TLR4、CRP与新生儿呼吸窘迫综合征病情严重程度、预后关系的研究  

Study on the Relationship Between TLR4,CRP and the Severity and Prognosis of Neonatal Respiratory Distress Syndrome

作　　者：张晋雷[1] 张静[1] 高云霞[1] 孙颖 ZHANG Jinlei;ZHANG Jing;GAO Yunxia;SUN Ying(Department of PediatricsⅠ,First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan,473058,China)

机构地区：[1]南阳医学高等专科学校第一附属医院儿科一病区,河南南阳473058

出　　处：《中外医疗》2024年第36期15-18,共4页China & Foreign Medical Treatment

摘　　要：目的研究C反应蛋白(C-reactive protein,CRP)、Toll样受体-4(Toll-like receptor 4,TLR4)与新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)病情严重程度和预后的关系。方法方便选取2022年1月—2023年12月南阳医学高等专科学校第一附属医院儿科一病区收治的112例NRDS患儿作为研究对象,根据氧合指数(oxygenation index,OI)将其分为轻度组(n=52)、中度组(n=36)及重度组(n=24),分析TLR4、CRP与OI的相关性;治疗后根据随访结果,将治愈患儿归为预后良好组(n=79),将出现病情加重、复发甚至死亡等的患儿归为预后不良组(n=33),对影响预后的相关因素采取临床采用单因素分析、多因素Logistic回归分析。结果轻度组NRDS患儿的TLR4、CRP水平低于中度组和重度组,且中度组低于重度组,差异均有统计学意义(P均<0.05)。Pearson相关性分析显示,TLR4及CRP水平与病情严重程度呈正相关(P均<0.05)。预后不良组患儿的TLR4、CRP、白细胞(white blood cell,WBC)水平均高于预后良好组,而淋巴细胞(lymphocyte,LYM)水平低于预后良好组,差异均有统计学意义(P均<0.05)。多因素Logistic回归分析显示,TLR4(OR=1.956,95%CI:1.274~2.987)、CRP(OR=2.081,95%CI:1.274~3.385)、WBC(OR=2.047,95%CI:1.284~3.308)及LYM(OR=2.146,95%CI:1.235~3.785)是NRDS患者预后不良的独立影响因素(P均<0.05)。结论TLR4、CRP水平与NRDS病情严重程度呈正相关,TLR4、CRP、WBC及LYM是导致预后不良的影响因素,应针对相关指标,进行早期干预。Objective To study the relationship between C-reactive protein(CRP),Toll-like receptor 4(TLR4)and the severity and prognosis of neonatal respiratory distress syndrome(NRDS).Methods A total of 112 children with NRDS admitted to the First Affiliated Hospital of Nanyang Medical College from January 2022 to December 2023 were conveniently selected as the research objects.According to the oxygenation index(OI),they were divided into mild group(n=52),moderate group(n=36)and severe group(n=24).The correlation between TLR4,CRP and OI was analyzed.After treatment,according to the follow-up results,the cured children were classified as a good prognosis group(n=79),and the children with aggravation,recurrence or even death were classified as a poor prognosis group(n=33).The related factors affecting the prognosis were analyzed by single factor analysis and multivariate Logistic regression analysis.Results The levels of TLR4 and CRP in the mild group were lower than those in the moderate group and the severe group,and those in moderate group were lower than those in severe group,and the differences were statistically significant(all P<0.05).Pearson correlation analysis showed that TLR4 and CRP levels were positively correlated with the severity of the disease(both P<0.05).The levels of TLR4,CRP and white blood cell(WBC)in the poor prognosis group were higher than those in the good prognosis group,the levels of lymphocyte(LYM)were lower than those in the good prognosis group,and the differences were statistically significant(both P<0.05).Multivariate Logistic regression analysis showed that TLR4(OR=1.956,95%CI:1.274-2.987),CRP(OR=2.081,95%CI:1.274-3.385),WBC(OR=2.047,95%CI:1.284-3.308)and LYM(OR=2.146,95%CI:1.235-3.785)were independent influencing factors for poor prognosis in NRDS patients(all P<0.05).Conclusion The levels of TLR4 and CRP were positively correlated with the severity of NRDS.TLR4,CRP,WBC and LYM were the influencing factors of poor prognosis.Early intervention should be carried out for related indexes.

关 键 词：新生儿呼吸窘迫综合征 TOLL样受体-4 C反应蛋白 

分 类 号：R722.1[医药卫生—儿科]