血清YKL-40、EGF表达水平与肺炎新生儿病情的关系及其对不良预后的预测价值分析-东南大学学报医学版

血清YKL-40、EGF表达水平与肺炎新生儿病情的关系及其对不良预后的预测价值分析

单位：保定市第二中心医院儿科, 河北保定 072750

分类号：R725.6

出版年·卷·期（页码）：2022·41·第五期（609-614）

摘要：

目的：探讨分析血清软骨糖蛋白-39（YKL-40）、表皮生长因子（EGF）表达水平与肺炎新生儿病情的关系及其对不良预后的预测价值。方法：选取2020年10月至2021年10月收治的126例肺炎新生儿患儿作为观察组，并选取同期80例足月健康新生儿作为对照组，根据患儿病情严重程度将患儿分为轻症组87例和重症组39例，然后根据患儿预后情况将患儿分为预后良好组98例和预后不良组28例。采用酶联免疫吸附法检测血YKL-40、EGF水平，分析其水平变化与肺炎患儿病情严重程度及预后不良的关系。结果：入院第7天，血清YKL-40水平较入院第1天时降低，且轻症组低于重症组（P<0.05）；入院第7天时血清EGF水平较入院第1天时升高，且轻症组高于重症组（P<0.05）；Pearson相关性分析结果显示，血清YKL-40水平与患儿病情严重程度呈正相关关系（r=0.534，P<0.05）；而血清EGF水平与患儿病情严重程度呈负相关关系（r=-0.519，P<0.05）。入院第7天血清YKL-40水平较入院第1天时降低，且预后良好组低于预后不良组（P<0.05）；入院第7天时血清EGF水平较入院第1天时升高，且预后良好组高于预后不良组（P<0.05）。入院第1天血清YKL-40水平截断值为40.13 ng·ml^-1时，预测肺炎新生儿预后不良的ROC曲线下面积为0.72（0.548~0.712），敏感度和特异度分别为75.42%、72.58%；血清EGF水平截断值为589.46 ng·L^-1时，预测肺炎新生儿预后不良的曲线下面积为0.75（0.623~0.759），敏感度和特异度分别为78.39%、71.26%；联合检测预测肺炎新生儿预后不良的曲线下面积为0.81（0.712~0.843），此时的敏感度和特异度分别为82.35%、71.46%。结论：肺炎新生儿血清YKL-40水平升高，血清EGF水平降低，血清YKL-40水平与患儿病情严重程度呈正相关关系，血清EGF水平与患儿病情严重程度呈负相关关系，血清YKL-40、EGF水平可作为肺炎患儿病情评估的重要参考指标，且二者联合检测对预测肺炎患儿不良预后具有重要参考价值。

Objective: To explore the relationships between the expression levels of serum cartilage glycoprotein 39(YKL-40), epidermal growth factor(EGF) and the condition of neonates with pneumonia and their predictive value for poor prognosis. Methods: A total of 126 neonates with pneumonia admitted from October 2020 to October 2021 were selected as the observation group, and 80 full-term healthy newborns were selected as the control group. According to the severity of the disease, the children were divided into the mild group(87 cases) and the severe group(39 cases), and then according to the prognosis of the children, the children were divided into a good prognosis group of 98 cases and a poor prognosis group of 28 cases. Serum YKL-40 and EGF levels were detected by enzyme-linked immunosorbent assay, and the relationships were analyzed between their levels and the severity, poor prognosis of children with pneumonia. Results: On the 7th day of admission, the serum YKL-40 level was lower than that on the 1st day of admission, and the mild group was lower than the severe group(P<0.05). On the 7th day of admission, the serum EGF level was higher than that on the 1st day of admission, and the mild group was higher than the severe group(P<0.05); Pearson correlation analysis showed that serum YKL-40 level was positively correlated with the severity of the children's disease(r=0.534, P<0.05); while the serum EGF level was negatively correlated with the children's disease severity(r=-0.519, P<0.05). On the 7th day of admission, the serum YKL-40(EGF) level was lower(higher) than that on the 1st day of admission, and the good prognosis group was lower than the poor prognosis group(P<0.05), and the serum EGF level in the good prognosis group was higher than that in the poor prognosis group(P<0.05). When the cut-off value of serum YKL-40 level on the first day of admission was 40.13 ng·ml^-1, the area under the ROC curve for predicting poor prognosis of neonates with pneumonia was 0.72(0.548-0.712), and the sensitivity and specificity were 75.42% and 72.58%, respectively; when the cut-off value of serum EGF level was 589.46 ng·L^-1, the area under the curve for predicting poor prognosis of neonates with pneumonia was 0.75(0.623-0.759), and the sensitivity and specificity at this time were 78.39% and 71.26%, respectively; The area under the curve for predicting poor prognosis of neonates with pneumonia on combined detection was 0.81(0.712-0.843), and the sensitivity and specificity were 82.35% and 71.46%, respectively. Conclusion: The level of serum YKL-40 in neonates with pneumonia was increased, and the level of serum EGF was decreased. The level of serum YKL-40 was positively correlated with the severity of the child's disease, and the serum EGF was negatively correlated with the severity of the child's disease. The serum YKL-40 and EGF can be used as important reference indexes for the evaluation of the condition of children with pneumonia, the combined detection has important reference value in predicting the poor prognosis of children with pneumonia.

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