中性粒细胞外诱捕网、纤溶酶原激活抑制剂1对早产急性呼吸窘迫综合征患儿预后的影响  

Effect of neutrophil extracellular traps and plasminogen activator inhibitor-1 on the prognosis of premature infants with acute respiratory distress syndrome

作　　者：张敏 杨立 ZHANG Min;YANG Li(Department of Neonatal,Beijing Tongzhou District Maternal and Child Health Hospital,Beijing 101100,China)

机构地区：[1]北京市通州区妇幼保健院新生儿科,北京101100

出　　处：《中国医药导报》2024年第11期70-73,77,共5页China Medical Herald

基　　金：北京市卫生健康委员会北京市卫生健康科技成果和适宜技术推广项目(BHTPP202019);北京市通州区科技计划项目(KJ2022CX055)

摘　　要：目的探讨中性粒细胞外诱捕网(NETs)、纤溶酶原激活抑制剂1(PAI-1)对早产急性呼吸窘迫综合征(ARDS)患儿预后的影响。方法选取2020年1月至2022年12月北京市通州区妇幼保健院收治的早产ARDS患儿125例作为ARDS组,根据患儿预后将其分为预后良好组和预后不良组。比较两组血浆游离DNA(cf-DNA)、中性粒细胞弹性蛋白酶(NE)和肿瘤坏死因子-α(TNF-α)、PAI-1水平;分析早产ARDS患儿cf-DNA与NE、TNF-α的相关性;分析早产ARDS患儿预后不良的影响因素;cf-DNA、PAI-1对早产ARDS患儿预后不良的预测价值采用受试者操作特征曲线评估。结果125例早产ARDS患儿预后不良47例,预后良好78例。预后不良组cf-DNA、NE、TNF-α、PAI-1水平高于预后良好组(P<0.05)。早产ARDS患儿cf-DNA与NE、TNF-α呈正相关(r=0.645、0.687,P<0.05)。cf-DNA、PAI-1水平升高是早产ARDS患儿预后不良的危险因素(OR=2.188、2.303,P<0.05)。cf-DNA、PAI-1联合预测早产ARDS患儿预后不良的曲线下面积高于各指标单独预测(Z=3.272、2.229,P<0.05)。结论NETs组成成分cf-DNA、PAI-1水平升高是早产ARDS患儿预后不良的危险因素,二者联合检测对患儿的预后具有较高的预测效能。Objective To investigate the effect of neutrophil extracellular traps(NETs)and plasminogen activation inhibitor-1(PAI-1)on the prognosis of premature infants with acute respiratory distress syndrome(ARDS).Methods A total of 125 premature infants with ARDS admitted to Beijing Tongzhou District Maternal and Child Health Hospital from January 2020 to December 2022 were selected as ARDS group,and they were divided into good prognosis group and poor prognosis group according to the prognosis of children.The plasma levels of cell free-DNA(cf-DNA),neutrophil elastase(NE),tumor necrosis factor-α(TNF-α),and PAI-1 between two groups were compared;the correlation between cf-DNA and NE,TNF-αin premature infants with ARDS were analyzed;the influencing factors of poor prognosis in premature infants with ARDS were analyzed;and the predictive value of cf-DNA and PAI-1 in premature infants with ARDS was evaluated by receiver operating characteristic curve.Results A total of 125 premature infants with ARDS,47 had poor prognosis and 78 had good prognosis.The levels of cf-DNA,NE,TNF-α,and PAI-1 in poor prognosis group were higher than those in good prognosis group(P<0.05).cf-DNA was positively correlated with NE and TNF-αin premature infants with ARDS(r=0.645,0.687,P<0.05).The increased levels of cf-DNA and PAI-1 were risk factors for poor prognosis in premature infants with ARDS(OR=2.188,2.303,P<0.05).The area under the curve of cf-DNA and PAI-1 combined prediction of premature infants with ARDS was higher than that predicted by each indicator alone(Z=3.272,2.229,P<0.05).Conclusion The elevated levels of NETs components cf-DNA and PAI-1 are risk factors for poor prognosis in premature infants with ARDS,and the combined detection of these two components has high predictive efficacy for the prognosis of infants with ARDS.

关 键 词：早产儿 急性呼吸窘迫综合征 中性粒细胞外诱捕网 纤溶酶原激活抑制剂1 

分 类 号：R722.6[医药卫生—儿科]