入院时血清PGRN、PCT水平、外周血Caspase-1表达与重症肺炎患儿严重程度的相关性及联合检测对重症肺炎患儿预后的预测价值  

Correlation of serum PGRN,PCT levels,peripheral blood Caspase-1 expression at admission with the severity of children with severe pneumonia and the predictive value of combined detection for prognosis of children with severe pneumonia

作　　者：张云云 贾沛生[2] 马威[2] Zhang Yun-yun;Jia Pei-sheng;Ma Wei(Department of Pediatrics,The Affiliated Hospital of Xinyang Vocational and Technical College,Xinyang 464000,Henan,China;PICU,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]信阳职业技术学院附属医院儿科,河南信阳464000 [2]郑州大学第一附属医院PICU,河南郑州450000

出　　处：《四川生理科学杂志》2024年第7期1431-1434,共4页

基　　金：河南省医学科技攻关联合共建项目(编号:LHGJ20211746)。

摘　　要：目的:探讨入院时血清颗粒蛋白前体(Progranulin,PGRN)、降钙素原(Procalcitonin,PCT)水平、外周血半胱氨酸天冬氨酸蛋白酶1(Caspase-1)表达与重症肺炎患儿严重程度的相关性及联合检测对重症肺炎患儿预后的预测价值。方法:选取2019年10月至2023年10月信阳职业技术学院附属医院收治的153例重症肺炎患儿为研究对象,入院时根据小儿危重病例评分法(Pediatric critical illness score,PCIS)将患儿分为非危重组(62例,80分<PCIS≤100分)、危重组(51例,70分<PCIS≤80分)、极危重组(40例,≤70分),根据28 d预后情况将重症肺炎患儿分为病死(21例)和生存(132例)两个亚组。比较非危重组、危重组、极危重组入院时血清PGRN、PCT水平及外周血Caspase-1表达,分析入院时血清PGRN、PCT水平及外周血Caspase-1表达与重症肺炎患儿严重程度相关性;比较病死患儿、生存患儿入院时血清PGRN、PCT水平及外周血Caspase-1表达;ROC分析入院时血清PGRN、PCT水平及外周血Caspase-1表达联合检测对重症肺炎患儿预后的预测效能。结果:3组入院时血清PGRN、PCT水平及外周血Caspase-1表达比较:非危重组<危重组<极危重组,且均与重症肺炎患儿严重程度呈正相关(P<0.05);病死患儿入院时血清PGRN、PCT水平及外周血Caspase-1表达高于生存患儿(P<0.05);入院时血清Caspase-1、PCT水平及外周血Caspase-1表达联合检测预测重症肺炎患儿病死的AUC、最佳敏感度分别为0.822、95.24%,高于入院时血清PGRN、PCT水平及外周血Caspase-1表达单独检测。结论:入院时血清PGRN、PCT水平及外周血Caspase-1表达检测可评估重症肺炎患儿病情严重程度,且联合检测可预测患儿的死亡情况。临床上可根据入院时血清PGRN、PCT水平及外周血Caspase-1表达早期评估患儿病情,制定针对性治疗干预措施,改善重症肺炎患儿的预后,减少死亡病例的发生。Objective:To investigate the correlation of serum progranulin(PGRN),procalcitonin(PCT)levels,peripheral blood Caspase-1 expression at admission with the severity of children with severe pneumonia and the predictive value of combined detection for prognosis of children with severe pneumonia.Methods:A total of 153 children with severe pneumonia admitted to the Affiliated Hospital of Xinyang Vocational and Technical College from October 2019 to October 2023 were selected as the study objects.At admission,according to pediatric critical illness score(PCIS),the children with severe pneumonia were divided into non-critical group(62 cases,80 points<PCIS≤100 points),critical group(51 cases,70 points<PCIS≤80 points),and extremely critical group(40 cases,PCIS≤70 points);according to the 28-day prognosis,the children with severe pneumonia were divided into two subgroups:death(21 cases)and survival(132 cases).The serum Caspase-1,PCT levels,and peripheral blood Caspase-1 expression at admission were compared among the non-critical group,critical group,and extremely critical group,and the correlation of the serum PGRN,PCT levels,and peripheral blood Caspase-1 expression with the severity of children with severe pneumonia was analyzed.Serum PGRN,PCT levels,and peripheral blood Caspase-1 expression at admission were compared between dead and surviving children.ROC analysis was used to analyze the predictive effectiveness of serum PGRN,PCT levels,and peripheral blood Caspase-1 expression combined detection for the prognosis of children with severe pneumonia.Results:The serum PGRN,PCT levels,and peripheral blood Caspase-1 expression at admission were compared among 3 groups:non-critical group<critical group<extremely critical group,and they were positively correlated with the severity of children with severe pneumonia(P<0.05).The serum PGRN,PCT levels,and peripheral blood Caspase-1 expression in the dead children were higher than those in the surviving children(P<0.05).The AUC and optimal sensitivity of combined detection of

关 键 词：重症肺炎 半胱氨酸天冬氨酸蛋白酶1 颗粒蛋白前体 降钙素原 病情严重程度 预后 

分 类 号：R725.6[医药卫生—儿科]