肺炎患儿血清s TREM-1、s CD163、SP-A、LP(a)的变化及其意义

Changes and Significance of Serum s TREM-1,s CD163,SP-A and LP( a) Levels in Children with Pneumonia

目的探讨肺炎患儿血清可溶性髓系细胞触发受体-1(s TREM-1)、可溶性CD163(sCD163)、肺表面活性蛋白A(SP-A)、脂蛋白a(LP(a))的变化及其意义。方法选取我院2016年1月至2017年12月收治的肺炎患儿120例(病例组)、选取同期健康小儿60例作为对照组,检测并比较两组的血清s TREM-1、sCD163、SP-A、LP(a)水平,并根据患儿病情、感染病原体情况进行分层分析。结果病例组患儿的血清s TREM-1、sCD163、SP-A、LP(a)水平均显著高于对照组,差异有统计学意义(P<0. 05);重症组肺炎患儿的血清s TREM-1、sCD163、SP-A、LP(a)水平均显著普通组肺炎患儿,差异有统计学意义(P<0. 05);细菌感染组肺炎患儿的血清s TREM-1、sCD163、LP(a)水平均显著非细菌感染组肺炎患儿,差异有统计学意义(P<0. 05),细菌感染组肺炎患儿血清SP-A水平与非细菌感染组患儿差异无统计学意义(P>0. 05);肺炎患儿的血清s TREM-1、sCD163、SP-A、LP(a)水平与CPIS评分呈显著的正相关关系(P<0. 05)。结论在不同病情的肺炎患儿中血清s TREM-1、sCD163、SP-A、LP(a)水平具有差异性,血清s TREM-1、sCD163、LP(a)在不同病原体感染的患儿中水平具有差异,联合检测上述指标对于临床诊断及指导治疗具有一定的价值。

Objective To investigate the changes and significance of serum soluble triggering receptor expressed on myeloid cells-1(sTREM-1),soluble CD163(sCD163),pulmonary surfactant-associated proteins A(SP-A)and lipoprotein A(LP(a))levels in children with pneumonia.Methods We selected 120 children admitted to our hospital(January 2016 to December 2017)with pneumonia as the case group and 60 healthy children in the same period as the control group,then detected and compared serum sTREM-1,sCD163,SP-A and LP(a)levels of the two groups,and performed stratified analysis according to the children s condition and pathogen infection.Results The serum sTREM-1,sCD163,SP-A and LP(a)levels in the case group were significantly higher than those in the control group(P﹤0.05);the serum sTREM-1,sCD163,SP-A and LP(a)levels of children with pneumonia in the severe group were significantly higher than those in the normal group(P﹤0.05);the serum sTREM-1,sCD163 and LP(a)levels of children with pneumonia in the bacterial infection group were significantly higher than those in the non-bacterial infection group(P﹤0.05),while there was no significant difference in serum SP-A level between bacterial infection group and non-bacterial infection group(P﹥0.05);serum sTREM-1,sCD163,SP-A and LP(a)levels were positively correlated with CPIS scores in children with pneumonia(P﹤0.05).Conclusion The serum sTREM-1,sCD163,SP-A and LP(a)levels are different in children with pneumonia in different conditions,and the serum sTREM-1,sCD163 and LP(a)levels are different in children with different pathogens.A joint detection of the above indicators has certain value for clinical diagnosis and treatment.