血浆sST2和IL-33在儿童噬血细胞综合征诊断及预后评估中的应用  

Application of Plasma sST2 and IL-33 in the Diagnosis and Prognosis Evaluation in Children with Hemophagocytic Syndrome

作　　者：李妍[1] 刘炜[2] 张合成 周建文[2] 刘云婧 刘俊闪 郭战萍[4] LI Yan;LIU Wei;ZHANG Hecheng(Department of Hematology Research Laboratory(He’nan Provincial Key Laboratory of Pediatric Hematology),Children’s Hospital Affiliated to Zhengzhou University,He’nan Children’s Hospital,Zhengzhou Children’s Hospital,Zhengzhou City,He’nan Province 450018;不详)

机构地区：[1]郑州大学附属儿童医院、河南省儿童医院、郑州儿童医院血液病研究室(河南省小儿血液医学重点实验室),河南省郑州市450018 [2]郑州大学附属儿童医院、河南省儿童医院、郑州儿童医院血液肿瘤科,河南省郑州市450018 [3]郑州大学附属儿童医院、河南省儿童医院、郑州儿童医院烧伤整形科,河南省郑州市450018 [4]新乡市中心医院检验科

出　　处：《医学理论与实践》2024年第21期3619-3622,共4页The Journal of Medical Theory and Practice

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20220726)。

摘　　要：目的:探讨血浆可溶性致癌抑制因子2(sST2)、白细胞介素-33(IL-33)对儿童噬血细胞综合征(HPS)的诊断及预后预测价值。方法:选取2019年6月—2022年9月本院收治的30例HPS患儿为HPS组,记录其临床资料及实验室指标,并根据生存结局分为存活组20例和死亡组10例;选取非HPS的30例感染患儿为感染组;同期选取本院门诊体检的30例健康儿童为健康组。采用酶联免疫吸附(ELISA)法检测血浆sST2、IL-33水平;血浆sST2、IL-33水平对HPS的诊断及预后预测价值采用受试者工作特征曲线(ROC曲线)分析;采用logistic多因素回归分析HPS患儿预后的影响因素。结果:HPS组血浆sST2、IL-33水平高于感染组和健康组,感染组血浆sST2、IL-33水平高于健康组(P<0.05)。sST2、IL-33及二者联合诊断HPS的AUC分别为0.848、0.857、0.942。死亡组铁蛋白、sST2、IL-33高于存活组,白细胞计数(WBC)低于存活组(P<0.05)。sST2、IL-33是HPS患儿死亡的独立危险因素(P<0.05)。sST2、IL-33及二者联合预测HPS患儿死亡的AUC分别为0.862、0.838、0.952。结论:血浆sST2、IL-33水平检测可能是诊断儿童HPS的重要方法,且二者对于预测HPS患儿死亡有重要参考价值。Objective:To explore the diagnostic and prognostic value of plasma suppression of tumorigenicity 2(sST2)and interleukin-33(IL-33)in children with hemophagocytic syndrome(HPS).Methods:From June 2019 to September 2022,30 children with HPS admitted to our hospital were regarded as the HPS group,and their clinical data and laboratory indicators were recorded.They were grouped into a survival group of 20 cases and a mortality group of 10 cases based on survival outcomes;30 infected children excluded from HPS were as the infection group;meantime,30 healthy children who underwent outpatient physical examinations were as the health group.Enzyme linked immunosorbent assay(ELISA)was applied to detect plasma levels of sST2 and IL-33;the diagnostic and prognostic values of plasma levels of sST2 and IL-33 for HPS were analyzed using the receiver operating characteristic;and logistic multivariate regression was applied to analyze the influencing factors of prognosis in children with HPS.Results:The plasma levels of sST2 and IL-33 in the HPS group were higher than those in the infected and healthy groups,while the plasma levels of sST2 and IL-33 in the infected group were higher than those in the healthy group(P<0.05).The AUC for diagnosing HPS with sST2,IL-33,and their combination was 0.848,0.857,and 0.942,respectively.Ferritin,sST2,IL-33 in mortality group were higher than those in survival group,while WBC was lower than that in survival group(P<0.05).sST2 and IL-33 were independent risk factors for mortality in children with HPS(P<0.05).The AUC of sST2,IL-33,and their combination in predicting mortality in HPS children were 0.862,0.838,and 0.952,respectively.Conclusion:The detection of plasma levels of sST2 and IL-33 may be an important method for diagnosing HPS in children,and both have important reference value for predicting mortality in children with HPS.

关 键 词：噬血细胞综合征 儿童 可溶性致癌抑制因子2 白细胞介素-33 诊断 预后 

分 类 号：R446[医药卫生—诊断学]