呼吸道合胞病毒肺炎患儿血清NRAV水平及临床意义

The level and clinical significance of NRAV in the serum of children with respiratory syncytial virus pneumonia

目的探讨呼吸道合胞病毒(RSV)肺炎患儿血清中抗病毒应答负性调节因子(NRAV)的表达水平及临床意义。方法选取我院收治的RSV肺炎患儿100例作为RSV组,并将RSV肺炎患儿根据肺炎严重指数(PSI)分为低危组(62例)、中危组(24例)及高危组(14例)。另选取同期于本院体检的102例健康儿童作为对照组。采用荧光定量PCR法检测血清NRAV水平,用肺功能仪检测受试儿童肺功能,采用Pearson法分析血清NRAV水平与RSV肺炎患儿肺功能的相关性;采用Logistics回归分析RSV肺炎患儿病情严重程度的影响因素;采用ROC曲线分析血清NRAV水平对RSV肺炎的诊断价值。结果RSV组患儿血清NRAV水平高于对照组,第1秒用力呼气容积占预计值百分比(FEV_(1)%)及FEV_(1)/用力肺活量(FVC)均低于对照组(均P<0.05)。不同严重程度RSV肺炎患儿血清NRAV水平、FEV_(1)%及FEV_(1)/FVC比较差异有统计学意义(均P<0.05)。低危组、中危组、高危组RSV肺炎患儿血清NRAV水平依次升高,FEV_(1)%及FEV_(1)/FVC均依次下降,组间两两比较差异有统计学意义(均P<0.05)。RSV肺炎患儿血清NRAV水平与FEV_(1)%及FEV_(1)/FVC均呈负相关(均P<0.05)。Logistics分析显示,血清NRAV水平升高、FEV_(1)%及FEV_(1)/FVC水平下降均是影响RSV肺炎严重程度的独立危险因素(均P<0.05)。ROC曲线分析显示,血清NRAV水平诊断RSV肺炎的曲线下面积为0.843,敏感度为76.0%,特异度为88.2%,最佳截断值为1.14。结论RSV肺炎患儿血清NRAV水平升高且随着疾病严重程度的加重而升高,其水平可反映肺功能,对RSV肺炎具有一定诊断价值。

Objective To observe the expression level and clinical significance of negative regulator of anti-viral response(NRAV)in the serum of children with respiratory syncytial virus(RSV)pneumonia.Methods One-hundred children with RSV pneumonia admitted to our hospital were selected as the RSV group,and were divided into low-risk group(62 cases),intermediate-risk group(24 cases)and high-risk group(14 cases)according to the pneumonia severity index(PSI).In addition,102 healthy children who received physical examination in our hospital during the same period were selected as the control group.Fluorescence quantitative PCR method was used to detect the level of serum NRAV.A pulmonary function meter was used to test the lung function.Pearson method was used to analyze the correlation between serum NRAV level and lung function.Logistics regression was used to analyze the factors affecting the severity of RSV pneumonia.ROC curve was used to analyze the diagnostic value of serum NRAV level for RSV pneumonia.Results The serum NRAV level in the RSV group was higher than that in the control group(P<0.05),and the percentage of forced expiratory volume in the first second to the predicted value(FEV_(1)%)and FEV_(1)/forced vital capacity(FVC)were lower than those in the control group(all P<0.05).The differences in serum NRAV level,FEV_(1)%and FEV_(1)/FVC among different severity of RSV pneumonia were statistically significant(all P<0.05);the serum NRAV level in children with RSV pneumonia in the low-risk group,intermediate-risk group,and high-risk group increased sequentially,and FEV_(1)%and FEV_(1)/FVC decreased sequentially,with statistically significant differences between groups(all P<0.05).The serum NRAV level in children with RSV pneumonia was negatively correlated with FEV_(1)%and FEV_(1)/FVC(all P<0.05).Logistics analysis showed that increased serum NRAV level,and decreased FEV_(1)%and FEV_(1)/FVC levels were independent risk factors affecting the severity of RSV pneumonia(all P<0.05).ROC curve analysis showed that the area under the curve for the diagnosis of RSV pneumonia by serum NRAV level was 0.843,the sensitivity was 76.0%,the specificity was88.2%,and the best cutoff value was 1.14.Conclusion The level of serum NRAV in children with RSV pneumonia rises and increases with the aggravation of the disease.Its level can reflect lung function and has a certain diagnostic value for RSV pneumonia.