摘要
目的 探讨肺部高频超声评分联合血清白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)水平评估新生儿呼吸窘迫综合征(NRDS)患儿预后的价值.方法 选取2021年3月至2022年12月在青岛大学附属山东省妇幼保健院治疗的NRDS患儿106例.根据出院结局分为预后不良组(n=11)和预后良好组(n=95),比较两组NRDS患儿临床资料差异.同时根据疾病严重程度分为轻中度组(n=75)和重度组(n=31),分析不同疾病严重程度NRDS患儿肺部高频超声评分及血清IL-6、CRP、PCT水平差异.采用logistic多因素回归分析评估预后的影响因素;ROC曲线分析肺部高频超声评分、IL-6及二者联合预测NRDS患儿的预后价值.结果 预后不良组胎龄、出生体重、肺部高频超声评分明显低于预后良好组(均P＜0.05);预后不良组妊娠期糖尿病比例、疾病严重程度重度比例、肺表面活性物质(PS)首次使用时间和IL-6水平明显高于预后良好组(均P＜0.05).重度患儿血清IL-6、CRP和PCT水平明显高于轻中度患儿(均P＜0.05);重度患儿肺部高频超声评分明显低于轻中度患儿(P＜0.05).Logistic多因素回归分析显示胎龄、肺部高频超声评分、妊娠期糖尿病、疾病严重程度、IL-6 是NRDS患儿预后不良的影响因素(均P＜0.05).肺部高频超声评分、IL-6及二者联合预测NRDS患儿预后不良的ROC曲线下面积分别为0.745、0.802和0.786.结论 NRDS患儿严重程度与肺部高频超声评分及血清IL-6、CRP、PCT水平有关,同时肺部高频超声评分及IL-6与NRDS患儿预后有关,在预测患儿预后方面有一定应用价值.
Abstract
Objective To explore the value of high frequency ultrasound scoring combined with serum levels of interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)in evaluating the prognosis of neonatal respiratory distress syndrome(NRDS)in children.Methods A total of 106 children with NRDS who were treated at Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University from March 2021 to December 2022 were selected.According to the discharge outcome,NRDS patients were divided into a poor prognosis group(n=11)and a good prognosis group(n.=95),and the clinical data differences between the two groups were compared.At the same time,NRDS patients were divided into mild to moderate group(n=75)and severe group(n=31)based on the severity of the disease.The differences in high-frequency ultrasound scores of the lungs and serum levels of IL-6,CRP,and PCT were analyzed in children with different disease severity levels of NRDS.Logistic multiple regression analysis was used to identify the influencing factors of prognosis;receiver operating characteristic(ROC)curve analysis of lung high-frequency ultrasound score,IL-6,and their combination predicted the prognostic value of NRDS in children.Results The gestational age,birth weight,and high-frequency ultrasound scores of the lungs in the poor prognosis group were significantly lower than those in the good prognosis group(all P＜0.05);The proportion of diabetes in pregnancy,the proportion of severe disease,the first use time of pulmonary surfactant(PS)and the level of IL-6 in the poor prognosis group were significantly higher than those in the good prognosis group(all P＜0.05).The serum levels of IL-6,CRP,and PCT in severe children were significantly higher than those in mild to moderate children(all P＜0.05);The high-frequency ultrasound score of the lungs in severe children was significantly lower than that in mild to moderate children(P＜0.05).Logistic regression analysis showed that gestational age,pulmonary high-frequency ultrasound score,gestational diabetes,disease severity,and IL-6 were the influencing factors for poor prognosis of children with NRDS(all P＜0.05).The area under the ROC curve for predicting poor prognosis in children with NRDS using high-frequency ultrasound score,IL-6,and their combination were 0.745,0.802,and 0.786,respectively.Conclusions The severity of NRDS in children is related to the high-frequency ultrasound score of the lungs and serum levels of IL-6,CRP,and PCT.At the same time,the high-frequency ultrasound score of the lungs and IL-6 are related to the prognosis of NRDS children,and have certain application value in predicting the prognosis of children.
基金项目
山东省妇幼保健协会科技创新项目(2021)(FYXH20210202)
NETL
NSTL
万方数据