炎症指标与新生儿急性呼吸窘迫综合征程度及结局的相关性研究  

Study on correlation of inflammatory indicators with the extent and outcome of acute respiratory distress syndrome in newborns

作　　者：徐窈 吴明赴[2] XU Yao;WU Mingfu(School of Medicine,Yangzhou University,Yangzhou,Jiangsu 225001,China;Department of Pediatrics,Affiliated Hospital of Yangzhou University,Yangzhou,Jiangsu 225001,China)

机构地区：[1]扬州大学医学院,江苏扬州225001 [2]扬州大学附属医院儿科,江苏扬州225001

出　　处：《现代医药卫生》2023年第17期2929-2934,2940,共7页Journal of Modern Medicine & Health

摘　　要：目的 探讨新生儿急性呼吸窘迫综合征(ARDS)患儿血嗜酸性粒细胞(EOS)、中性粒细胞(NEU)、血清降钙素原(PCT)及超敏C反应蛋白(hs-CRP)水平与严重程度及结局的关系。方法 选取2018年1月至2022年6月出生后24 h内转入该院新生儿科、符合研究纳入标准的55例患儿。根据氧合指数分为轻度ARDS组(26例)、中度ARDS组(13例)、重度ARDS组(16例);根据结局情况分为结局良好组(34例)及综合不良结局(死亡、转院、放弃或有创≥10 d)组(21例),分别比较不同程度及结局患者临床资料、EOS、NEU、PCT及hs-CRP等指标水平;ROC曲线分析EOS、NEU、PCT对ARDS新生儿综合不良结局的评估价值。结果 重度组NEU、PCT水平均高于轻、中度组,差异有统计学意义(P<0.05)。重度组hs-CRP水平高于轻度组,差异有统计学意义(P<0.05),但与中度组比较,差异无统计学意义(P>0.05)。综合不良结局组NEU、NLR、PCT水平高于结局良好组,EOS水平低于结局良好组,差异均有统计学意义(P<0.05);EOS、NEU及PCT是新生儿ARDS结局不良的独立危险因素(P<0.05);NEU、PCT水平及联合诊断预测新生儿ARDS结局不良的曲线下面积分别为0.877、0.835和0.912。结论 新生儿ARDS患儿血EOS、NEU,血清PCT水平与病情严重程度及结局密切相关,可作为新生儿ARDS结局评估指标。Objective To investigate the relationship between blood eosinophil(EOS),neutrophil(NEU),procalcitonin(PCT)and hypersensitive C-reactive protein(hs-CRP)levels and severity and outcome in neonatal acute respiratory distress syndrome(ARDS).Methods From January 2018 to June 2022,a total of 55 patients who were transferred to Department of Neonatal in our hospital within 24 hours after birth and met the inclusion criteria of the study were selected.According to oxygenation index,they were divided into the mild ARDS group(26 cases),the moderate ARDS group(13 cases)and the severe ARDS group(16 cases).According to the outcome,they were divided into the good outcome group(34 cases)and the comprehensive adverse outcome group(21 cases).The clinical data,EOS,NEU,PCT and hs-CRP levels of patients with different degrees and outcomes were compared separately;ROC curves were used to analyze the value of EOS,NEU and PCT in the assessment of comprehensive adverse outcomes in neonates with ARDS.Results The levels of NEU,and PCT in the severe group were higher than in the mild and moderate groups(P<0.05).The levels of hs-CRP in the severe group was higher than in the mild group(P<0.05),but the difference in hs-CRP was not significant in the moderate and severe groups(P>0.05);the levels of NEU,NLR,and PCT were higher in the comprehensive adverse outcome group than those in the good outcome group,and the levels of EOS were lower than those in the good outcome group(P<0.05);EOS,NEU,and PCT were independent risk factors for poor outcome in neonatal ARDS(P<0.05);the area under the curves for NEU,PCT levels and combined diagnosis to predict poor neonatal ARDS outcome were 0.877,0.835 and 0.912,respectively.Conclusion The levels of serum EOS,NEU and PCT in neonatal ARDS are closely related to the severity of dis-ease and outcome,and can be used as indicators for the assessment the outcome of neonatal ARDS.

关 键 词：新生儿急性呼吸窘迫综合征 急性肺损伤 嗜酸性粒细胞 中性粒细胞 降钙素原 超敏C反应蛋白 

分 类 号：R722[医药卫生—儿科]