血清人分泌型磷脂酶A2、人可溶性髓系细胞触发受体-1、巨噬细胞炎性蛋白3α在妊娠合并获得性重症肺炎患者中的临床应用价值  

Clinical application value of serum secreted phospholipase A2,soluble myeloid cell trigger receptor-1 and macrophage inflammatory protein-3αin pregnant patients with acquired community severe pneumonia

作　　者：罗雅伊 钟惠 王军 金华[1] LUO Ya-yi;ZHONG Hui;WANG Jun;JIN Hua(Department of Obstetrics,Zigong Maternal and Child Health Hospital,Zigong 643000,China)

机构地区：[1]四川省自贡市妇幼保健院产科,四川自贡643000

出　　处：《实用医院临床杂志》2024年第5期144-148,共5页Practical Journal of Clinical Medicine

基　　金：四川省卫生健康委员会科研基金资助项目(编号:20PJ123)。

摘　　要：目的探讨血清人分泌型磷脂酶A2(sPLA2)、人可溶性髓系细胞触发受体-1(sTREM-1)、巨噬细胞炎性蛋白3α(MIP-3α)在妊娠合并获得性重症肺炎(SCAP)疾病中的临床应用价值。方法选择2019年2月至2023年1月我院收治疗80例妊娠合并SCAP患者作为研究组,同期100例妊娠合并获得性非重症肺炎患者作为对照组,比较两组血清sPLA2、sTREM-1、MIP-3α水平、急性生理学及慢性健康状况评分系统II(APACHE-II)评分及孕妇妊娠结局与新生儿结局,经Spearman分析妊娠合并SCAP患者血清sPLA2、sTREM-1、MIP-3α水平与APACHE-II评分的关系;采用多元Logistic回归分析影响妊娠合并SCAP患者新生儿结局发展的因素。结果研究组血清sPLA2、sTREM-1、MIP-3α水平及APACHE-II评分明显高于对照组,其孕产妇不良妊娠结局发生率以及新生儿出现感染、窒息、败血症、宫内窘迫、新生儿肺炎发生率均高于对照组(P<0.05);经Spearman分析发现妊娠合并SCAP患者sPLA2、sTREM-1、MIP-3α水平与APACHE-II评分存在正相关(P<0.05);多元Logistic回归分析显示高水平sPLA2、sTREM-1、MIP-3α水平及APACHE-II评分升高是妊娠合并SCAP患者新生儿不良结局的危险因素(P<0.05);ROC曲线分析提示MIP-3α、sTREM-1、sPLA2均可预测妊娠合并SCAP患者新生儿不良结局,其中sTREM-1的诊断效能最高(P<0.05)。结论血清sPLA2、sTREM-1、MIP-3α与妊娠合并SCAP患者病情发展密切相关,能有效预测新生儿结局发展,可应用于临床。Objective To explore the clinical application value of serum human secreted phospholipase A2(sPLA2),human soluble myeloid cell trigger receptor-1(sTREM-1)and macrophage inflammatory protein-3α(MIP-3α)in pregnancy patients with severe community acquired pneumonia(SCAP).Methods Eighty pregnant patients with SCAP admitted to our hospital from February 2019 to January 2023 were selected as a study group.During the same period,another 100 pregnant patients with non-severe community acquired pneumonia were selected as a control group.Serum levels of sPLA2,sTREM-1 and MIP-3α,Acute Physiology and Chronic Health Status Score System II(APACHE-II),pregnancy outcomes and neonatal outcomes were compared between the two groups.The relationship between serum levels of sPLA2,sTREM-1,MIP-3αand APACHE-II score in pregnant patients with SCAP was analyzed by Spearman analysis.Multiple logistic regressions were used to analyze the factors affecting the neonatal outcome and development in pregnant patients with SCAP.Results The levels of serum sPLA2,sTREM-1 and MIP-3 as well as APACHE-II score in the study group were significantly higher than those in the control group,and the incidence of maternal adverse pregnancy outcomes and the incidence of neonatal infection,asphyxia,sepsis,intrauterine distress,and neonatal pneumonia in the study group were higher than those in the control group(P<0.05).Spearman analysis showed that the levels of sPLA2,sTREM-1 and MIP-3αwere positively correlated with APACHE-II score(P<0.05).Multiple logistic regression analysis showed that high levels of sPLA2,sTREM-1,MIP-3αand elevated APACHE-II scores were risk factors for adverse neonatal outcomes in pregnancy patients with SCAP(P<0.05).ROC curve analysis indicated that sPLA2,sTREM-1 and MIP-3αcould predict the adverse neonatal outcomes in pregnancy patients with SCAP.Among these indicators,sTREM-1 had the highest diagnostic efficiency(P<0.05).Conclusions Serum sPLA2,sTREM-1 and MIP-3αare closely related to the disease development of pregnant patien

关 键 词：人分泌型磷脂酶A2 人可溶性髓系细胞触发受体-1 巨噬细胞炎性蛋白3α 妊娠合并获得性重症肺炎 APACHE-II评分 新生儿结局发展 

分 类 号：R446[医药卫生—诊断学]