血清可溶性髓系细胞触发受体1水平联合改良儿童早期预警评分对腺病毒肺炎患儿病情及预后的评估价值  

Evaluation value of serum sTREM1 levels combined with modified pediatric early warning score in assessing the condition and prognosis of children with adenovirus pneumonia

作　　者：高程凤 孙蕊 张明瑛 GAO Chengfeng;SUN Rui;ZHANG Mingying(Department of Pediatrics,Beijing Shunyi Hospital,101300,China)

机构地区：[1]北京市顺义区医院儿科,101300

出　　处：《传染病信息》2025年第1期56-61,共6页Infectious Disease Information

摘　　要：目的探讨血清可溶性髓系细胞触发受体1(soluble triggering receptor expressed on myeloid cells 1,sTREM1)水平联合改良儿童早期预警评分(modified pediatric early warning score,MPEWS)对腺病毒肺炎(adenovirus pneumonia,AdVP)患儿病情及预后的评估价值。方法将2021年1月至2024年7月北京市顺义区医院收治的153例AdVP患儿(AdVP组)和同期50例健康儿童(对照组)纳入研究。将AdVP患儿根据病情程度分为重度AdVP组(60例)和轻度AdVP组(93例);根据28 d预后分为不良预后组(21例)和良好预后组(132例)。采用酶联免疫吸附法检测血清sTREM1水平,并计算MPEWS评分。通过多因素非条件Logistic回归分析血清sTREM1水平和MPEWS评分与AdVP患儿预后的关系,受试者工作特征曲线(receiver operating curve,ROC)分析血清sTREM1水平联合MPEWS评分对AdVP患儿病情及预后的评估价值。结果与对照组比较,AdVP组血清sTREM1水平升高(P<0.05)。与轻度AdVP组比较,重度AdVP组血清sTREM1水平和MPEWS评分均升高(P均<0.05)。AdVP组患儿不良预后率为13.73%(21/153)。与良好预后组比较,不良预后组血清sTREM1水平和MPEWS评分均升高(P均<0.05)。重度AdVP、sTREM1高、MPEWS评分高为AdVP患儿不良预后的独立危险因素(P均<0.05)。血清sTREM1水平联合MPEWS评分评估重度AdVP的曲线下面积(area under the curve,AUC)为0.904,大于血清sTREM1水平、MPEWS评分单独评估的AUC(0.777、0.815)(P均<0.05);血清sTREM1水平联合MPEWS评分评估AdVP患儿不良预后的AUC为0.947,大于血清sTREM1水平、MPEWS评分单独评估的AUC(0.811、0.875)(P均<0.05)。结论AdVP患儿血清sTREM1水平和MPEWS评分升高与病情加重、不良预后有关,血清sTREM1水平联合MPEWS评分评估AdVP患儿病情及预后的价值较高。Objective To explore the value of serum soluble triggering receptor expressed on myeloid cells 1(sTREM1)levels combined with the modified pediatric early warning score(MPEWS)in assessing the condition and prognosis of children with adenovirus pneumonia(AdVP).Methods A total of 153 children with AdVP(AdVP group)admitted to Beijing Shunyi District Hospital,Beijing,from January 2021 to July 2024 and 50 healthy children(control group)during the same period were enrolled.The AdVP group was further divided into a severe AdVP group(60 cases)and a mild AdVP group(93 cases)based on the disease severity,and was divided into a poor prognosis group(21 cases)and a good prognosis group(132 cases)based on 28-day outcomes.Serum sTREM1 levels were measured using enzyme-linked immunosorbent assay,and MPEWS scores were calculated.Multivariate unconditional logistic regression was used to analyze the relationship between serum sTREM1 levels,MPEWS scores,and prognosis in children with AdVP.The value of serum sTREM1 levels combined with MPEWS scores in assessing the disease severity and prognosis was evaluated using receiver operating curve analysis.Results Compared with the control group,serum sTREM1 levels were significantly higher in the AdVP group(P<0.05).In the severe AdVP group,serum sTREM1 levels and MPEWS scores were significantly higher than in the mild AdVP group(P<0.05).The poor prognosis rate among the 153 children with AdVP was 13.73%(21/153).Compared with the good prognosis group,serum sTREM1 levels and MPEWS scores were significantly higher in the poor prognosis group(P<0.05).Severe AdVP,high sTREM1 levels,and high MPEWS scores were independent risk factors for poor prognosis in children with AdVP(P<0.05).The area under the curve(AUC)for serum sTREM1 levels combined with MPEWS scores in evaluating severe AdVP was 0.904,which was greater than the AUCs for serum sTREM1 levels(0.777)and MPEWS scores(0.815)alone(P<0.05).The AUC for evaluating poor prognosis in children with AdVP was 0.947 for the combined assessment,which w

关 键 词：儿童 腺病毒肺炎 可溶性髓系细胞触发受体1 改良儿童早期预警评分 病情 预后 

分 类 号：R521[医药卫生—内科学]