血浆IL-6与IL-27在鉴别早产儿急性呼吸窘迫综合征与呼吸窘迫综合征的初步研究

A pilot study of plasma interleukin-6 and interleukin-27 in differential diagnosis of acute respiratory distress syndrome and neonatal respiratory distress syndrome in preterm infants

目的 探讨血浆白细胞介素(interleukin,IL)-6、IL-27在鉴别早产儿急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)及新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)中的价值。方法 前瞻性纳入2021年3~11月重庆医科大学附属儿童医院新生儿诊治中心具有呼吸窘迫表现的早产儿,根据诊断结果分为ARDS组(n=18)及NRDS组(n=20)。采用酶联免疫吸附试验法检测患儿血浆IL-6和IL-27水平,受试者工作特征(receiver operating characteristic,ROC)曲线分析各指标诊断ARDS的价值。结果 ARDS组血浆IL-6及IL-27水平均高于NRDS组(P<0.05)。ROC曲线分析显示:当IL-6取56.21 pg/m L时,曲线下面积、灵敏度和特异度分别为0.867、61.1%、95.0%;当IL-27取135.8 pg/m L时,曲线下面积、灵敏度和特异度分别为0.881、83.3%、80.0%。结论 血浆IL-6和IL-27可作为早期鉴别早产儿ARDS与NRDS的生物学指标。

Objective To study the significance of interleukin-6(IL-6) and interleukin-27(IL-27) in the differential diagnosis of acute respiratory distress syndrome(ARDS) and neonatal respiratory distress syndrome(NRDS) in preterm infants.Methods The preterm infants with the manifestation of respiratory distress who were treated in the Neonatal Diagnosis and Treatment Center,Children’s Hospital of Chongqing Medical University,from March to November 2021,were enrolled in this prospective study.According to the diagnosis results,they were divided into two groups:ARDS group(n=18) and NRDS group(n=20).ELISA was used to measure the plasma levels of IL-6 and IL-27.The receiver operating characteristic(ROC) curve was used to analyze the value of each index in the diagnosis of ARDS.Results The ARDS group had significantly higher plasma levels of IL-6 and IL-27 than the NRDS group(P<0.05).The ROC curve analysis showed that IL-6 had an area under the ROC curve(AUC) of 0.867 for the diagnosis of ARDS,with a sensitivity of 61.1% and a specificity of 95.0% at the cut-off value of 56.21 pg/mL.The ROC curve analysis also showed that IL-27 had an AUC of 0.881 for the diagnosis of ARDS,with a sensitivity of 83.3% and a specificity of 80.0% at the cut-off value of 135.8 pg/mL.Conclusions Plasma IL-6 and IL-27 can be used as biological indicators for early differential diagnosis of ARDS and NRDS in preterm infants.