The expression levels of sIL-2R,CGRP,sVCAM-1 in cerebrospinal fluid of children with severe viral encephalitis and their prognostic factors
Objective To analyze the expression levels of soluble interleukin-2 receptor(sIL-2R),calcitonin gene-related peptide(CGRP)and soluble vascular intercellular adhesion molecule-1(sVCAM-1)in cerebrospinal fluid of children with severe viral encephalitis and the prognostic factors.Methods Clinical data of 136 children with severe viral encephalitis admitted to the Nanyang South Stone Hospital from June 2020 to January 2023 were retrospectively collected.All the children were followed up for 3 months after discharge,and were divided into the poor prognosis group(43 cases)and the good prognosis group(93 cases)according to the prognosis during the follow-up.The single factor of poor prognosis in children with severe viral encephalitis was analyzed.The risk factors of poor prognosis in children with severe viral encephalitis were analyzed by multivariate logistic regression.The expression levels of sIL-2R,CGRP and sVCAM-1 in cerebrospinal fluid of the two groups were compared.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of cerebrospinal fluid sIL-2R,CGRP and sVCAM-1 in children with severe viral encephalitis.Results Multivariate logistic regression analysis showed that fever duration ≥5 d,persistent convulsion,stress hyperglycemia and abnormal magnetic resonance imaging(MRI)were independent risk factors for poor prognosis in children with severe viral encephalitis(OR=3.501,1.960,2.643,2.743;all P＜0.05).The expression levels of sIL-2R,CGRP and sVCAM-1 in cerebrospinal fluid of the poor prognosis group were higher than those of the good prognosis group,the differences were statistically significant(t=7.214,6.779,3.558;all P＜0.05).The area under the curve value and sensitivity of cerebrospinal fluid combined with sIL-2R,CGRP and sVCAM-1 to predict the prognosis of children with severe viral encephalitis were higher than those of the three tests alone,the sensitivity of CGRP was higher than that of sIL-2R and sVCAM-1,the specificity of sIL-2R and sVCAM-1 was higher than that of CGRP and CGRP combined,the differences were statistically significant(all P＜0.05).Conclusions The risk factors for poor prognosis in children with severe viral encephalitis include fever duration ≥5 d,persistent convulsion,stress hyperglycemia,and abnormal MRI.There were significant differences in the expression levels of sIL-2R,CGRP,and sVCAM-1 in cerebrospinal fluid of children with severe viral encephalitis with different prognosis,and the combination of the three factors had better predictive value for poor prognosis.
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