血清高迁移率族蛋白B1、人β防御素2与腺病毒肺炎患儿闭塞性细支气管炎发生的关系  

Relationships between serum HMGB1 and hBD-2 and the development of occlusive bronchiolitis obliterans in children with adenovirus pneumonia

作　　者：程佳敏 谭志军 蒙勇球 梁宙 赵玉莲 郑凤丽 CHENG Jiamin;TAN Zhijun;MENG Yongqiu;LIANG Zhou;ZHAO Yulian;ZHENG Fengli(Department of Pediatrics,Guigang People's Hospital(The Eighth Affiliated Hospital of Guangxi Medical University),Guigang 537100,China)

机构地区：[1]贵港市人民医院(广西医科大学第八附属医院)儿科,广西贵港537100

出　　处：《山东医药》2024年第7期38-41,共4页Shandong Medical Journal

基　　金：广西壮族自治区卫生健康委西医类自筹经费科研课题(20213447)。

摘　　要：目的探讨血清高迁移率族蛋白B1(HMGB1)、人β防御素2(hBD-2)与腺病毒肺炎(AP)患儿闭塞性细支气管炎(BO)发生的关系。方法选取193例AP患儿,根据出院3个月后是否发生BO将AP患儿分为BO组58例和非BO组135例。收集两组临床资料并用酶联免疫吸附试验检测血清HMGB1、hBD-2,用单因素及多因素Logistic回归分析AP患儿发生BO的影响因素,以受试者工作特征(ROC)曲线分析血清HMGB1、hBD-2对AP患儿发生BO的预测价值。结果BO组月龄小于非BO组,热程长于非BO组,低氧血症、机械通气发生比例及血液白细胞计数、血小板计数、C反应蛋白、降钙素原、HMGB1、hBD-2高于非BO组(P均<0.05)。多因素Logistic回归分析显示,低氧血症、机械通气和HMGB1、hBD-2升高为AP患儿发生BO的独立危险因素(P均<0.05)。ROC曲线分析显示,血清HMGB1、hBD-2联合应用预测AP患儿发生BO的曲线下面积为0.818,与血清HMGB1、hBD-2单独预测的曲线下面积(0.739、0.726)比较差异有统计学意义(P均<0.05)。结论血清HMGB1、hBD-2水平升高是AP患儿发生BO的危险因素,二者联合检测对AP患儿发生BO的预测价值较高。Objective To investigate the relationships between serum high-mobility group protein B1(HMGB1),humanβ-defensin 2(hBD-2)and the development of occlusive bronchiolitis obliterans(BO)in children with adenovirus pneumonia(AP)and its predictive value.Methods Totally 193 children with AP were selected,and the children with AP were divided into the BO group(58 cases)and the non-BO group(135 cases)according to whether BO occurred 3 months after discharge.Serum HMGB1 and hBD-2 levels were measured by enzyme-linked immunosorbent assay.Univariate and Multifactorial Logistic regression analyses were used to analyze the factors influencing the development of BO in children with AP;the receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum HMGB1 and hBD-2 for BO in AP children.Results The age of the BO group was younger than that of the non-BO group,the duration of fever was longer than that of the non-BO group,the proportions of hypoxemia and mechanical ventilation and the white blood cell count,platelet count,C-reactive protein,procalcitonin,HMGB1,and hBD-2 were higher than those of the non-BO group(all P<0.05).Multifactorial Logistic regression model analysis showed that hypoxemia,mechanical ventilation and elevated HMGB1 and hBD-2 were independent risk factors for the development of BO in children with AP(all P<0.05).ROC curve analysis showed that the area under the curve of serum HMGB1 and hBD-2 in predicting the development of BO in children with AP was 0.818,which was greater than that of serum HMGB1 and hBD-2 alone(0.739 and 0.726)(both P<0.05).Conclusion Elevated serum HMGB1 and hBD-2 levels are risk factors for BO in children with AP,and the combined detection of serum HMGB1 and hBD-2 levels has high predictive value for the development of BO in children with AP.

关 键 词：腺病毒肺炎 闭塞性细支气管炎 高迁移率族蛋白B1 人Β防御素2 

分 类 号：R725.6[医药卫生—儿科]