血清ICAM-1、sTREM-1、IL-6在儿童病毒性肺炎诊断及病情评估中的价值  

Value of Serum ICAM-1,sTREM-1,and IL-6 in the Diagnosis and Condition Assessment of Viral Pneumonia in Children

作　　者：程倩倩 陈帅 周慧琴 李可法 梁建军 CHENG Qianqian;CHEN Shuai;ZHOU Huiqin;LI Kefa;LIANG Jianjun(Department of Pediatrics,the Sixth Affiliated Hospital of Henan University of Chinese Medicine/Zhumadian TCM Hospital,Zhumadian 463000,China;Department of Encephalopathy,the Sixth Affiliated Hospital of Henan University of Chinese Medicine/Zhumadian TCM Hospital,Zhumadian 463000,China)

机构地区：[1]河南中医药大学第六附属医院/驻马店市中医院儿科,河南驻马店463000 [2]河南中医药大学第六附属医院/驻马店市中医院脑病科,河南驻马店463000

出　　处：《河南医学研究》2025年第7期1252-1256,共5页Henan Medical Research

基　　金：河南省中医药青苗人才培养项目(豫卫中医函〔2021〕16号)。

摘　　要：目的观察病毒性肺炎患儿血清细胞间黏附分子1(ICAM-1)、可溶性髓样细胞触发受体1(sTREM-1)、白细胞介素-6(IL-6)水平变化,探讨三者在儿童病毒性肺炎诊断及病情评估中的价值。方法选取50例病毒性肺炎患儿为肺炎组,根据病情严重程度分为轻症组和重症组;同期选取健康儿童50例为对照组。比较肺炎组与对照组、轻症组与重症组血清ICAM-1、sTREM-1、IL-6水平;采用Pearson相关法分析病毒性肺炎患儿病情严重程度与血清ICAM-1、sTREM-1、IL-6水平的相关性;绘制受试者工作特征(ROC)曲线,评估血清ICAM-1、sTREM-1、IL-6诊断儿童病毒性肺炎的效能。结果肺炎组血清ICAM-1、sTREM-1、IL-6水平均高于对照组(P<0.05),性别比例、年龄与对照组差异无统计学意义(P>0.05)。重症组病程长于轻症组(P<0.05),重症组血清ICAM-1、sTREM-1、IL-6水平均高于轻症组(P<0.05),重症组性别比例、年龄与对照组比较,差异无统计学意义(P>0.05)。病毒性肺炎患儿病情严重程度与血清ICAM-1、sTREM-1、IL-6水平均呈正相关(P<0.05)。血清ICAM-1、sTREM-1、IL-6分别以224.05μg·L^(-1)、48.20μg·L^(-1)、60.15 ng·L^(-1)为最佳截断值,诊断儿童病毒性肺炎的曲线下面积分别为0.936(95%CI:0.917~0.955,P<0.001)、0.811(95%CI:0.777~0.845,P<0.001)、0.953(95%CI:0.937~0.969,P<0.001),灵敏度分别为79.5%、64.4%、88.1%,特异度分别为90.0%、82.6%、91.3%;血清ICAM-1、sTREM-1、IL-6联合诊断儿童病毒性肺炎的曲线下面积为0.975(95%CI:0.963~0.987,P<0.001),灵敏度为93.4%,特异度为94.1%。结论病毒性肺炎患儿血清ICAM-1、sTREM-1、IL-6水平增高,病情重者水平更高;血清ICAM-1、sTREM-1、IL-6联合诊断病毒性肺炎有较高价值。Objective To observe the changes of serum intercellular cell adhesion molecule-1(ICAM-1),soluble triggering receptor expressed on myeloid cells-1(sTREM-1),and interleukin-6(IL-6)levels of children with viral pneumonia,and to explore the value of the three in the diagnosis of viral pneumonia and the assessment of the disease in children.Methods A total of 50 children with viral pneumonia were in the pneumonia group,which was divided into the mild group and severe group according to the severity of the disease.A total of 50 healthy children were selected as the control group in the same period.The serum ICAM-1,sTREM-1 and IL-6 levels were compared between pneumonia group and control group,and between mild group and severe group.The correlation between the severity of viral pneumonia in children and serum ICAM-1,sTREM-1 and IL-6 levels were analyzed by using Pearson correlation method.Receiver operating characteristic(ROC)curves were plotted to assess the efficacy of serum ICAM-1,sTREM-1,and IL-6 in diagnosing viral pneumonia in children.Results Serum ICAM-1,sTREM-1 and IL-6 levels were higher in pneumonia group than those in control group(P<0.05),and there were no significant difference in the sex ratio and age in pneumonia group compared to control group(P>0.05).The duration of illness in severe group was longer than that in mild group(P<0.05),and serum ICAM-1,sTREM-1 and IL-6 levels were higher than those in mild group(P<0.05),with no significant differences in gender ratio and age compared with control group(P>0.05).The severity of viral pneumonia in children was positively correlated with serum ICAM-1,sTREM-1 and IL-6 levels(P<0.05).Serum ICAM-1,sTREM-1 and IL-6 with the optimal cut-off values of 224.05μg·L^(-1),48.20μg·L^(-1),and 60.15 ng·L^(-1),respectively,the area under the curve for diagnosing viral pneumonia in children were 0.936(95%CI:0.917-0.955,P<0.001),0.811(95%CI:0.777-0.845,P<0.001)and 0.953(95%CI:0.937-0.969,P<0.001),with sensitivities of 79.5%,64.4%and 88.1%,and specificities of 90.0%,82.6%a

关 键 词：病毒性肺炎 儿童 细胞间黏附分子1 可溶性髓样细胞触发受体1 白细胞介素-6 

分 类 号：R725.6[医药卫生—儿科]