血清内皮细胞特异性分子-1、白细胞介素-1α和人类软骨糖蛋白-39水平与反复呼吸道感染患儿病情及预后的关系  

Relationships of serum levels of endocan,interleukin-1αand YKL-40 with disease severity and prognosis in children with recurrent respiratory infection

作　　者：王爱英[1] 张晓鹏 张欣 范琳[3] WANG Aiying;ZHANG Xiaopeng;ZHANG Xin;FAN Lin(Department of Blood Transfusion,the Eighth People′s Hospital of Qingdao of Shandong Province,Qingdao,Shandong,266100;Qingdao Central Hospital of Kangfu University,Qingdao Central Medical Group,Qingdao,Shandong,266000;Department of Clinical Laboratory,the Third People′s Hospital of Qingdao of Shandong Province,Qingdao,Shandong,266029)

机构地区：[1]山东省青岛市第八人民医院输血科,山东青岛266100 [2]康复大学青岛中心医院/青岛市中心医疗集团,山东青岛266000 [3]山东省青岛市第三人民医院检验科,山东青岛266029

出　　处：《实用临床医药杂志》2025年第6期7-12,共6页Journal of Clinical Medicine in Practice

基　　金：山东省青岛市2020年度医药科研指导计划项目(2020-WJZD090)。

摘　　要：目的探讨血清内皮细胞特异性分子-1(ESM-1,又称endocan)、白细胞介素(IL)-1α和人类软骨糖蛋白-39(又称YKL-40)水平与反复呼吸道感染(RRI)患儿病情严重程度及预后的关系。方法前瞻性选取86例RRI患儿作为病例组,并根据病情严重程度分为轻度组37例、中度组31例和重度组18例,根据预后分为预后良好组64例和预后不良组22例;另选取同期体检的94例健康儿童作为对照组。采用酶联免疫吸附试验(ELISA)检测所有儿童的血清endocan、IL-1α和YKL-40水平;采用Spearman相关性分析法评估血清endocan、IL-1α和YKL-40水平与RRI患儿病情严重程度的相关性;采用多因素Logistic回归分析探讨RRI患儿预后的影响因素;采用受试者工作特征(ROC)曲线评估血清endocan、IL-1α和YKL-40对RRI患儿预后的预测价值。结果病例组血清endocan、IL-1α、YKL-40水平均高于对照组,差异有统计学意义(P<0.05);中度组和重度组患儿血清endocan、IL-1α、YKL-40水平均高于轻度组,且重度组患儿水平高于中度组,差异有统计学意义(P<0.05);预后不良组患儿血清endocan、IL-1α、YKL-40水平均高于预后良好组,差异有统计学意义(P<0.05)。血清endocan、IL-1α、YKL-40水平与RRI患儿病情严重程度均呈显著正相关(r=0.407、0.493、0.452,P<0.001)。多因素Logistic回归分析结果显示,血清endocan(OR=1.412)、IL-1α(OR=1.583)、YKL-40(OR=1.259)均为RRI患儿预后的独立影响因素(P<0.05)。ROC曲线显示,血清endocan、IL-1α和YKL-40联合预测RRI患儿预后不良的曲线下面积为0.925,显著大于endocan、IL-1α、YKL-40单独预测。结论血清endocan、IL-1α和YKL-40水平均与RRI患儿的病情严重程度和预后密切相关,三者联合检测对RRI患儿预后具有较高的预测价值。Objective To investigate the correlations of serum levels of endothelial cell-specific molecule-1(ESM-1,also known as endocan),interleukin(IL)-1α,and human chondroglycan protein-39(also known as YKL-40)with disease severity and prognosis in children with recurrent respiratory infections(RRI).Methods A total of 86 children with RRI were prospectively enrolled as case group and divided into mild(37 cases),moderate(31 cases),and severe(18 cases)groups based on disease severity,and divided into good prognosis(64 cases)and poor prognosis(22 cases)groups based on prognosis.Additionally,94 healthy children who underwent physical examinations during the same period were selected as control group . Serum levels of endocan , IL-1α, and YKL-40 weremeasured using enzyme-linked immunosorbent assay (ELISA) in all children. Spearman′s correlation analysis was used to assess the correlation between serum levels of endocan, IL-1α, and YKL-40 and disease severity in children with RRI. Multivariate Logistic regression analysis was conducted to explore the factors influencing the prognosis of children with RRI. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of serum endocan, IL-1α, and YKL-40 for the prognosis of children with RRI. Results The serum levels of endocan, IL-1α, and YKL-40 in the case group were higher than those in the control group ( P <0.05). The serum levels of endocan, IL-1α, and YKL-40 in the moderate and severe groups were higher than those in the mild group, and the levels in the severe group were higher than those in the moderate group ( P <0.05). The serum levels of endocan, IL-1α, and YKL-40 in the poor prognosis group were higher than those in the good prognosis group ( P <0.05). Serum levels of endocan, IL-1α, and YKL-40 were significantly positively correlated with disease severity in children with RRI ( r =0.407, 0.493, 0.452 , respectively;P <0.001). Multivariate Logistic regression analysis showed that serum endocan(OR=1.412), IL-1α(OR=1.583), and YK

关 键 词：反复呼吸道感染 预后 内皮细胞特异性分子-1 白细胞介素-1Α 人类软骨糖蛋白-39 受试者工作特征曲线 免疫力低下 内皮细胞 

分 类 号：R725.6[医药卫生—儿科] R563.1[医药卫生—临床医学] R446