社区获得性肺炎患儿Notch信号通路相关分子、降钙素原及血清25-羟维生素D_(3)表达与预后的相关性分析  

Correlation analysis of Notch signaling pathway related molecules,procalcitonin,and serum 25-hydroxyvitamin D_(3) expression and prognosis in children with community-acquired pneumonia

作　　者：李晓娜 赵和萌 周进进 王娟[1] 孟孟 丁洁 LI Xiaona;ZHAO Hemeng;ZHOU Jinjin;WANG Juan;MENG Meng;DING Jie(Department of Pediatric Internal Medicine,the First People’s Hospital of Lianyungang,Jiangsu Province,Lianyungang 222000,China;Department of Pediatrics,the Affiliated Hospital of Xuzhou Medical University,Jiangsu Province,Xuzhou 221006,China;Department of Pediatrics,Yancheng NO.1 People’s Hospital,Jiangsu Province,Yancheng 224004,China)

机构地区：[1]江苏省连云港市第一人民医院儿内科,江苏连云港222000 [2]徐州医科大学附属医院儿科,江苏徐州221006 [3]江苏省盐城市第一人民医院儿科,江苏盐城224004

出　　处：《中国医药导报》2023年第35期110-114,共5页China Medical Herald

基　　金：江苏省自然科学青年基金项目(BK20190808);江苏省连云港市卫生科技项目(201913)。

摘　　要：目的 研究社区获得性肺炎(CAP)患儿Notch信号通路相关分子、降钙素原(PCT)及血清25-羟维生素D_(3)[25(OH)D_(3)]表达与预后的相关性。方法 回顾性分析2018年1月至2021年1月江苏省连云港市第一人民医院收治的160例CAP患儿的临床资料。治疗后随访60 d,结合临床症状及影像学结果将其分为预后良好组及预后不良组。比较两组相关基础资料及实验室指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、PCT、25(OH)D_(3)]及Notch信号通路相关分子(Notch1、Notch2、Notch3、Notch4及Jagged1、DLL1、DLL3)表达;分析CAP患儿预后不良的危险因素;受试者操作特征曲线分析Notch1、Notch3、Jagged1、DLL1、PCT及25(OH)D_(3)对CAP患儿预后不良的预测价值。结果 160例CAP患儿中31例预后不良。两组性别、年龄、TC、TG、HDL-C、Notch2、Notch4、DLL3比较,差异无统计学意义(P>0.05);预后不良组Notch1、Notch3、Jagged1、DLL1、PCT水平高于预后良好组,25(OH)D3低于预后良好组(P<0.05)。Notch1、Notch3、Jagged1、DLL1、PCT是CAP患儿预后不良的危险因素(OR>1,P<0.05),25(OH)D_(3)是CAP患儿预后不良的保护因素(OR<1,P<0.05)。Notch1、Notch3、Jagged1、DLL1、PCT及25(OH)D_(3)预测患儿预后不良的曲线下面积分别为0.830、0.883、0.935、0.934、0.708、0.867。结论 CAP患儿的预后受到诸多因素的影响,与Notch1、Notch3、Jagged1、DLL1、PCT、25(OH)D_(3)关系密切,临床应密切关注。Objective To study the relationship between Notch signaling pathway related molecules,procalcitonin(PCT),and serum 25-hydroxyvitamin D_(3)(25[OH]D_(3))expression,and prognosis in children with community-acquired pneumonia(CAP).Methods The clinical data of 160 children with CAP admitted to the First People’s Hospital of Lianyungang,Jiangsu Province from January 2018 to January 2021 were retrospectively analyzed.The patients were followed up for 60 days after treatment and they were divided into good prognosis group and poor prognosis group according to clinical symptoms and imaging results.The expression of relevant basic data and laboratory indicators(total cholesterol[TC],triglyceride[TG],high density lipoprotein cholesterol[HDL-C],PCT,and 25[OH]D_(3)),and Notch signaling pathway related molecules(Notch1,Notch2,Notch3,Notch4,Jagged1,DLL1,and DLL3)were compared between two groups;the risk factors of poor prognosis in children with CAP were analyzed;the predictive value of Notch1,Notch3,Jagged1,DLL1,PCT,and 25[OH]D_(3) for poor prognosis in children with CAP was analyzed.Results A total of 31 out of 160 children with CAP had poor prognosis.There were no significant differences in gender,age,TC,TG,HDL-C,Notch2,Notch4,and DLL3 between two groups(P>0.05);Notch1,Notch3,Jagged1,DLL1,and PCT level in poor prognosis group were higher than those in good prognosis group,and 25[OH]D_(3) level was lower than that in good prognosis group(P<0.05).Notch1,Notch3,Jagged1,DLL1,PCT were risk factors for poor prognosis of children with CAP(OR>1,P<0.05);25[OH]D_(3) was protective factor for poor prognosis of children with CAP(OR<1,P<0.05).The areas under the curve of Notch1,Notch3,Jagged1,DLL1,PCT,and 25[OH]D_(3) predicting poor prognosis were 0.830,0.883,0.935,0.934,0.708,and 0.867,respectively.Conclusion The prognosis of children with CAP is influenced by many factors,and is closely related to Notch1,Notch3,Jagged1,DLL1,PCT,and 25[OH]D_(3),which should be paid close attention to clinically.

关 键 词：社区获得性肺炎 NOTCH信号通路 预后 NOTCH配体 

分 类 号：R563.1[医药卫生—呼吸系统]