社区获得性肺炎患儿血清内皮素-1水平变化及临床意义

Changes and clinical significance of serum endothelin-1 in children with community-acquired pneumonia

目的:探究社区获得性肺炎(CAP)患儿血清内皮素-1(ET-1)水平的变化及临床意义。方法:选取134例CAP患儿(CAP组),依据疾病严重程度分为轻症组(69例)和重症组(65例)。另选取同期健康体检儿童70例作为健康组。采用酶联免疫吸附(ELISA)法检测所有受试者血清ET-1、C反应蛋白(CRP)、免疫球蛋白G(IgG)水平。比较不同程度CAP患儿血清ET-1、CRP、IgG水平。分析CAP患儿血清ET-1水平与CRP、IgG的相关性。采用受试者工作特征(ROC)曲线评价血清ET-1、CRP、IgG水平对重症CAP的诊断价值。结果:CAP组患儿血清ET-1、CRP水平明显高于健康组,IgG水平明显低于健康组(均P<0.05)。重症组患儿血清ET-1、CRP水平明显高于轻症组,IgG水平明显低于轻症组(均P<0.05)。CAP患儿血清ET-1水平与CRP水平呈正相关,与IgG水平呈负相关(r=0.476、-0.469,均P<0.05)。血清ET-1诊断重症CAP的曲线下面积(AUC)为0.887,截断值为108.86 pg/ml时灵敏度、特异度分别为78.5%和88.4%。血清ET-1与CRP联合预测重症CAP的AUC为0.902,灵敏度、特异度分别为84.6%和88.4%。结论:CAP患儿血清ET-1水平明显升高,其可能与CRP、IgG相互影响,进而在CAP发展中发挥重要作用。ET-1与CRP联合可更好地筛查重症CAP患儿。

Objective:To explore the changes and clinical significance of serum endothelin-1(ET-1)level in children with community-acquired pneumonia(CAP).Methods:134 children with CAP(CAP group)were divided into mild group(69 cases)and severe group(65 cases)according to the severity of the disease.Another 70 healthy children were selected as the healthy group.The serum levels of ET-1,C-reactive protein(CRP)and immunoglobulin G(IgG)were detected by ELISA.The levels of serum ET-1,CRP and IgG in children with CAP were compared.The correlation between serum ET-1 level and CRP,IgG in children with CAP was analyzed.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of serum ET-1,CRP and IgG levels for severe CAP.Results:The levels of ET-1 and CRP in CAP group were significantly higher than those in the healthy group,and the level of IgG was significantly lower than those in the healthy group(all P<0.05).The levels of serum ET-1 and CRP in severe group were significantly higher than those in mild group,and the level of IgG was significantly lower than that in mild group(all P<0.05).Serum ET-1 level was positively correlated with CRP level and negatively correlated with IgG level(r=0.476,-0.469,all P<0.05).The area under the curve(AUC)of serum ET-1 in the diagnosis of severe CAP was 0.887.When the cutoff value was 108.86 pg/ml,the sensitivity and specificity were 78.5% and 88.4% respectively.The AUC of serum ET-1 and CRP in predicting severe CAP was 0.902,the sensitivity and specificity were 84.6%and 88.4%respectively.Conclusion:The level of ET-1 in children with CAP is significantly increased,which may interact with CRP and IgG,and play an important role in the development of CAP.The combination of ET-1 and CRP can better screen children with severe CAP.