血清人分泌型磷脂酶A2、人可溶性髓系细胞触发受体-1、巨噬细胞炎性蛋白3α在妊娠合并获得性重症肺炎患者中的临床应用价值

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中文摘要：目的探讨血清人分泌型磷脂酶A2(sPLA2)、人可溶性髓系细胞触发受体-1(sTREM-1)、巨噬细胞炎性蛋白3α(MIP-3α)在妊娠合并获得性重症肺炎(SCAP)疾病中的临床应用价值.方法选择2019年2月至2023年1月我院收治疗80例妊娠合并SCAP患者作为研究组,同期100例妊娠合并获得性非重症肺炎患者作为对照组,比较两组血清sPLA2、sTREM-1、MIP-3α水平、急性生理学及慢性健康状况评分系统Ⅱ(APACHE-Ⅱ)评分及孕妇妊娠结局与新生儿结局,经Spearman分析妊娠合并SCAP患者血清sPLA2、sTREM-1、MIP-3α水平与APACHE-Ⅱ评分的关系;采用多元Logistic回归分析影响妊娠合并SCAP患者新生儿结局发展的因素.结果研究组血清sPLA2、sTREM-1、MIP-3α水平及APACHE-Ⅱ评分明显高于对照组,其孕产妇不良妊娠结局发生率以及新生儿出现感染、窒息、败血症、宫内窘迫、新生儿肺炎发生率均高于对照组(P＜0.05);经Spearman分析发现妊娠合并SCAP患者sPLA2、sTREM-1、MIP-3α水平与APACHE-Ⅱ评分存在正相关(P＜0.05);多元Logistic回归分析显示高水平sPLA2、sTREM-1、MIP-3α水平及APACHE-Ⅱ评分升高是妊娠合并SCAP患者新生儿不良结局的危险因素(P＜0.05);ROC曲线分析提示MIP-3α、sTREM-1、sPLA2均可预测妊娠合并SCAP患者新生儿不良结局,其中sTREM-1的诊断效能最高(P＜0.05).结论血清sPLA2、sTREM-1、MIP-3α与妊娠合并SCAP患者病情发展密切相关,能有效预测新生儿结局发展,可应用于临床.

外文标题：Clinical application value of serum secreted phospholipase A2,soluble myeloid cell trigger re-ceptor-1 and macrophage inflammatory protein-3 a in pregnant patients with acquired community severe pneumonia

外文摘要：Objective To explore the clinical application value of serum human secreted phospholipase A2(sPLA2),human soluble myeloid cell trigger receptor-1(sTREM-1)and macrophage inflammatory protein-3α(MIP-3α)in pregnancy patients with severe community acquired pneumonia(SCAP).Methods Eighty pregnant patients with SCAP admitted to our hospital from February 2019 to January 2023 were selected as a study group.During the same period,another 100 pregnant patients with non-severe community acquired pneumonia were selected as a control group.Serum levels of sPLA2,sTREM-1 and MIP-3α,Acute Physiology and Chronic Health Status Score System Ⅱ(APACHE-Ⅱ),pregnancy outcomes and neonatal outcomes were compared between the two groups.The relationship between serum levels of sPLA2,sTREM-1,MIP-3α and APACHE-Ⅱ score in pregnant patients with SCAP was analyzed by Spearman analysis.Multiple logistic regressions were used to analyze the factors affecting the neonatal outcome and de-velopment in pregnant patients with SCAP.Results The levels of serum sPLA2,sTREM-1 and MIP-3 as well as APACHE-Ⅱ score in the study group were significantly higher than those in the control group,and the incidence of maternal adverse pregnancy outcomes and the incidence of neonatal infection,asphyxia,sepsis,intrauterine distress,and neonatal pneumonia in the study group were higher than those in the control group(P＜0.05).Spearman analysis showed that the levels of sPLA2,sTREM-1 and MIP-3α were positively correlated with APACHE-Ⅱ score(P＜0.05).Multiple logistic regression analysis showed that high levels of sPLA2,sTREM-1,MIP-3α and elevated APACHE-Ⅱ scores were risk factors for adverse neonatal outcomes in pregnancy patients with SCAP(P＜0.05).ROC curve analysis indicated that sPLA2,sTREM-1 and MIP-3α could predict the adverse neonatal outcomes in pregnancy patients with SCAP.Among these indicators,sTREM-1 had the highest diagnostic efficiency(P＜0.05).Conclusions Serum sPLA2,sTREM-1 and MIP-3 α are closely related to the disease development of pregnant patients with SCAP.These indicators can effectively predict the neonatal outcome and development.Therefore,they can be applied in clinic practice.

外文关键词：

Human secreted phospholipase A2Human soluble myeloid cell trigger receptor-1Macrophage inflammatory protein-3αPregnancy with severe community acquired pneumoniaAPACHE-Ⅱ scoreNeonatal outcome and development

作者：

罗雅伊、钟惠、王军、金华

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作者单位：

四川省自贡市妇幼保健院产科,四川自贡 643000

关键词：

人分泌型磷脂酶A2 人可溶性髓系细胞触发受体-1 巨噬细胞炎性蛋白3α 妊娠合并获得性重症肺炎 APACHE-Ⅱ评分新生儿结局发展

基金：

四川省卫生健康委员会科研基金资助项目

项目编号：

20PJ123

出版年：

2024

实用医院临床杂志

四川省医学科学院四川省人民医院

实用医院临床杂志

CSTPCD

影响因子：1.179

ISSN：1672-6170

年,卷(期)：2024.21(5)