急性呼吸窘迫综合征患儿外周血单个核细胞中CD73、HIF-1α的表达及其临床意义  

Expressions and clinical significance of CD73 and HIF-1αin peripheral blood mononuclear cells of children with acute respiratory distress syndrome

作　　者：向豪 况建华 XIANG Hao;KUANG Jian-hua(Department of Pediatrics,Guang'an People's Hospital,Guang'an Sichuan 638000,China)

机构地区：[1]广安市人民医院儿科,四川广安638000

出　　处：《临床和实验医学杂志》2024年第9期987-990,共4页Journal of Clinical and Experimental Medicine

基　　金：四川省卫生健康委员会科研课题(编号:20PJ310)。

摘　　要：目的探究急性呼吸窘迫综合征(ARDS)患儿外周血单个核细胞(PBMCs)中5′胞外核苷酸酶(CD73)、缺氧诱导因子1α(HIF-1α)的表达及其临床意义。方法选取2022年2月至2023年4月广安市人民医院收治的117例ARDS患儿为研究对象,根据病情严重程度分为轻症组(n=27)、中症组(n=38)和重症组(n=52)。比较3组患儿PBMCs中CD73、HIF-1α表达水平及肺部感染指数(CPIS)评分。采用Pearson相关系数分析CD73、HIF-1α表达水平与CPIS评分的相关性。治疗后随访3个月,根据患儿生存状况分为生存组(n=34)和死亡组(n=83),比较两组患儿PBMCs中CD73、HIF-1α表达水平,采用受试者工作特征(ROC)曲线评估PBMCs中CD73、HIF-1α表达水平对ARDS患儿预后的诊断价值。结果轻症组PBMCs中CD73、HIF-1α表达水平分别为0.44±0.06、0.60±0.11、(4.82±0.81)分,均显著低于中症组[0.53±0.10、0.76±0.14、(6.33±1.02)分]、重症组[0.62±0.07、0.89±0.08、(7.03±1.14)分],中症组PBMCs中CD73、HIF-1α表达水平均显著低于重症组,差异均有统计学意义(P<0.05)。Pearson相关系数分析结果显示,CD73、HIF-1α相对表达水平与CPIS评分均呈显著正相关(r=0.623、0.687,P<0.05)。生存组PBMCs中CD73、HIF-1α表达水平分别为0.53±0.08、0.74±0.15,显著低于死亡组(0.60±0.08、0.88±0.09),差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,CD73、HIF-1α单独及联合预测ARDS患儿预后的敏感度分别为79.41%、85.29%、94.12%,曲线下面积(AUC)为0.746、0.801、0.843,联合检测预测价值更高。结论ARDS患儿PBMCs中CD73、HIF-1α表达水平随疾病严重程度增加而升高,且与患儿肺部感染呈显著相关性,检测患儿PBMCs中CD73、HIF-1α表达水平对预后具有较高的诊断价值。Objective To investigate the expression of 5'extracellular nucleotidase(CD73)and hypoxia-inducing factor 1α(HIF-1α)in peripheral blood mononuclear cells(PBMCs)in children with severe acute respiratory distress syndrome(ARDS)and their clinical significance.Methods One hundred and seventeen children with ARDS aduitted to Guang'an People's Hospital from February 2022 to April 2023 were selected as the study subjects and divided into mild group(n=27),moderate group(n=38)and severe group(n=52)according to the severity of the disease.The expression levels of CD73 and HIF-1αin PBMCs and pulmonary infection index(CPIS)scores of the three groups were compared.Pearson correlation coefficient was used to analyze the correlation between CD73 and HIF-1αexpression levels and CPIS score.After 3 months of follow-up after treatment,the children were divided into survival group(n=34)and death group(n=83)according to their survival status,and the expression levels of CD73 and HIF-1αin PBMCs were compared between the two groups.The value expression levels of CD73 and HIF-1αin PBMCs in prognosis of ARDS children were evaluated by receiver operating characteristic(ROC)curve.Results The expression levels of CD73 and HIF-1αin PBMCs in mild group were 0.44±0.06,0.60±0.11,(4.82±0.81)points,respectively,which were significantly lower than those in moderate group[0.53±0.10,0.76±0.14,(6.33±1.02)points]and severe group[0.62±0.07,0.89±0.08,(7.03±1.14)points],the expression levels of CD73 and HIF-1αin PBMCs in moderate group were significantly lower than those in severe group,and the differences were statistically significant(P<0.05).Pearson correlation coefficient analysis showed that the relative expression levels of CD73 and HIF-1αwere significantly positively correlated with CPIS scores(r=0.623,0.687,P<0.05).The expression levels of CD73 and HIF-1αin PBMCs in survival group were significantly lower than those in death group(P<0.05).ROC curve analysis showed that the sensitivity of CD73 and HIF-1αalone and combined to pre

关 键 词：缺氧诱导因子1 Α亚基 预后 急性呼吸窘迫综合征 外周血单个核细胞 5′胞外核苷酸酶 肺部感染指数 

分 类 号：R725.6[医药卫生—儿科]