血清可溶性白介素2受体在判断新生儿呼吸窘迫综合征严重程度和预后中的临床价值分析  

Clinical value of serum soluble interleukin-2 receptor in judging the severity and prognosis of neonatal respiratory distress syndrome

作　　者：查永圣 谷兆琪 张献陆 陈聪聪 ZHA Yongsheng;GU Zhaoqi;ZHANG Xianlu;CHEN Congcong(Department of Neonatology,Linyi Maternal and Child Health Hospital,Linyi,Shandong,276000,China)

机构地区：[1]临沂市妇幼保健院新生儿科,山东临沂276000

出　　处：《当代医学》2024年第12期70-73,共4页Contemporary Medicine

摘　　要：目的探讨血清可溶性白介素2受体(sIL-2R)在判断新生儿呼吸窘迫综合征(NRDS)严重程度和预后中的临床价值。方法选取2019年5月至2022年5月临沂市妇幼保健院收治的116例NRDS患儿作为观察组,根据疾病严重程度分为轻度组(Ⅰ~Ⅱ级,n=77)、重度组(Ⅲ~Ⅳ级,n=39)。另选取同期于本院产科出生的120名健康新生儿作为对照组。比较观察组与对照组血清sIL-2R水平,统计患儿预后情况,比较不同预后患儿血清sIL-2R水平,单因素及多因素Logistic回归分析影响NRDS患儿预后的危险因素。结果重度组血清sIL-2R水平高于轻度组、对照组,且轻度组高于对照组,差异有统计学意义(P<0.05)。住院期间,116例NRDS患儿存活99例,死亡17例。死亡患儿血清sIL-2R水平高于存活患儿,差异有统计学意义(P<0.05)。血清sIL-2R预测NRDS患儿预后的AUC为0.894(95%CI:0.844~0.944),截断值为62.92ng/L,特异度为84.16%,灵敏度为80.79%。存活与死亡患儿性别、分娩方式、宫内窘迫、新生儿窒息、母亲高龄、母亲妊娠期高血压情况、血小板计数(PLT)、血红蛋白(Hb)水平、部分活化凝血酶时间(APTT)、纤维蛋白原(Fg)水平比较差异无统计学意义;存活和死亡患儿胎龄、出生体质量、母亲妊娠期糖尿病、肺部超声评分、WBC、凝血酶原时间(PT)比较差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,胎龄小、出生体质量低、肺部超声评分低、sIL-2R水平高是NRDS患儿预后不良的危险因素(P<0.05)。结论血清sIL-2R在NRDS患儿中呈高表达,且与疾病严重程度和预后有关,对NRDS预后的评估具有较高的临床价值。Objective To explore the clinical value of serum soluble interleukin-2 receptor(sIL-2R)in judging the severity and prognosis of neo-natal respiratory distress syndrome(NRDS).Methods A total of 116 children with NRDS who were treated in Linyi Maternal and Child Health Hos-pital from May 2019 to May 2022 were selected as the observation group,and they were divided into the mild group(gradeⅠ-Ⅱ,n=77)and the se-vere group(gradeⅢ-Ⅳ,n=39)according to the severity of the disease.In addition,120 healthy newborns born in the obstetrics department of our hospital during the same period were selected as the control group.The serum sIL-2R levels between the observation group and the control group were compared,the prognosis of the children was counted,the serum sIL-2R levels of the children with different prognosis were compared,and the risk factors affecting the prognosis of the children with NRDS were analyzed by univariate and multivariate Logistic regression analysis.Results Se-rum sIL-2R level in the severe group was significantly higher than that in the mild group and control group,and the mild group was significantly higher than the control group,and the differences were statistically significant(P<0.05).During hospitalization,99 of 116 NRDS children survived,and 17 died.The serum sIL-2R level of the death children was higher than that of the survival children,and the difference was statistically significant(P<0.05).The AUC of serum sIL-2R for predicting the prognosis of children with NRDS was 0.894(95%CI:0.844-0.944),with the cut-off value of 62.92 ng/L,the specificity of 84.16%,and the sensitivity of 80.79%.There was no significant difference in gender,mode of delivery,intrauterine dis-tress,neonatal asphyxia,maternal age,maternal gestational hypertension,platelet count(PLT),hemoglobin(Hb)level,activated partial thrombin time(APTT)and fibrinogen(Fg)level between the survival and the death children;there were significant differences in gestational age,birth weight,maternal gestational diabetes,lung ultrasound

关 键 词：可溶性白介素2受体 新生儿 呼吸窘迫综合征 严重程度 预后 

分 类 号：R722.1[医药卫生—儿科]