血清DcR3水平与早产儿呼吸窘迫综合征的关系

Relationship between the serum DcR3 level and respiratory distress syndrome of premature infants.

目的分析血清肿瘤诱骗受体3 (DcR3)水平与早产儿呼吸窘迫综合征(RDS)的关系,为临床诊断提供参考。方法选取2016年1月至2018年1月在上海德达医院儿科住院治疗的RDS早产儿88例作为研究对象,按照入院24 h内病情严重程度分为轻度组46例和重度组42例。另选取同期在本院产科出生的正常早产儿56例作为对照组。采用酶联免疫吸附法(ELISA)检测血清DcR3水平;多因素Logistic回归分析早产儿发生RDS的影响因素;ROC曲线分析血清DcR3水平对RDS的诊断价值。结果轻度组和重度组早产儿的血清DcR3水平分别为(139.15±45.66) pg/mL、(252.35±52.03) pg/mL,明显高于对照组的(75.09±19.06) pg/mL,重度组又明显高于轻度组,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,新生儿窒息、血清DcR3高表达是早产儿发生RDS的独立危险因素(P<0.05);ROC曲线分析结果显示,在血清DcR3水平截断值为111.471 pg/mL时,诊断RDS的AUC值为0.893 (95%CI:0.832~0.896),灵敏度和特异度分别为82.3%、85.6%。结论除窒息外,早产儿血清DcR3水平高表达可能是RDS的独立危险因素,可反映患儿病情严重程度,可作为评估病情的生物学指标,为临床早期诊断早产儿RDS提供参考。

Objective To analyze the relationship between the level of serum tumor decoy receptor 3(DcR3)and respiratory distress syndrome(RDS)of premature infants,so as to provide reference for clinical diagnosis.Methods From January 2016 to January 2018,88 RDS premature infants in Department of Pediatrics,Shanghai Deda Hospital were selected as study subjects.According to the severity of the disease,they were divided into 46 cases in mild RDS group and 42 cases in severe RDS group.In addition,56 normal newborns born in the hospital at the same time were selected as the control group.The level of serum DcR3 was detected by enzyme-linked immunosorbent assay(ELISA).Multi-factor Logistic analysis was used to analyze the influencing factors of RDS in preterm infants.ROC curve was used to analyze the predictive value of serum DcR3 level in the diagnosis and prognosis of RDS.Results The serum DcR3 levels of premature infants was(139.15±45.66)pg/mL in the mild RDS and(252.35±52.03)pg/mL in the severe RDS group,which were significantly higher than(75.09±19.06)pg/mL in the control group(P<0.05).Multivariate logistic regression analysis showed that neonatal asphyxia and high serum DcR3 expression were the independent risk factors for RDS in preterm infants(P<0.05).ROC curve analysis showed that when the cutoff value of serum DcR3 was 111.471 pg/mL,the AUC value of RDS was 0.893(95%CI:0.832-0.896),and the sensitivity and specificity were 82.3%and 85.6%.Conclusion In addition to asphyxia,high level of serum DcR3 in premature may be an independent risk factor for RDS,which can reflect the severity of children's condition,and can be used as a biological index to evaluate the condition,and thus provide reference for early clinical diagnosis of RDS in premature infants.