血清标志物联合检测对儿童呼吸窘迫综合征早期预测的临床价值  

Clinical value of combined serum biomarker detection for early prediction of pediatric acute respiratory distress syndrome

作　　者：冯雨慧 邹兰兰 崔晨航 黄先杰[1] 乔俊英[1] Feng Yuhui;Zou Lanlan;Cui Chenhang;Huang Xianjie;Qiao Junying(Department of Pediatric Critical Care Medicine,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院儿童重症医学科,河南郑州450052

出　　处：《临床荟萃》2025年第3期237-242,共6页Clinical Focus

摘　　要：目的探讨血清涎液化糖链抗原-6(Krebs von den Lungen-6,KL-6)、血管性血友病因子(von Willebrand factor,vWF)和白介素8(interleukin-8,IL-8)在儿童急性呼吸窘迫综合征(pediatric acute respiratory distress syndrome,pARDS)早期识别中的临床预测价值。方法纳入2023年11月-2024年11月于郑州大学第三附属医院儿童重症医学科接受机械通气治疗的患儿92例,依据患儿在明确病因损害后的7 d内是否发展为pARDS,将患儿分为pARDS组(n=35)和非pARDS组(n=57)。pARDS组分别于机械通气开始(T_(1))时、确诊pARDS(T_(2))时和确诊后第3天(T_(3)),非pARDS组于T_(1)时,采用酶联免疫吸附法检测血清标志物水平,收集并分析相关临床数据。结果T_(1)时pARDS组KL-6、vWF和IL-8水平高于非pARDS组(P<0.05)。pARDS组KL-6、vWF和IL-8水平在不同时间点的变化差异有统计学意义(P<0.05);KL-6水平在T_(2)时高于T_(1),且在T_(3)时达到研究期间峰值(P<0.01);IL-8和vWF水平在T_(2)达到峰值后于T_(3)有所下降(P<0.05)。受试者工作特征曲线分析显示,KL-6、IL-8和vWF的曲线下面积分别为0.749、0.662和0.631,三者联合检测的曲线下面积为0.776(P<0.05),对应的敏感度分别为74.3%、62.9%、62.9%和85.7%,特异度分别为82.5%、61.4%、68.4%和63.2%。结论血清KL-6、IL-8及vWF水平升高可作为pARDS早期识别的有效生物标志物,三者联合检测可提高诊断效率。Objective To investigate the clinical predictive value of serum Krebs von den Lungen-6(KL-6),von Willebrand factor(vWF),and interleukin-8(IL-8)in the early identification of pediatric acute respiratory distress syndrome(pARDS).Methods A total of 92 children who received mechanical ventilation in the Department of Pediatric Intensive Care Unit of the Third Affiliated Hospital of Zhengzhou University from November 2023 to November 2024 were included.According to the development of pARDS within 7 days after the confirmation of etiological damages,included children were divided into the pARDS group(n=35)and non-pARDS group(n=57).Serum biomarker levels were measured using enzyme-linked immunosorbent assay(ELISA)at the initiation of mechanical ventilation(T_(1))in both groups,the time of pARDS diagnosis(T_(2)),and on the third day post-diagnosis(T_(3))in the pARDS group.Relevant clinical data were collected and analyzed.Results At T_(1),the levels of KL-6,vWF,and IL-8 were significantly higher in the pARDS group compared to the non-pARDS group(P<0.05).The levels of KL-6,vWF and IL-8 in the pARDS group were significantly different at different time points(P<0.05).The level of KL-6 at T_(2)was significantly higher than that at T_(1),and reached the peak at T_(3)(P<0.01).The levels of IL-8 and vWF reached the peak at T_(2)and then decreased at T_(3)(P<0.05).Receiver operating characteristic(ROC)curve analysis demonstrated that the area under the curve(AUC)of KL-6,IL-8,and vWF in diagnosing pARDS was 0.749,0.662,and 0.631,respectively,with the sensitivity of 74.3%,62.9%,and 62.9%,and specificity of 82.5%,61.4%,and 68.4%.When combined,the AUC reached 0.776(P<0.05),with the corresponding sensitivity of 85.7%,and specificity of 63.2%.Conclusion Elevated serum levels of KL-6,IL-8,and vWF are effective biomarkers for the early identification of pARDS.A combined detection of these biomarkers can improve diagnostic accuracy.

关 键 词：呼吸窘迫综合征 血清涎液化糖链抗原-6 白介素8 血管性血友病因子 

分 类 号：R563.8[医药卫生—呼吸系统]