血清CysC联合MMP-9在小儿病毒性脑炎病情判断及预后评估中的应用价值

Application value of serum CysC combined with MMP-9 in diseases condition judgment and prognosis evaluation in infants with viral encephalitis

目的分析血清CysC联合MMP-9在小儿病毒性脑炎病情判断及预后评估中的应用价值。方法选择2017年1月至2018年10月接诊的138例小儿病毒性脑炎患儿作为病例组,另选60例同期的健康体检小儿作为对照组,检测病例组入院时及出院时,对照组体检当日的血清CysC、MMP-9;比较病例组入院时与对照组血清CysC、MMP-9水平,观察病例组入院时与出院时,重症与非重症患儿的血清CysC、MMP-9差异情况,采用Pearson相关性分析小儿病毒性脑炎患儿入院时血清CysC水平与MMP-9水平的相关性;随访6个月,以神经系统后遗症作为随访指标,采用ROC曲线分析血清CysC联合MMP-9预测神经系统后遗症的效能。结果病例组入院时血清CysC、MMP-9水平均明显高于对照组,差异均有统计学意义(P<0.05);病例组出院时CysC、MMP-9水平均较入院时明显降低,差异均有统计学意义(P<0.05);在病例组138例患儿中,重症组入院时血清CysC、MMP-9水平均明显高于非重症组,差异均有统计学意义(P<0.05);小儿病毒性脑炎患儿血清CysC水平与MMP-9水平呈正相关(r=0.233,P=0.006),线性相关较好;随访6个月,共37例患儿存在神经系统后遗症,CysC联合MMP-9预测小儿病毒性脑炎患儿发生神经系统后遗症的ROC曲线下面积(AUC)为0.850,明显大于CysC的0.625或MMP-9的0.605,差异均有统计学意义(P<0.05)。结论小儿病毒性脑炎患儿病情严重程度与血清CysC、MMP-9水平有关,两者联合检测可协同提高对神经系统后遗症的预测效能,值得进一步研究应用。

Objective To analyze the application value of serum CysC combined with MMP9 in diseases condition judgment and prognosis evaluation in infants with viral encephalitis.Methods A total of 138 infants with viral encephalitis,who were admitted and treated in our hospital from January 2017 to October 2018,were enrolled as case group,at the same time,60 healthy children were enrolled as control group.The levels of serum CysC and MMP-9 of the patients at admission and discharge and those of the infants in control group on the inspection day were detected.Moreover,the levels of serum CysC and MMP-9 of the patients at admission were compared with those of the infants in control group.And the differences of serum levels of CysC and MMP-9 between severe cases and common cases at admission and in discharging from hospital in case group were observed and compared.Pearson correlation analysis was used to analyze the correlation between the serum levels of CysC and those of MMP-9 in patients at admission.Furthermore,all the patients were followed up for six months,with neurological sequelae being used as observation index.In addition,ROC curve was used to analyze the efficacy of serum CysC combined with MMP-9 in predicting neurological sequelae.Results The levels of serum CysC and MMP-9 of the patients at admission in case group were significantly higher than those in control group(P<0.05).The serum levels of CysC and MMP-9 in case group in discharging from hospital were significantly decreased(P<0.05).Among the 138 patients in case group,the levels of serum CysC and MMP-9 in severe case group at admission were significantly higher than those in non-severe case group(P<0.05).Moreover,the serum levels of CysC were positively correlate with those of MMP-9 in infants with viral encephalitis(r=0.233,P<0.01).Thirty-seven patients developed neurological sequelae at the follow-up.In addition,the areas under the ROC curve(AUC)to predict neurological sequelae using CysC combined with MMP-9 was 0.850,which was markedly larger than those when using CysC(0.625)and MMP-9(0.605)alone(P<0.05).Conclusion The severity of infants with is correlated with the levels of serum CysC and MMP-9.The combination detection of the two indexes can improve the efficiency of predicting neurological sequelae,which is worthy of further research.