入院时CD11b平均荧光强度、血清锌、D-乳酸水平与轮状病毒肠炎患儿病情严重程度的相关性及其联合检测对患儿发生脓毒血症的预测价值

Correlation of mean fluorescence intensity of CD11b,serum zinc,and D-lactic acid levels at admission with the severity of rotavirus enteritis in children and the predictive value of combined detection for sepsis in children

目的探讨中性粒细胞表面白细胞分化抗原11b(CD11b)平均荧光强度、血清锌、D-乳酸(D-LAC)水平与轮状病毒肠炎(RVE)患儿病情严重程度的相关性及其联合检测对患儿发生脓毒血症的预测价值。方法回顾性选取2022年1月至2023年12月驻马店市中心医院收治的168例RVE患儿纳入研究,根据是否并发脓毒血症分为发生组33例和未发生组135例。比较两组患儿的基线资料及CD11b平均荧光强度、血清锌、D-LAC水平,采用Spearman相关性分析各指标与RVE病情严重程度的相关性,采用受试者工作特征(ROC)曲线分析各指标对RVE患儿发生脓毒血症的预测价值。结果脓毒血症发生组患儿的轻、中、重病情程度占比分别为3.03%、9.09%、87.88%,未发生组轻、中、重病情程度占比分别为28.15%、60.00%、11.85%,发生组病情严重程度较未发生组严重,差异有统计学意义(P<0.05);发生组患儿入院时CD11b平均荧光强度、血清D-LAC水平分别为(91.25±5.36)AU、(8.35±2.74)mg/L,明显高于未发生组的(84.30±7.28)AU、(5.80±0.67)mg/L,血清锌水平为(51.95±6.77)μmol/L,明显低于未发生组的(70.59±8.34)μmol/L,差异均有统计学意义(P<0.05);Spearman相关性分析结果显示,入院时CD11b平均荧光强度、血清D-LAC水平与RVE患儿严重程度呈正相关(r=0.685、0.709,P<0.05),血清锌水平与RVE患儿严重程度呈负相关(r=-0.664,P<0.05);ROC曲线分析结果显示,入院时CD11b平均荧光强度、血清锌、D-LAC水平联合预测RVE患儿发生脓毒血症的AUC为0.897,明显大于上述指标单独检测的0.758、0.712、0.742。结论入院时CD11b平均荧光强度、血清锌、D-LAC水平与RVE患儿病情严重程度具有一定相关性,联合检测对RVE患儿脓毒血症的发生具有较高的预测价值,可为RVE患儿病情评估及制定预防脓毒血症的方案提供参考依据。

Objective To investigate the correlation of the mean fluorescence intensity of cluster of differentiation 11b(CD11b),serum zinc,D-lactic acid(D-LAC)levels with the severity of rotavirus enteritis(RVE)in children,and the value of combined detection in the prediction of sepsis in RVE children.Methods A total of 168 children with RVE admitted to Zhumadian Central Hospital from Jan.2022 to Dec.2023 were retrospectively selected and divided into occurrence group(33 cases)and non-occurrence group(135 cases)according to whether they were complicated with sepsis.The baseline data,mean fluorescence intensity of CD11b,serum zinc,and D-LAC levels were compared between the two groups.Spearman correlation analysis was used to analyze the correlation of each index with the severity of RVE children,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of each index alone and in combination for sepsis in children with RVE.Results The proportion of mild,moderate,and severe cases in the occurrence group were 3.03%,9.09%,and 87.88%,respectively,which were significantly lower than 28.15%,60.00%,and 11.85%in the non-occurrence group(P<0.05).The mean fluorescence intensity of CD11b and the serum D-LAC level at admission in the occurrence group were(91.25±5.36)AU and(8.35±2.74)mg/L,respectively,which were significantly higher than(84.30±7.28)AU and(5.80±0.67)mg/L in the non-occurrence group;the serum zinc level was(51.95±6.77)μmol/L,which was significantly lower than(70.59±8.34)μmol/L in the non-occurrence group;the differences were statistically significant(P<0.05).Spearman correlation analysis showed that the mean fluorescence intensity of CD11b and serum D-LAC level were positively correlated with the severity of RVE children at admission(r=0.685,0.709;P<0.05),and serum zinc level was negatively correlated with the severity of RVE children(r=-0.664,P<0.05).ROC curve analysis showed that the AUC of the combined detection of mean fluorescence intensity of CD11b,serum zinc,and D-LAC levels at admission for predicting sepsis in RVE children was 0.897,which was significantly higher than 0.758,0.712,and 0.742 of the above indicators alone.Conclusion The mean fluorescence intensity of CD11b,serum zinc,and D-LAC levels at admission are correlated with the severity of RVE children.Combined detection of the above indicators has a high predictive value for the occurrence of sepsis in children with RVE,which can provide a reference for the assessment of the disease and the formulation of prevention of sepsis in children with RVE.