系统性红斑狼疮合并尿路感染患儿血清25-(OH)D3和HDL-C与TGF-β1的表达及临床意义

Expression of serum 25-(OH)D3,HDL-C and TGF-β1 in systemic lupus erythematosus children complicated with urinary tract infection and clinical significance

目的探讨系统性红斑狼疮合并尿路感染患儿体内病原菌的分布以及血清25羟维生素D3(25-(OH)D3)、转化生长因子β1(TGF-β1)、高密度脂蛋白(HDL-C)的表达和临床意义。方法选取2016年6月-2019年1月就诊于武汉儿童医院的系统性红斑狼疮患儿共50例,根据尿路感染情况分为感染组(25例)和非感染组(25例),选取同期25名健康儿童作为对照组。对感染组患儿体内病原菌的分布进行检测;比较不同组血清中25-(OH)D3、TGF-β1、HDL-C水平。结果感染组共检出病原菌101株,其中革兰阴性菌66株(65.35%),大肠埃希菌最多为28株(27.73%);革兰阳性菌29株(28.71%),以金黄色葡萄球菌居多为18株(17.82%)。感染组和非感染组患儿血清中25-(OH)D3、HDL-C水平均较对照组降低(P<0.05),且感染组低于非感染组(P<0.05);与对照组相比,感染组患儿血清TGF-β1水平升高(P<0.05),但非感染组患儿血清TGF-β1水平降低(P<0.05)。单一指标检测的特异性、灵敏度、准确度、曲线下面积(AUC)、95%CI等均低于三者联合检测,差异有统计学意义(P<0.05)。结论系统性红斑狼疮合并尿路感染患儿体内病原菌分布广泛,其中以革兰阴性菌为主;血清25-(OH)D3、HDL-C水平降低,TGF-β1水平升高;三者联合检测提高了诊断系统性红斑狼疮患儿是否发生尿路感染的特异性、灵敏度、准确度。

OBJECTIVE To explore the distribution of pathogens isolated from systemic lupus erythematosus children complicated with urinary tract infection,expression of serum 25-hydroxyvitamin D3(25-(OH)D3),transforming growth factorβ1(TGF-β1)and high-density lipoprotein(HDL-C),and analyze the clinical significance.METHODS A total of 50 children with systemic lupus erythematosus who were treated in Wuhan Children’s Hospital from Jun.2016 to Jan.2019 were enrolled in the study and divided into the infection group with 25 cases and the non-infection group with 25 cases according the status of urinary tract infection,meanwhile,25 healthy children were assigned as the control group.The distribution of pathogens isolated from the children of the infection group was observed,and the levels of serum 25-(OH)D3,TGF-β1 and HDL-C were compared among the three groups.RESULTS Totally 101 strains of pathogens isolated from the infection group,66(65.35%)of which were gram-negative bacteria,and 29(28.71%)were gram-positive bacteria;Escherichia coli(28,27.73%)was the predominant species of the gram-negative bacteria;Staphylococcus aureus(18,17.82%)was dominant among the gram-positive bacteria.The levels of serum 25-(OH)D3 and HDL-C of the infection group and the non-infection group were significantly lower than those of the control group(P<0.05),and the levels of above indexes of the infection group were significantly lower than those of the non-infection group.The serum TGF-β1 level of the infection group was significantly higher than that of the control group(P<0.05),while the serum TGF-β1 of the non-infection group was significantly reduced(P<0.05).The specificity,sensitivity,accuracy,area under curve(AUC)and 95%CI of the single index detection were significantly lower than those of the joint detection of the indexes(P<0.05).CONCLUSION There is a wide range of pathogens isolated from the systemic lupus erythematosus children complicated with urinary tract infection,and the gram-negative bacteria are dominant.The levels of serum 25-(OH)D3 and HDL-C are reduced,and the TGF-β1 level is elevated.The joint detection of the three indexes raise the specificity,sensitivity and accuracy of diagnosis of urinary tract infection in the children with systemic lupus erythematosus.