血清尿素氮、25-(OH)D_(3)、IGF-1水平与学龄前营养不良儿童STRONGkids评分的相关性及对临床结局的预测价值  

Correlation between serum urea nitrogen,25-(OH)D_(3),IGF-1 and STRONGkids score in preschool children with malnutrition and their predictive value for clinical outcomes

作　　者：郭江 李佳育 李薇 余涛[1] GUO Jiang;LI Jiayu;LI Wei;YU Tao(Department of Child Health Care,West China Second Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西第二医院儿童保健科,四川成都610041

出　　处：《检验医学与临床》2025年第7期874-879,共6页Laboratory Medicine and Clinic

基　　金：2021年四川省医学(青年创新)科研课题项目(S211128)。

摘　　要：目的探讨血清尿素氮、25-羟维生素D_(3)[25-(OH)D_(3)]、胰岛素生长因子1(IGF-1)水平与学龄前营养不良儿童营养状况和生长风险筛查工具(STRONGkids)评分的相关性,并分析对临床结局的预测价值。方法选取2023年1-12月该院收治的116例学龄前营养不良患儿为观察组,按1∶1匹配原则选取同期学龄前健康体检儿童116例作为对照组。比较观察组干预前与对照组血清尿素氮、25-(OH)D_(3)、IGF-1水平及STRONGkids评分,分析观察组干预前血清尿素氮、25-(OH)D_(3)、IGF-1水平与STRONGkids评分的相关性,比较不同临床结局患儿干预前及干预2个月后血清尿素氮、25-(OH)D_(3)、IGF-1水平,分析干预前及干预2个月后尿素氮、25-(OH)D_(3)、IGF-1对学龄前营养不良患儿临床结局不良的预测价值及对临床结局不良风险的影响。结果观察组干预前STRONGkids评分高于对照组,血清尿素氮、25-(OH)D_(3)、IGF-1水平低于对照组,差异均有统计学意义(P<0.05)。干预前观察组血清尿素氮、25-(OH)D_(3)、IGF-1水平与STRONGkids评分均呈负相关(r=-0.744、-0.676、-0.737,P<0.05)。干预前、干预2个月后结局不良患儿血清尿素氮、25-(OH)D_(3)、IGF-1水平低于结局良好患儿,差异均有统计学意义(P<0.05)。干预前、干预2个月后血清尿素氮、25-(OH)D_(3)、IGF-1联合预测的AUC分别为0.883、0.908,明显大于各时期指标单独预测的AUC(P<0.05)。血清尿素氮、25-(OH)D_(3)、IGF-1分别以ROC曲线分析结果干预前、干预2个月后的cut-off值分为高表达(>cut-off值)、低表达(≤cut-off值),相对危险度(RR)分析结果显示,干预前、干预2个月后血清尿素氮、25-(OH)D_(3)、IGF-1高表达可降低学龄前营养不良患儿发生临床结局不良的风险(干预前:RR=0.178、0.257、0.244,P<0.001;干预2个月后:RR=0.183、0.228、0.222,P<0.001)。结论学龄前营养不良患儿血清尿素氮、25-(OH)D_(3)、IGF-1水平与STRONGkids评分、临床结局�Objective To investigate the correlation of serum urea nitrogen,25-hydroxyvitamin D_(3)[25-(OH)D_(3)],insulin growth factor 1(IGF-1)and screening tool for risk of nutrition in growth kids(STRONGkids)scores in preschool children with malnutrition,and to analyze the predictive value of clinical outcomes.Methods A total of 116 preschool malnourished children admitted to the hospital from January to December 2023 were selected as the observation group,and 116 healthy preschool children who underwent physical examination during the same period were selected as the control group by ratio of 1∶1.The levels of serum urea nitrogen,25-(OH)D_(3),IGF-1 and STRONGkids score were compared between the observation group before intervention and the control group.The correlation between serum urea nitrogen,25-(OH)D_(3),IGF-1 and STRONGkids score in the observation group before intervention was analyzed.The levels of serum urea nitrogen,25-(OH)D_(3)and IGF-1 before and after intervention for 2 months were compared in children with different clinical outcomes.The predictive value of serum urea nitrogen,25-(OH)D_(3)and IGF-1 on the poor clinical outcomes of preschool children with malnutrition before and after intervention for 2 months was analyzed,as well as their impact on the risk of poor clinical outcomes.Results The STRONGkids score of the observation group before intervention was higher than that of the control group,and the levels of serum urea nitrogen,25-(OH)D_(3)and IGF-1 were lower than those of the control group,with statistically significant differences(P<0.05).Before intervention,serum urea nitrogen,25-(OH)D_(3),IGF-1 and STRONGkids scores correlated negatively(r=-0.744,-0.676,-0.737,P<0.05).Before intervention and after 2 months of intervention,the levels of serum urea nitrogen,25-(OH)D_(3)and IGF-1 of the poor outcome preschool children were lower than those in the good outcome preschool children,and the differences were statistically significant(P<0.05).The area under the area(AUC)of the combined prediction of seru

关 键 词：尿素氮 25-羟维生素D_(3) 胰岛素生长因子1 学龄前 营养不良 营养状况和生长风险筛查工具 临床结局 

分 类 号：R723.13[医药卫生—儿科]