摘要
目的:探讨重症肺炎(SP)患儿血清趋化因子配体17(CCL17)、生长分化因子-15(GDF-15)、血管生成素2(ANG2)水平表达及对预后的评估价值.方法:选取344例SP患儿(SP组)和150例体检健康儿童(对照组).检测并对比两组血清CCL17、GDF-15、ANG2、炎症因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)]水平.采用多因素Logistic 回归分析影响SP患儿预后的因素.采用受试者操作特征(ROC)曲线分析血清GDF-15、ANG2和CCL17对SP患儿预后的评估价值.结果:相较于对照组,SP组血清CCL17、GDF-15、ANG2、IL-6、CRP、PCT水平均显著升高(P＜0.05).小儿危重病例评分(PCIS)降低、血清CCL17、GDF-15、ANG2水平均升高是SP患儿预后不良的危险因素(P＜0.05).ROC曲线分析结果显示,CCL17、GDF-15、ANG2单独及联合预测SP患儿预后的曲线下面积(AUC)分别为0.833、0.801、0.806、0.974,联合预测SP患儿预后不良的价值高于各指标单独预测(P＜0.05).结论:SP患儿血清CCL17、GDF-15、ANG2水平呈异常高表达,且与预后不良密切相关,三指标联合检测对预测SP患儿预后不良具有较高价值.
Abstract
Objective:To investigate the expression of serum chemokine ligand 17(CCL17),growth differentiation factor-15(GDF-15)and angiopoietin 2(ANG2)in children with severe pneumonia(SP)and their prognostic value.Methods:344 SP children(SP group)and 150 healthy children(control group)were selected.The levels of serum CCL17,GDF-15,ANG2,inflammatory factors[interleukin-6(IL-6),C-reactive protein(CRP),procalcitonin(PCT)]were detected and compared between two groups.Multivariate logistic regression was used to analyze the prognostic factors of children with SP.The prognostic value of serum GDF-15,ANG2 and CCL17 in children with SP was analyzed using receiver operating characteristic(ROC)curves.Results:Compared with control group,the levels of serum CCL17,GDF-15,ANG2,IL-6,CRP and PCT in SP group were significantly increased(P＜0.05).The decrease of pediatric critical illness score(PCIS)and the increase of serum CCL17,GDF-15 and ANG2 levels were risk factors for poor prognosis in children with SP(P＜0.05).The results of ROC curve analysis showed that,the areas under the curve(AUC)of CCL17,GDF-15 and ANG2 alone and in combination for predicting the prognosis of children with SP were 0.833,0.801,0.806 and 0.974,respectively,the value of combined prediction of poor prognosis in children with SP was higher than that of each index alone(P＜0.05).Conclusion:The levels of serum CCL17,GDF-15 and ANG2 in children with SP are abnormally high,and are closely related to the poor prognosis,the combined detection of the three indexes has a high value in predicting the poor prognosis of children with SP.
维普
万方数据