腺病毒感染患儿血清LDH、SAA、IL-17A水平与病情严重程度的相关性  

Correlation between serum LDH,SAA,IL⁃17A levels and the severity of adenovirus infection in children

作　　者：王璇 陈海云 刘慧 江华 WANG Xuan;CHEN Haiyun;LIU Hui;JIANG Hua(The People's Hospital Pediatric Internal Medicine Department of Dongying District,Dongying,Shandong,China,257000;Shengli Oilfield Central Hospital Paediatrics,Dongying,Shandong,China,257000)

机构地区：[1]山东省东营市东营区人民医院儿内科,山东东营257000 [2]胜利油田中心医院儿科,山东东营257000

出　　处：《分子诊断与治疗杂志》2024年第9期1717-1720,共4页Journal of Molecular Diagnostics and Therapy

基　　金：山东省医药卫生科技项目(202306010819)。

摘　　要：目的探讨分析腺病毒感染患儿血清乳酸脱氢酶(LDH)、淀粉样蛋白A(SAA)、白细胞介素-17A(IL-17A)水平与病情严重程度的相关性。方法选取2020年1月至2023年11月128例于东营市东营区人民医院儿内科就诊的腺病毒感染患儿的临床资料。根据其病情分为轻症组74例和重症组54例,比较两组临床基本资料及血清LDH、SAA、IL-17A水平,Logistic回归分析影响腺病毒肺炎严重程度的相关因素;ROC曲线分析LDH、SAA、IL-17A对腺病毒患儿病情严重程度的诊断价值。结果重症组血清C反应蛋白(CRP)、降钙素原(PCT)、LDH、SAA、IL-17A水平及儿童序贯器官衰竭(p-SOFA)评分与Murray肺损伤评分均高于轻症组(t=14.538,8.669,6.990,5.314,8.686,10.319,11.456,P<0.05);血小板计数(PLT)低于轻症组,差异均有统计学意义(t=4.201,P<0.05);Logistic回归分析显示、CRP、PCT、p-SOFA、Murray肺损伤评分合并LDH、SAA、IL-17A均是影响腺病毒感染病情严重程度的独立危险因素,PLT为其独立保护因素(P<0.05);LDH、SAA、IL-17A联合检测腺病毒重症感染具有良好的敏感度(79.6%)及特异度(95.9%),曲线下面积为0.934,联合预测效能高于单一检测(P<0.05)。结论腺病毒感染患儿血清LDH、SAA、IL-17A是影响病情严重程度的独立危险因素,具有显著相关性,三者联合诊断对疾病严重程度具有良好的诊断应用价值。Objective To investigate the correlation between the levels of serum lactate dehydro-genase(LDH),amyloid A(SAA)and interleukin-17A(IL-17A)and the severity of the disease in children infected with adenovirus.Methods The clinical data of 128 children with adenovirus infection treated at the Department of Pediatrics of Dongying District People's Hospital from January 2020 to November 2023 were analyzed.The patients were divided into two groups:mild group(74 cases)and severe group(54 cases).The basic clinical data and serum LDH,SAA and IL-17A levels between the two groups were compared,and the related factors affecting the severity of adenovirus pneumonia were analyzed by logistic regression.The diagnostic value of LDH,SAA,and IL-17A on the severity of adenovirus infection in children was as-sessed using ROC curves.Results The levels of serum C-reactive protein(CRP),calcitonin(PCT),LDH,SAA,IL-17A,child sequential organ failure(p-SOFA)score and Murray lung injury score in the severe group were higher than those in the mild group(t=14.538,8.669,6.990,5.314,8.686,10.319,11.456,P<0.05).The platelet count(PLT)was lower than that of mild patients,and the differences were statistically significant(t=4.201,P<0.05).Logistic regression analysis showed that CRP,PCT,P-SOFA,Murray lung injury score combined with LDH,SAA,and IL-17A were independent risk factors for the severity of adenovi-rus infection,and PLT was an independent protective factor(P<0.05).The combined detection of LDH,SAA,and IL-17A had good sensitivity(79.6%)and specificity(95.9%),and the area under the curve was 0.934.The combined detection was more effective than single detection(P<0.05).Conclusion Serum LDH,SAA,and IL-17A in children infected with adenovirus are independent risk factors affecting the severity of the disease and have a significant correlation.The combined diagnosis of the three factors has good diagnostic value for determining the severity of the disease.

关 键 词：腺病毒感染 病情严重程度 乳酸脱氢酶 淀粉样蛋白A 白细胞介素-17A 

分 类 号：R725.1[医药卫生—儿科] R446.6[医药卫生—临床医学]