血清SP-D、IL-17、IL-33与重症肺炎患儿肺损伤程度的关系及判断预后的价值  

Analysis of the Correlation between Serum SP-D,IL-17,IL-33 and the Degree of Lung Injury in Children with Severe Pneumonia and Its Prognostic Value

作　　者：王静[1] 汤昱 赵二要 陈超辉 WANG Jing;TANG Yu;ZHAO Eryao(Respiratory Department,Children′s Hospital Affiliated to Zhengzhou University/Henan Children′s Hospital/Zhengzhou Children′s Hospital,Henan 450018,China)

机构地区：[1]郑州大学附属儿童医院、河南省儿童医院、郑州儿童医院呼吸科,450018

出　　处：《医学研究杂志》2022年第6期89-92,27,共5页Journal of Medical Research

基　　金：河南省医学科技攻关计划项目(LHGJ20200625)。

摘　　要：目的探讨血清肺泡表面活性物质蛋白D(surfactant protein D,SP-D)、白细胞介素-17(inteleukin-17,IL-17)、白细胞介素-33(inteleukin-33,IL-33)水平与重症肺炎患儿肺损伤程度及预后的关系。方法选取笔者医院2018年4月~2021年2月收治的148例重症肺炎患儿作为病例组,70例健康儿童作为对照组进行临床研究。比较两组儿童血清SP-D、IL-17、IL-33水平,并分析3项指标与病例组患儿急性肺损伤评分、急性生理与慢性健康评分(APACHEⅡ)的相关性,以及在重症肺炎患儿治疗结局中的预测价值。结果病例组血清SP-D、IL-17、IL-33水平显著高于对照组(P<0.05)。病例组儿童治愈出院121例,死亡27例。治愈组患儿的血清SP-D、IL-17、IL-33水平,APACHEⅡ、LPS评分均低于死亡组患儿(P<0.05)。重症肺炎患儿血清SP-D、IL-17、IL-33水平与APACHEⅡ、LPS评分均呈正相关(P<0.05)。血清SP-D、IL-17、IL-33预测患儿的治疗结局的AUC值分别为0.712、0.803、0.877。结论血清SP-D、IL-17、IL-33水平能在一定程度上反映重症肺炎患儿肺损伤及病情的严重程度,对于患儿治疗结局有一定的预测价值。Objective To explore the relationship between the levels of serum SP-D,IL-17,IL-33 and the degree of lung injury in children with severe pneumonia.Methods A total of 148 children(case group)with severe pneumonia admitted to our hospital from April 2018 to February 2021 were selected for clinical research.Another 70 healthy children(control group)were selected for clinical research.The serum SP-D,IL-17 and IL-33 levels of the two groups of children were compared.The correlation between these three indicators and the acute lung injury score,acute physiology and chronic health score(APACHEⅡ)of children in the case group were analyzed.And the predictive value of these three indicators in the treatment outcome of children with severe pneumonia was assessed.Results The serum levels of SP-D,IL-17 and IL-33 in the case group were significantly higher than those in the control group(P<0.05).In the case group,121 children were cured and discharged,and 27 cases died.The serum SP-D,IL-17,IL-33 levels,APACHEⅡscore,and LPS score of the children in the cured group were lower than those in the death group(P<0.05).Serum SP-D,IL-17 and IL-33 levels in children with severe pneumonia were positively correlated with APACHEⅡscore and LPS score(P<0.05).The AUC values of serum SP-D,IL-17 and IL-33 predicting the outcome of treatment in children were 0.712,0.803 and 0.877,respectively.Conclusion Serum SP-D,IL-17 and IL-33 levels in children with severe pneumonia can reflect the severity of lung injury to a certain extent.They have certain predictive value for the treatment outcome of children.

关 键 词：肺泡表面活性物质蛋白D 白细胞介素-17 白细胞介素-33 重症肺炎 肺损伤 预后 

分 类 号：R725.6[医药卫生—儿科]