
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