重症肺炎患儿血清肺表面活性蛋白A水平的临床意义

Clinical significance of serum level of SP-A in children with severe pneumonia

目的通过观察重症肺炎患儿不同疾病时期血清中肺表面活性蛋白A(SP-A)的水平,探讨其在判断肺损伤病情程度的临床意义。方法检测正常儿童、普通肺炎及和重症肺炎患儿急性期、恢复期的血清SP-A水平,同时记录氧合指数[动脉血氧分压(PaO2)/吸入氧深度(FiO2)]和小儿危重病例评分(PCIS)并进行比较,并行血清SP-A与PaO2/FiO2及PCIS相关分析。结果重症肺炎患儿急性期组较对照两组血清中SP-A水平升高,而PaO2/FiO2和PCIS值下降(P均<0.05),恢复期与对照两组间比较差异无统计学意义(P>0.05);血清SP-A水平与氧合指数及PCIS评分的相关系数分别为0.615和0.573(P均<0.05)。结论重症肺炎患儿急性期血清SP-A的水平反映肺损伤病情严重程度,或可作为创伤较小的临床检测指标。

Objective To observe the serum level of pulmonary surfactant protein A（SP-A） in children with severe pneumonia in different period,and to investigate its clinical significance in judging lung injury degree.Methods The serum SP-A level of normal children was detected in children with ordinary pneumonia and children with severe pneumonia at acute stage and recovery stage,and the oxygenation index（PaO2/FiO2） and pediatric critical illness score（PCIS） of them simultaneously was recorded,then comparisons and correlation analysis were made.Results Serum SP-A level of children with severe pneumonia at the acute phase was higher than others,while PaO2/FiO2 and PCIS were lower（P＆lt;0.05）.There was no significant difference among children with sever pneumonia at recovery stage,children with ordinary pneumonia and normal children（P＆gt;0.05）.Line correlation coefficients of serum SP-A level and oxygenation index,PCIS were 0.615 and 0.573（P＆lt;0.05）.Conclusion Serum SP-A level in children with severe pneumonia at acute phase can reflect the severity of lung injury of this disease,it could be used as a less invasive clinical indicators.