血清VEGF、sICAM-1、25-(OH)D_(3)水平与腺病毒肺炎患儿炎症因子和喘息的关系研究

Study on the relationships between serum VEGF,sICAM-1,25-(OH)D_(3)levels and inflammatory factors,wheezing in children with adenovirus pneumonia

目的探讨血清血管内皮生长因子(VEGF)、可溶性细胞间黏附分子-1(sICAM-1)、25-羟维生素D_(3)[25-(OH)D_(3)]水平与腺病毒肺炎患儿炎症因子和喘息的关系。方法选取2020年2月至2022年2月西安经开妇幼医院收治的97例腺病毒肺炎患儿为观察组,另选取同期进行治疗的50例非腺病毒肺炎患儿为对照组。比较观察组与对照组VEGF、sICAM-1、25-(OH)D_(3)、炎症因子水平。对VEGF、sICAM-1、25-(OH)D_(3)与炎症因子水平进行相关分析。将97例腺病毒肺炎患儿根据是否发生喘息分为喘息组和非喘息组,对腺病毒肺炎患儿发生喘息进行多因素Logistic回归分析。结果观察组VEGF、sICAM-1、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)水平高于对照组,25-(OH)D_(3)水平低于对照组,差异均有统计学意义(P<0.05)。腺病毒肺炎患儿的VEGF、sICAM-1水平与TNF-α、IL-6、CRP水平呈正相关(P<0.05),25-(OH)D_(3)水平与TNF-α、IL-6、CRP水平呈负相关(P<0.05)。喘息组VEGF、sICAM-1水平及合并重症肺炎、特应性体质比例高于非喘息组,25-(OH)D_(3)水平低于非喘息组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,VEGF、sICAM-1水平升高,以及合并重症肺炎、特应性体质是腺病毒肺炎患儿喘息发生的危险因素(P<0.05),25-(OH)D_(3)水平升高则是保护因素(P<0.05)。结论检测VEGF、sICAM-1、25-(OH)D_(3)水平对于腺病毒肺炎患儿的辅助诊断、病情评估、预后判断及治疗有重要作用;同时,对于25-(OH)D_(3)低水平患儿需及时补充维生素D以预防喘息的发生。

Objective To investigate the relationships between serum levels of vascular endothelial growth factor(VEGF),soluble intercellular adhesion molecule-1(sICAM-1),25-hydroxyvitamin D_(3)[(25-(OH)D_(3)],inflammatory factors and wheezing in children with adenovirus pneumonia.Methods A total of 97 children with adenovirus pneumonia who were admitted to Xi'an Jingkai District Women's and Children's Hospital from February 2020 to February 2022 were selected as the observation group,and 50 children with non adenovirus pneumonia who were treated in this hospital at the same period were selected as the control group.The VEGF,sICAM-1,25-(OH)D_(3)levels and inflammatory factors were detected and compared in the two groups,and the correlations between VEGF,sICAM-1,25-(OH)D_(3)and inflammatory factors were analyzed.According to whether the children with adenovirus pneumonia had wheezing or not,the children were divided into wheezing group and non-wheezing group.Multivariate Logistic regression analysis was used to analyze the influencing factors of wheezing in children with adenovirus pneumonia.Results The levels of VEGF,sICAM-1,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP)in observation group were higher than those in control group,and the levels of 25-(OH)D_(3)was lower than that in control group,with statistical significance(P<0.05).VEGF and sICAM-1 levels correlated positively with TNF-α,IL-6 and CRP levels in children with adenovirus pneumonia(P<0.05),and 25-(OH)D_(3)level correlated negatively with TNF-α,IL-6 and CRP levels(P<0.05).The levels of VEGF,sICAM-1,and the proportion of severe pneumonia and atopic constitution in asthmatic group were higher than those in non-asthmatic group,and the level of 25-(OH)D_(3)was lower than that in non-asthmatic group,with statistical significance(P<0.05).Mul-tivariate Logistic regression analysis showed that increased levels of VEGF and sICAM-1,combined with se-vere pneumonia and atopic constitution were risk factors for wheezing in children with adenovirus pneumonia(P<0.05),and increased levels of 25-(OH)D_(3)was protective factor(P<0.05).Conclusion Detection of VEGF,sICAM-1,25-(OH)D_(3)levels is important for the auxiliary diagnosis,disease evaluation,prognosis and treatment of children with adenovirus pneumonia.At the same time,children with low level of 25-(OH)D_(3)need to supplement vitamin D in time to prevent wheezing.