Objective To investigate the predictive value of serum receptor for advanced glycation end products(RAGE)and pre B cell colony enhancing factor(PBEF)levels in children with severe pneumonia(SP)secondary to acute re-spiratory distress syndrome(ARDS).Methods Eight hundred and seventy-five cases of SP children admitted to the Re-spiratory Department and Intensive Care Unit of Harbin Children's Hospital from January 2020 to February 2024 were select-ed and divided into 83 cases in the ARDS group and 792 cases in the non-ARDS group according to whether they were secondary to ARDS.Serum RAGE and PBEF levels were detected by enzyme linked immunosorbent assay.Pearson's corre-lation coefficient was used to analyze the correlation between serum RAGE and PBEF levels and the scores of the pediatric early warning score(PEWS);a multifactorial unconditional logistic regression model was established to determine the factors influencing secondary ARDS in children with SP as the dependent variable;and ROC curves were plotted to evaluate the value of serum RAGE and PBEF levels in predicting secondary ARDS in children with SP.Results Eight hundred and sev-enty-five cases children with SP had secondary ARDS within 7 d of admission 83(9.49％ ).Compared with the non-ARDS group,serum RAGE and PBEF levels were elevated in the ARDS group(t=8.801,9.082,all P＜0.001);and there was a posi-tive correlation between serum RAGE and PBEF levels and PEWS scores(r=0.691,0.625,all P＜0.001);Independent risk factors for secondary ARDS in children with SP were increased PEWS score,prolonged duration of mechanical ventilation,increased oxygen index,increased procalcitonin,increased RAGE,and increased PBEF[OR(95％ CI)=2.308(1.535-3.469),2.525(1.619-3.938),3.738(2.123-6.581),6.916(3.034-15.768),1.085(1.061-1.109,1.464(1303-1.646)];The area under the curve of RAGE,PBEF and the combination of the two for predicting secondary ARDS in children with SP was 0.791,0.789 and 0.905,respectively,and the combination of the two was superior to their respective individual predictive efficacy(Z=4256,4.419,all P＜0.001).Conclusion Elevated serum RAGE and PBEF levels are independent risk factors for secondary ARDS in children with SP,and serum RAGE combined with PBEF levels have high value in predicting secondary ARDS in children with SP.
Severe pneumoniaAcute respiratory distress syndromeReceptor for advanced glycation end prod-uctsPre B cell colony enhancing factorChildren
维普
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