肺炎患儿血清G-CSF、sTREM-1、sICAM-1水平的变化及意义  

Changes and significance serum G-CSF,sTREM-1 and sICAM-1 in children patients with pneumonia and its significance

作　　者：胡晶[1] 朱敏[1] 苏华平 闵锋[1] 谭心海 HU Jing;ZHU Mi;SU Huaping;MIN Feng;TAN Xinhai(Department of Pediatrics,Tianmen Municipal First People′s Hospital,Tianmen,Hubei 431700,China)

机构地区：[1]湖北省天门市第一人民医院儿科,431700

出　　处：《检验医学与临床》2018年第6期817-820,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨肺炎患儿血清粒细胞集落刺激因子(G-CSF)、可溶性髓系细胞触发受体-1(sTREM-1)、可溶性细胞间黏附分子-1(sICAM-1)水平的变化及对肺炎的诊断价值。方法选择该院2015年6月至2016年6月收治的128例肺炎患儿,根据患儿临床表现及影像学诊断结果分为重症肺炎组(78例)及轻症肺炎组(50例),另选取同期进行健康检查的50例健康体检儿童为对照组,应用酶联免疫吸附试验测定各组血清G-CSF、sTREM-1、sICAM-1水平,并应用受试者工作特征(ROC)曲线分析血清G-CSF、sTREM-1、sICAM-1在肺炎中的诊断价值。结果重症肺炎组、轻症肺炎组患儿血清G-CSF、sTREM-1、sICAM-1水平显著高于对照组(P<0.05),且重症肺炎组血清G-CSF、sTREM-1、sICAM-1水平高于轻症肺炎组(P<0.05)。重症肺炎存活组患者随着病情好转,血清G-CSF、sTREM-1、sICAM-1水平显著下降,至出院时恢复正常水平(P<0.05);死亡组患者随着时间推移,血清G-CSF、sTREM-1、sICAM-1水平不断升高,并在死亡时达到最大值(P<0.05)。3项指标诊断重症肺炎的ROC曲线下面积(AUC)分别为0.712、0.789、0.756,3项指标联合诊断的AUC为0.802。经Pearson相关分析可知,G-CSF水平与sTREM-1、sICAM-1呈正相关(r=0.356、0.337,P=0.000),而sTREM-1水平与sICAM-1呈正相关(r=0.322,P=0.000)。结论血清G-CSF、sTREM-1、sICAM-1可作为肺炎患儿有价值的诊断指标,通过监测3项指标的动态变化趋势能够反映肺炎患儿病情进展及预后。Objective To investigate the levels of serum granulocyte colony-stimulating factor(G-CSF),soluble medullary cell triggers receptor-1(sTREM-1)and soluble intercellular adhesion molecule-1(sICAM-1)in children patients with pneumonia and their value in the diagnosis of pneumonia.Methods One hundred and twenty-eight children patients with pneumonia in this hospital from June 2015 to June 2016 were selected and divided into the severe pneumonia group(n=78)and mild pneumonia group(n=50)according to the clinical manifestations and imaging diagnosis.Contemporaneous 50 healthy children undergoing physical examination were selected as the control group.The levels of serum G-CSF,sTREM-1 and sICAM-1 in each group were determined by using ELISA and their diagnostic values in pneumonia were analyzed by using the receiver operating characteristic(ROC)curve.Results The levels of serum G-CSF,sTREM-1 and sICAM-1 in the severe pneumonia group and mild pneumonia group were significantly higher than those in the control group(P<0.05),moreover the levels of serum G-CSF,sTREM-1 and sICAM-1 in the severe were higher than those in the mild pneumonia group(P<0.05).The levels of serum G-CSF,sTREM-1 and sICAM-1 in the pneumonia groups were significantly higher than those in the control group(P<0.05),moreover which in the severe pneumonia survival group were significantly decreased with the disease condition improvement and recovered to the normal level at discharge(P<0.05);the levels of serum G-CSF,sTREM-1 and sICAM-1 in the death group were unceasingly increased with the time elapse and reached the maximal value at death(P<0.05).The areas under the ROC curve(AUC)of 3 indicators for diagnosing severe pneumonia were 0.712,0.789 and 0.756 respectively and AUC of the three-index combined diagnosis was 0.802.The Pearson correlation analysis indicated that the G-CSF level was positively correlated with the levels of sTREM-1 and sICAM-1(r=0.356,0.337,P=0.000)and sTREM-1 was positively correlated with sICAM-1(P=0.322,P=0.000).Conclusion Serum G-CS

关 键 词：粒细胞集落刺激因子 可溶性髓系细胞触发受体-1 可溶性细胞间黏附分子-1 肺炎 诊断价值 

分 类 号：R446.1[医药卫生—诊断学]