支气管肺炎患儿血清sVCAM-1、ANXA2、CXCL11表达与病情及预后的相关性分析-东南大学学报医学版

支气管肺炎患儿血清sVCAM-1、ANXA2、CXCL11表达与病情及预后的相关性分析

单位：1. 焦作煤业有限责任公司中央医院儿科, 河南焦作 454000;
2. 许昌市疾病预防控制中心检验科, 河南许昌 461700

关键词：支气管肺炎可溶性血管内皮细胞黏附因子-1 膜联蛋白A2 CXC趋化因子配体11 病情预后

分类号：R563.12

出版年·卷·期（页码）：2024·43·第三期（460-466）

摘要：

目的:探讨可溶性血管内皮细胞黏附因子-1(sVCAM-1)、膜联蛋白A2(ANXA2)、CXC趋化因子配体11(CXCL11)水平检测在儿童支气管肺炎病情和预后评估中的临床作用。方法:回顾性纳入本院收治的支气管肺炎患儿共102例为支气管肺炎组,肺部感染评分(CPIS)评估病情并分为轻型组和重型组,根据患儿预后情况分为预后好组和预后差组;同期纳入本院健康体检儿童共106例作为健康对照组。采用ELISA法检测血清中sVCAM-1、ANXA2、CXCL11的水平。Pearson相关分析法评估血清指标与CPIS相关性,Logistic回归分析进行影响因素分析,ROC曲线分析指标诊断价值。结果:支气管肺炎组血清sVCAM-1、ANXA2、CXCL11水平均显著高于健康对照组(均P＜0.05)。重型组患儿血清sVCAM-1、ANXA2、CXCL11水平及CPIS均显著高于轻型组患儿(均P＜0.05)。支气管肺炎患儿血清sVCAM-1、ANXA2、CXCL11水平与CPIS均呈正相关(r分别为0.643、0.526、0.677,均P＜0.05)。sVCAM-1(OR=2.478)、ANXA2(OR=2.662)、CXCL11(OR=2.407)是支气管肺炎患儿病情进展的影响因素(均P＜0.05)。血清sVCAM-1、ANXA2、CXCL11水平诊断重型支气管肺炎的AUC为0.825、0.811、0.833,显著低于联合诊断的0.971(均P＜0.05)。预后差组患儿血清sVCAM-1、ANXA2、CXCL11水平及CPIS显著高于预后好组患儿(均P＜0.05)。结论:支气管肺炎患儿血清sVCAM-1、ANXA2、CXCL11水平与患儿病情程度及预后均有一定联系,上述指标检测可辅助临床评估患儿病情及预后。

Objective: To explore the clinical role of detecting soluble vascular cell adhesion molecule-1(sVCAM-1), annexin A2(ANXA2), and CXC chemokine ligand-11(CXCL11) levels in the disease and prognosis evaluation of children with bronchopneumonia. Methods: 102 children with bronchopneumonia accepted by our hospital were retrospectively included as the bronchopneumonia group. The Clinical Pulmonary Infection Score(CPIS) was used to evaluate the condition and divided them into a mild group and a severe group. According to the prognosis of the children, they were separated into a good prognosis group and a poor prognosis group; another 106 children who underwent health examinations in our hospital were included as the healthy control group. ELISA method was applied to detect the levels of sVCAM-1, ANXA2, and CXCL11 in serum. Pearson correlation analysis was applied to evaluate the correlation between serum indicators and CPIS, Logistic regression was applied to analyze the influencing factors, ROC curve was applied to analyze the diagnostic value of indicators. Results: The serum levels of sVCAM-1, ANXA2, and CXCL11 in the bronchopneumonia group were greatly higher than those in the healthy control group(all P＜0.05). The serum levels of sVCAM-1, ANXA2, CXCL11, and CPIS in the severe group were greatly higher than those in the mild group(all P＜0.05). The serum levels of sVCAM-1, ANXA2, CXCL11 in children with bronchopneumonia were positively correlated with the CPIS(r:0.643, 0.526, 0.677, all P＜0.05). sVCAM-1(OR=2.478), ANXA2(OR=2.662), and CXCL11(OR=2.407) were influencing factors for the progression of bronchopneumonia in children(all P＜0.05). The AUC of serum sVCAM-1, ANXA2, and CXCL11 levels for diagnosing severe bronchopneumonia was 0.825, 0.811, and 0.833, which was greatly lower than the AUC of combined diagnosis, 0.971(all P＜0.05). The serum levels of sVCAM-1, ANXA2, CXCL11, and CPIS in poor prognosis group were greatly higher than those in good prognosis group(all P＜0.05). Conclusion: The serum levels of sVCAM-1, ANXA2, and CXCL11 in children with bronchopneumonia are related to the severity and prognosis of the disease. The detection of these indicators can assist in clinical evaluation of disease and prognosis of the children.

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