重症腺病毒肺炎患儿血清IL-6R和MYD88水平与患儿预后的关系  

Relationship between serum IL-6R and MYD88 levels and prognosis in children with severe adenovirus pneumonia

作　　者：王兰 刘佳 于雅彬 李英 于欣 蔡永艳[1] 马娜[1] 阎志新[1] WANG Lan;LIU Jia;YU Yabin;LI Ying;YU Xin;CAI Yongyan;MA Na;YAN Zhixin(Department of Pediatrics,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China;Department of Blood Donation Service,Cangzhou Central Blood Station,Cangzhou,Hebei 061000,China)

机构地区：[1]沧州市中心医院儿科,河北沧州061000 [2]沧州市中心血站献血服务部,河北沧州061000

出　　处：《国际检验医学杂志》2024年第5期559-563,568,共6页International Journal of Laboratory Medicine

基　　金：河北省医学科学研究课题计划项目(20232109)。

摘　　要：目的分析重症腺病毒肺炎患儿血清白细胞介素-6受体(IL-6R)和髓样分化因子88(MYD88)水平与患儿预后的关系。方法将沧州市中心医院2020年6月至2022年6月收治的腺病毒肺炎患儿146例纳入研究,根据患儿病情严重程度分为非重症组(50例)和重症组(96例);根据重症腺病毒肺炎患儿出院时病情将患儿分为预后良好组(63例)及预后不良组(33例)。血清IL-6R和MYD88水平检测采用酶联免疫吸附法(ELISA)。分析重症腺病毒肺炎患儿血清IL-6R、MYD88水平及二者与序贯器官功能衰竭(SOFA)评分、Murray肺损伤评分、白细胞计数(WBC)、C反应蛋白(CRP)、血小板计数(PLT)的相关性。采用Logistic回归分析重症腺病毒肺炎患儿预后的影响因素。采用受试者工作特征(ROC)曲线分析血清IL-6R和MYD88水平对重症腺病毒肺炎患儿预后的预测价值。结果重症组血清IL-6R、MYD88水平及SOFA评分、Murray肺损伤评分均高于非重症组(P<0.05)。预后不良组WBC>10×10^(9)/L、CRP≥8 mg/L及PLT≥10×10^(9)/L患儿比例均高于预后良好组(P<0.05),IL-6R、MYD88水平及SOFA、Murray肺损伤评分均高于预后良好组(P<0.05)。血清IL-6R和MYD88呈正相关(P<0.05)。血清IL-6R、MYD88均与SOFA评分、Murray肺损伤评分、WBC、CRP以及PLT呈正相关(P<0.05)。经Logistic回归分析,IL-6R、MYD88升高是影响重症腺病毒肺炎患儿预后的危险因素(P<0.05)。经ROC曲线分析,血清IL-6R和MYD88联合预测重症腺病毒肺炎患儿预后的曲线下面积(AUC)优于各自单独预测(P<0.05)。结论重症腺病毒肺炎患儿血清IL-6R和MYD88水平显著升高,二者与患儿预后密切相关,二者联合较各自单独使用可更好地预测患儿预后。Objective To analyze the relationship between serum levels of interleukin-6 receptor(IL-6R)and myeloid differentiation factor 88(MYD88)and prognosis of children with severe adenovirus pneumonia.Methods A total of 146 children with adenovirus pneumonia admitted to Cangzhou Central Hospital from June 2020 to June 2022 were enrolled in the study,and were divided into non-severe group(50 cases)and severe group(96 cases)according to the severity of their disease.The children with severe adenovirus pneumonia were divided into good prognosis group(63 cases)and poor prognosis group(33 cases)according to their discharge condition.Serum IL-6R and MYD88 levels were detected by enzyme-linked immunosorbent assay(ELISA).The serum IL-6R,MYD88 levels and their correlation with Sequential organ failure(SOFA)score,Murray lung injury score,white blood cell count(WBC),C-reactive protein(CRP),platelet count(PLT)in children with severe adenovirus pneumonia were analyzed.Logistic regression was used to analyze the prognostic factors of children with severe adenovirus pneumonia.The predictive value of serum IL-6R and MYD88 levels in children with severe adenovirus pneumonia was analyzed by using receiver operating characteristic(ROC)curve.Results The levels of IL-6R,MYD88,SOFA and Murray lung injury score in severe group were higher than those in non-severe group(P<0.05).The proportions of WBC>10×10^(9)/L,CRP≥8 mg/L and PLT≥10×10^(9)/L in the poor prognosis group were higher than those in the good prognosis group(P<0.05),the levels of IL-6R,MYD88,SOFA and Murray lung injury scores were higher than those in the good prognosis group(P<0.05).Serum IL-6R was positively correlated with MYD88(P<0.05).Serum IL-6R and MYD88 were positively correlated with SOFA score,Murray lung injury score,WBC,CRP and PLT(P<0.05).Logistic regression analysis showed that the increase of IL-6R and MYD88 was a risk factor for the prognosis of children with severe adenovirus pneumonia(P<0.05).According t o ROC curve analysis,the area under the curve(AUC)of t

关 键 词：重症腺病毒肺炎 白细胞介素-6受体 髓样分化因子88 预后 相关性 

分 类 号：R446.11[医药卫生—诊断学] R725.6[医药卫生—临床医学]