重症和非重症社区获得性肺炎患儿血浆细胞因子表达水平分析  

Expression of cytokines in plasma of children with severe and non-severe community-acquired pneumonia

作　　者：董林森 董翔 申雅菁 赵颖 王微微 贾红芳 Dong Linsen;Dong Xiang;Shen Yajing;Zhao Ying;Wang Weiwei;Jia Hongfang(Tianjin Rehabilitation Center,Tianjin 300381,China)

机构地区：[1]天津康复疗养中心,天津300381

出　　处：《保健医学研究与实践》2022年第9期55-58,共4页Health Medicine Research and Practice

摘　　要：目的探讨重症和非重症社区获得性肺炎(CAP)患儿血浆细胞因子水平的差异性,以期为临床治疗和相关研究提供参考。方法选取2017年5月—2020年5月天津康复疗养中心收治的80例CAP患儿为研究对象。根据患儿病情是否进展为重症肺炎,将患儿分为非重症组(n=37)和重症组(n=43)。采集2组患儿第3、5、7天血标本后,分析比较2组患儿B7同源物1(B7-H1)、干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)、白细胞介素-17(IL-17)、白细胞介素-36α(IL-36α)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)水平。分析B7-H1、IFN-γ、IL-17、IL-36α、GM-CSF水平在评估CAP严重程度中的敏感度、特异度和准确度。结果重症组患儿第3、5、7天B7-H1、IFN-γ、IL-17、IL-36α、GM-CSF水平高于非重症组,而IL-4水平则低于非重症组,差异均有统计学意义(P<0.05)。B7-H1评估CAP严重程度的敏感度、特异度、准确度分别为83.56%、90.25%、94.15%。IFN-γ评估CAP严重程度的敏感度、特异度、准确度分别为72.16%、70.12%、72.54%。结论重症CAP患儿血浆中B7-H1、IFN-γ、IL-17、IL-36α、GM-CSF水平呈现出高表达,但血浆细胞因子IL-4的表达水平则相反。此外,B7-H1、IFN-γ、IL-17、IL-36α、GM-CSF评估重症、非重症CAP的灵敏度、特异度及准确度均较高。故CAP患儿血浆细胞因子水平变化有助于评估患儿病情的严重程度,这也为进一步确定CAP患儿的治疗方案提供相应的理论依据。Objective To investigate the difference in plasma cytokine levels between children with severe and non-severe community-acquired pneumonia(CAP)to guide the clinical treatment and related research.Methods Eighty children with CAP admitted to Tianjin Rehabilitation Center from May 2017 to May 2020 were selected as the study subjects.According to whether the child progressed to severe pneumonia,subjects were assigned to the non-severe group(n=37)and the severe group(n=43).After blood samples were collected from the two groups on days 3,5,and 7,the levels of B7 homolog 1(B7-H1),interferon-γ(IFN-γ),interleukin-4(IL-4),interleukin-17(IL-17),interleukin-36α(IL-36α),and granulocyte-macrophage colony-stimulating factor(GM-CSF)were analyzed and compared between the two groups.The sensitivity,specificity,and accuracy of B7-H1,IFN-γ,IL-17,IL-36α,and GM-CSF levels in assessing CAP severity were analyzed.Results The levels of B7-H1,IFN-γ,IL-17,IL-36α,and GM-CSF in the severe group were higher than those in the non-severe group on the 3rd,5th,and 7th day,while the levels of IL-4 were significantly lower than those in the non-severe group(P<0.05).The sensitivity,specificity,and accuracy of B7-H1 in assessing CAP severity were 83.56%,90.25%,and 94.15%,respectively.The sensitivity,specificity,and accuracy of IFN-γin assessing CAP severity were 72.16%,70.12%,and 72.54%,respectively.Conclusion The plasma levels of B7-H1,IFN-γ,IL-17,IL-36α,and GM-CSF are highly expressed in children with severe CAP,but the plasma levels of IL-4 are on the opposite.In addition,B7-H1,IFN-γ,IL-17,IL-36α,and GM-CSF levels showed high sensitivity,specificity,and accuracy in assessing severe and non-severe CAP.Therefore,changes in plasma cytokine levels in children with CAP are helpful to assess the severity of the children's condition,which also provides a corresponding theoretical basis for further determination of treatment options in children with CAP.

关 键 词：社区获得性肺炎患儿 血浆细胞因子 感染 

分 类 号：R466.11[医药卫生—临床医学]