血清前列腺素D2和白细胞相关免疫球蛋白样受体-1的表达对儿童急性呼吸窘迫综合征诊断及预后的意义  

Diagnostic and prognostic significance of expressions of serum prostaglandin D2 and LAIR-1 for acute respiratory distress syndrome in children

作　　者：黄金显 方建锋 石晴 卢孝明 陈倩茜 谭郡 HUANG Jinxian;FANG Jianfeng;SHI Qing;LU Xiaoming;CHEN Qianqian;TAN Jun(Department of Paediatrics,Daye Municipal People's Hospital,Hubei Daye 435100,China;Department of General Medical Practice,No.95019 Military Hospital of P.L.A,Hubei Daye 435100,China;Department of Clinical Laboratory,Pengren Hospital of Daye City,Hubei Daye 435100,China;Clinical College of Hubei Traditional Chinese Medicine University,Hubei Wuhan 430065,China)

机构地区：[1]大冶市人民医院儿科,湖北大冶435100 [2]中国人民解放军95019部队医院全科,湖北大冶435100 [3]大冶市朋仁医院检验科,湖北大冶435100 [4]湖北中医药大学中医临床学院,湖北武汉430065

出　　处：《中国妇幼健康研究》2025年第2期78-82,共5页Chinese Journal of Woman and Child Health Research

基　　金：黄石市卫生健康委员会科研项目(WJ2021F023)。

摘　　要：目的探讨急性呼吸窘迫综合征(ARDS)患儿血清前列腺素D2(PGD2)、白细胞相关免疫球蛋白样受体-1(LAIR-1)的表达对疾病诊断及预后的意义。方法选取2021年10月至2023年10月大冶市人民医院收治的80例2~8岁ARDS患儿为研究对象(观察组),选择同期同年龄段体检健康的94例儿童为对照组;应用酶联免疫吸附法(ELISA)检测观察组和对照组患儿血清PGD2、LAIR-1水平,采用受试者工作特征(ROC)曲线分析血清PGD2、LAIR-1对儿童发生ADRS的诊断价值;随访患儿的预后状况,并将其分为生存组65例与死亡组15例;比较观察组与对照组、生存组与死亡组的一般资料及血清PGD2、LAIR-1水平,采用多因素Logistic回归分析ADRS患儿预后的影响因素。结果观察组血清PGD2、LAIR-1水平与对照组比较,差异均有统计学意义(t值分别为7.436、7.945,P<0.05)。ROC曲线分析显示,血清PGD2、LAIR-1单独及联合诊断儿童发生ARDS的曲线下面积(AUC)分别为0.794、0.785、0.873,二者联合诊断优于PGD2、LAIR-1各自单独诊断效能(Z值分别为3.302、3.161,P<0.05)。生存组机械通气时间、小儿危重病例评分(PCIS)、氧合指数(OI)及血清PGD2和LAIR-1水平与死亡组比较,差异均有统计学意义(t值分别为6.921、2.620、15.325、2.686、5.225,P<0.05)。多因素Logistic回归分析显示,PGD2(OR=2.335,95%CI:1.713~3.183)、LAIR-1(OR=2.562,95%CI:1.451~4.523)均是ARDS患儿28d发生死亡的危险因素(P<0.05)。结论ARDS患儿血清PGD2、LAIR-1水平均有升高,二者联合检测对儿童发生ARDS具有一定的诊断价值,且与患儿的预后有关联。Objective To explore diagnostic and prognostic significance of serum prostaglandin D2(PGD2)and leukocyte associated immunoglobulin like receptor-1(LAIR-1)expressions for acute respiratory distress syndrome(ARDS)in children.Methods 80 children aged 2-8 years with ARDS who admitted to Daye Municipal People's Hospital from October 2021 to October 2023 were selected as observation group,and 94 healthy age-matched children who underwent physical examinations in the same period were as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to detect expression levels of PGD2 and LAIR-1 in serum of the children in the control group and the observation group.Receiver operating characteristic(ROC)curve was applied to analyze diagnostic values of serum PGD2 and LAIR-1 levels for occurrence of ADRS in children.The children with ARDS were followed up,and according to prognosis of the children at the follow-up,the children were divided into survival group(n=65)and death group(n=15).General information and serum levels of PGD2 and LAIR-1 of the children were compared between the two groups.Multivariate Logistic regression was applied to analyze factors affecting prognosis of the children with ADRS.Results Compared with the control group,the serum levels of PGD2 and LAIR-1 of the children with ARDS in the observation group increased,and the differences were significant(t=7.436 and 7.945 respectively,both P<0.05).The areas under the curve(AUCs)of serum PGD2 alone,LAIR-1 alone and combination of the two indexes for predicting occurrence of ARDS in children were 0.794,0.785 and 0.873 respectively,indicating that the diagnostic efficacy of combination of the two was superior to those of single PGD2 and single LAIR-1 alone(Z=3.302 and 3.161 respectively,both P<0.05).There were no statistically significant differences in age,gender,admission weight,arterial carbon dioxide pressure(PaCO_(2))and arterial oxygen pressure(PaO_(2))between the survival group and the death group(all P>0.05).The mechanical ventilation time,oxy

关 键 词：急性呼吸窘迫综合征 患儿 前列腺素D2 白细胞相关免疫球蛋白样受体-1 诊断 预后 

分 类 号：R179[医药卫生—妇幼卫生保健]