新生儿感染性肺炎血清维生素D、IL-6和PCT水平与病情程度相关分析

Relationship between serum vitamin D, IL-6, PCT levels and severity of neonatal infectious pneumonia

目的 探讨血清维生素D、白介素6(IL-6)、降钙素原(PCT)与新生儿感染性肺炎(NIP)病情程度的关系,为NIP有效防治提供依据。方法 对2019年8月—2021年12月收治的NIP患儿120例,按病情程度分为轻症NIP组72例和重症NIP组48例,以40例同期健康体检新生儿为对照组。检测三组受试对象外周静脉血25-羟基维生素D[25-(OH)D]、IL-6和PCT水平,以二元Logistic回归分析重症NIP的独立相关因素,应用受试者工作特征(ROC)曲线评价25-(OH)D、IL-6和PCT对重症NIP的评估价值。结果 与对照组比较,轻症NIP组和重症NIP组25-(OH)D水平明显降低,IL-6和PCT水平明显升高,25-(OH)D缺乏率明显升高,三组比较差异均有统计学意义(F=79.480,43.803,30.838,38.406,P<0.05);与轻症NIP组比较,重症NIP组25-(OH)D水平明显降低,IL-6和PCT水平明显升高,25-(OH)D缺乏率明显升高,差异有统计学意义(t=6.142,8.437,5.771,54.218,P<0.05)。Logistic回归提示,25-(OH)D水平(OR=0.758,95%CI:0.609~0.944)是重症NIP的独立保护因素(P<0.05),而IL-6(OR=3.442,95%CI:1.612~7.349)和PCT(OR=4.297,95%CI:2.106~8.771)是重症NIP的独立危险因素(P<0.05)。血清25-(OH)D、IL-6及PCT三者联合评估重症NIP的AUC为0.850(95%CI:0.778~0.907),分别大于各指标单独评估的AUC,差异有统计学意义(P<0.05)。结论 NIP患儿血清25-(OH)D、IL-6及PCT水平与病情程度密切相关,三者联合检测对重症NIP具有较高的评估价值。

Objective To explore the relationship between serum vitamin D, interleukin-6(IL-6), procalcitonin(PCT)levels and severity of neonatal infectious pneumonia(NIP), and to provide a basis for NIP prevention and treatment.MethodsAccording to disease severity, 120 children with NIP treated from August 2019 to December 2021 were divided into mild NIP group(72 cases) and severe NIP group(48 cases). A total of 40 healthy neonates during the same period were enrolled as control group. The levels of 25-hydroxyvitamin D[25-(OH)D], IL-6 and PCT in peripheral venous blood of the three groups were detected. The independent related factors of severe NIP were analyzed by binary Logistic regression analysis. The evaluation value of 25-(OH)D, IL-6 and PCT for severe NIP was assessed by receiver operating characteristic(ROC) curves.ResultsCompared with control group, 25-(OH)D level was significantly decreased, levels of IL-6 and PCT were significantly increased, and deficiency rate of 25-(OH)D was significantly increased in mild and severe NIP groups(F=79.480,43.803,30.838,38.406,P<0.05). Compared with mild NIP group, 25-(OH)D level was significantly decreased, levels of IL-6 and PCT were significantly increased, and deficiency rate of 25-(OH)D was significantly increased in severe NIP group(t=6.142,8.437,5.771,54.218,P<0.05). Logistic regression analysis showed that 25-(OH)D(OR=0.758, 95% CI: 0.609-0.944) was an independent protective factor against severe NIP(P<0.05), while IL-6(OR=3.442, 95% CI: 1.612-7.349) and PCT(OR=4.297,95% CI: 2.006-8.771) were independent risk factors(P<0.05). AUC of serum 25-(OH)D combined with IL-6 and PCT for assessing severe NIP was 0.850(95% CI: 0.778-907), greater than that of single index(P<0.05).ConclusionsThe levels of serum 25-(OH)D, IL-6 and PCT are closely related to disease severity in NIP children. The combined detection of the three indexes has high evaluation value for severe NIP.