腺病毒肺炎患儿血清sPLA2、CCSP水平及临床意义

SERUM LEVELS OF SPLA2 AND CCSP IN CHILDREN WITH ADENOVIRUS PNEUMONIA AND THEIR CLINICAL SIGNIFICANCE

目的 探讨腺病毒肺炎患儿血清分泌型磷脂酶A2(sPLA2)、克拉拉细胞分泌蛋白(CCSP)的水平及意义。方法 选取2017年1月—2019年6月该院治疗的腺病毒肺炎患儿201例(观察组),其中轻症患儿121例,重症患儿80例;同时选取健康儿童100例作为对照组;检测二组血清sPLA2、CCSP水平,检测观察组每千克体重潮气量(Vt/kg)、潮气呼气峰流速(PTEF)。结果观察组血清sPLA2、CCSP水平分别为(120.21±32.03)IU/ml和(40.41±11.51)ng/ml,明显高于对照组(P<0.05);观察组中重症患儿血清sPLA2、CCSP及PTEF分别为(132.01±25.43)IU/ml、(49.12±11.53)ng/ml和(142.41±18.46)ml/s,明显高于轻症患儿(P<0.05),而Vt/Kg为(4.21±0.97)ml/kg,明显低于轻症患儿(P<0.05);血清sPLA2、CCSP与Vt/kg呈负相关(r=-0.341和-0.360,P<0.05);血清sPLA2、CCSP、Vt/kg、PTEF预测重症患儿方程为:Y=0.07X_(1)+0.09X_(2)-4.22X_(3)+0.12X_(4)-26.50;四者联合预测重症的ROC曲线下面积为0.811(P<0.05),灵敏性和特异性分别为87.00%和59.60%;观察组治疗后血清sPLA2、CCSP水平分别为(108.45±21.03)IU/ml和(32.56±10.94)ng/ml,明显低于治疗前(P<0.05)。结论 腺病毒肺炎患儿血清sPLA2、CCSP水平升高,与病情及肺功能有一定关系,参与疾病发生发展。

Objective To investigate the level and significance of serum secretory phospholipase A2(sPLA2) and Clara cell secretory protein(CCSP) in children with adenovirus pneumonia.Methods From January 2017 to June 2019,two hundred and one children with adenovirus pneumonia(observation group) were selected,including one hundred and twenty-one children with mild illness and eighty children with severe illness;one hundred healthy children were selected as the control group;the serum levels of sPLA2 and CCSP were measured,the tidal volume per kilogram body weight(VT/kg) and peak tidal expiratory flow(PTEF) were measured in the observation group.Results The serum levels of sPLA2 and CCSP in the observation group were(120.21 ± 32.03) IU/ml and(40.41 ± 11.51) ng/ml,which were significantly higher than those in the control group(P<0.05);In the observation group,the serum levels of sPLA2,CCSP and PTEF in the devere cases were(132.01 ± 25.43) IU/ml/(49.12 ± 11.53) ng/ml and(142.41 ± 18.46) ml/s,which were significantly higher than those in the mild group(P<0.05),while the VT/kg was(4.21 ± 0.97) ml/kg,which was significantly lower than those in the mild group(P<0.05);The serum levels of sPLA2 and CCSP were negatively correlated with VT/kg(r=-0.341 and-0.360,P<0.05);The prediction equation of serum SPLA2,CCSP,VT/kg and PTFE in severe children was as follows:Y=0.07 X_(1)+0.09 X_(2)-4.22 X_(3)+0.12 X_(4)-26.50;The area under the ROC curve of severe cases was predicted jointly by the four methods was 0.811(P<0.05),and the sensitivity and specificity were 87.00% and 59.60%,respectively;The serum levels of sPLA2 and CCSP in the observation group after treatment were(108.45 ± 21.03) IU/ml and(32.56 ±10.94) ng/ml,which were significantly lower than those before treatment(P<0.05).Conclusion The serum levels of sPLA2 and CCSP in children with adenovirus pneumonia are increased,which are related to the disease condition and lung function,may play a role in the occurrence and development of the disease.