血清可溶性髓样细胞触发受体-1、可溶性白细胞分化抗原14亚型水平与儿童反复上呼吸道感染的相关性研究

Correlation between serum s TREM-1,presepsin levels and recurrent upper respiratory tract infection in children

目的探讨血清可溶性髓样细胞触发受体-1(s TREM-1)、可溶性白细胞分化抗原14亚型(presepsin)水平与儿童反复上呼吸道感染(r URTIs)的相关性。方法选取2019年10月—2021年11月衢州市人民医院收治的153例r URTIs患儿为观察组,另外选取同期130例体检健康儿童作为对照组。采用免疫比浊法检测血清免疫球蛋白M(Ig M)、Ig A、Ig G水平,采用酶联免疫吸附法(ELISA)检测血清s TREM-1、presepsin水平,并进行组间比较;采用Spearman分析r URTIs患儿血清s TREM-1、presepsin水平与既往一年发生上呼吸道感染次数及Ig A、Ig G水平相关性;绘制受试者工作特征(ROC)曲线评估血清s TREM-1、presepsin对r URTIs的诊断价值。结果与对照组相比,观察组血清s TREM-1、presepsin水平均较高(P<0.05),血清Ig A、Ig G水平均较低(P<0.05)。Spearman分析结果显示,r URTIs患儿血清s TREM-1、presepsin水平与既往一年发生上呼吸道感染次数均成正相关(P<0.05),与Ig A、Ig G水平均成负相关(P<0.05)。血清s TREM-1、presepsin单独及两者联合诊断r URTIs的曲线下面积(AUC)分别为0.780、0.787、0.878,s TREM-1、presepsin单独诊断r URTIs的截断值分别为15.48 pg/ml、113.58 pg/ml,敏感度分别为69.30%、61.40%,特异度分别为75.40%、89.20%,两者联合诊断r URTIs的敏感度为78.40%,特异度为73.40%,较单独诊断,敏感度较高。结论r URTIs患儿血清s TREM-1、presepsin均为高表达,且与既往一年发生上呼吸道感染次数及Ig A、Ig G水平具相关性,可能用于r URTIs发生风险评估及早期诊断。

Objective To investigate the correlation between levels of serum soluble triggering receptor expressed on myeloid cells-1(s TREM-1)and soluble CD14 subtype(presepsin)and recurrent upper respiratory tract infections(r URTIs)in children.Methods A total of 153 pediatric patients with r URTIs in Quzhou People’s Hospital from October 2019 to November2021 were selected as the observation group,and 130 healthy children in the same period were selected as the control group.The levels of serum immunoglobulin M(Ig M),Ig A and Ig G were detected by immunoturbidimetry,and the levels of s TREM-1 and presepsin were detected by enzyme-linked immunosorbent assay(ELISA)and compared.Spearman was used to analyze the correlation of serum s TREM-1 and presepsin levels with the number of upper respiratory tract infections in the past year,Ig A and Ig G levels;receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of serum s TREM-1 and presepsin in r URTIs.Results Compared with those in the control group,the levels of serum s TREM-1 and presepsin in the observation group were higher(P<0.05),and the levels of serum Ig A and Ig G were lower(P<0.05).Spearman analysis showed that levels of serum s TREM-1 and presepsin were positively correlated with the number of upper respiratory tract infections in the past year(P<0.05),and negatively correlated with Ig A and Ig G levels(P<0.05);the area under the curve(AUC)of serum s TREM-1,presepsin alone or in combination in the diagnosis of r URTIs was 0.780,0.787and 0.878,respectively,and the cut-off value of s TREM-1 and presepsin in the diagnosis of r URTIs was 15.48 pg/ml and113.58 pg/ml,respectively,the sensitivity was 69.30%,61.40%,and the specificity was 75.40%and 89.20%,respectively,the sensitivity and specificity of the combination of two methods were 78.40%and 73.40%,respectively.Conclusion Serum s TREM-1 and presepsin are highly expressed in pediatric patients with r URTIs,and they are correlated with the number of upper respiratory tract infections in the past year and the levels of Ig A and Ig G,which may be used for risk assessment and early diagnosis of r URTIs.