重症肺炎患儿suPAR水平对比分析及与影像学表现的相关性

Comparative Analysis of SuPAR Level in Children with Severe Pneumonia and Its Correlation with Imaging Findings

目的:探讨重症肺炎患儿可溶性尿激酶型纤溶酶原激活物受体(soluble urokinase-type plasminogen activator receptor,suPAR)水平并对比分析及与影像学表现的相关性。方法:选取贵阳市第二人民医院及贵阳市儿童医院2020年1月到2020年12月共收治的70例肺炎患儿作为研究对象,其中重症肺炎患儿35例,男22例、女13例,将其分为重症组,轻症肺炎患儿35例,男20例、女15例,将其分为轻症组。对比两组患儿的suPAR水平、心肌酶水平以及肺部影像学结果,了解suPAR在重症肺炎中是否具有敏感性及特异性,并分析重症肺炎suPAR水平与心肌酶、肺部影像学结果是否存在相关性。结果:重症组suPAR水平较轻症组明显升高,差异具有统计学意义(P<0.05),重症组患儿肌酸激酶同工酶(creatine kinase isoenzymes-MB,CK-MB)、肌酸激酶(creatine kinase,CK)、乳酸脱氢酶(lactate dehydrogenase,LDH)、谷草转氨酶(Aspartate aminotransferase,AST)心肌酶相关指标明显高于轻症组,差异具有显著性(P<0.05);两组患儿密度增高影、带片絮状影、节段性实变、斑片状影人数对比无明显差异(P>0.05),两组患儿肺不张、大片状影、双肺纹增多人数对比差异显著(P<0.05);suPAR水平与CK-MB、CK、LDH、AST以及影像学特征呈正相关(P<0.05)。血清suPAR水平对重症肺炎病情危重程度ROC的AUC为0.897(95%CI:0.819~0.975),最佳cutoff值为1.9 ng/mL,此时特异度、灵敏度为82.86%、85.71%。结论:重症肺炎组suPAR的值与心肌酶呈正相关;suPAR水平与影像学表现具有相关性;suPAR水平越高提示病情越危重,在重症肺炎评估中其敏感性及特异性增高。

Objective:To investigate the correlation between suPAR(soluble urokinase type plasminogen activator receptor)levels and imaging findings in children with severe pneumonia.Methods:70 cases of children with pneumonia in our hospital from January2020 to December 2020 were selected as the research object.Among them,35 children with severe pneumonia,22 males and 13 females,were divided into severe group,35 children with mild pneumonia,20 males and 15 females.The levels of suPAR,myocardial enzymes,and lung imaging results were compared between the two groups,to understand whether suPAR has sensitivity and specificity in severe pneumonia,and to analyze whether there is correlation between suPAR level andmyocardial enzyme and lung imaging results.Results:The level of suPAR in the severe group was significantly higher than that in the mild group,and the difference was statistically significant(P<0.05).The severe group was creatine kinase isoenzyme(CK-MB)and creatine kinase(CK),lactate dehydrogenase(LDH),aspartate aminotransferase(AST)myocardial enzyme related indicators were significantly higher than the mild group,and the difference was statistically significant(P<0.05),the two groups of children with increased density,flocculent shadows,knots,there was no significant difference in the number of segmental consolidation and patchy shadows(P>0.05).There was a significant difference in the number of atelectasis,large patchy shadows,and double lung striae between the two groups(P<0.05);suPAR level and CK-MB,CK,LDH,AST and imaging characteristics were positively correlated(P<0.05).The AUC of serum suPAR level for ROC of severe pneumonia was 0.897(95%CI:0.819-0.975),and the optimal cutoff value was 1.9 ng/ml.the specificity,sensitivity were 82.86%,85.71%,respectively.Conclusion:The value of suPAR in the severe pneumonia group is positively correlated with myocardial enzymes;the level of suPAR is correlated with imaging findings;the higher the level of suPAR,the more critical the condition,high sensitivity and specificity in the evaluation of severe pneumonia.