骨髓炎患儿血清组织蛋白酶G、乳铁蛋白表达与疾病严重程度的相关性

Correlation between serum cathepsin G,lactoferrin expression and disease severity in children with osteomyelitis

目的 研究骨髓炎患儿血清组织蛋白酶G(ctsg)、乳铁蛋白(lf)表达与疾病严重程度的相关性。方法 选取2020年11月至2021年11月在黑龙江中医药大学附属第一医院就诊的骨髓炎患儿60例,分为骨髓炎组,预后良好20例,预后不良40例。选取同时期在本院健康体检患儿50名为正常组。采用酶联免疫吸附试验检测ctsg、lf水平。采用急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评估患儿病情严重程度,采用小儿危重症评分(PCIS)、儿童死亡危险评分(PRISM)评估患儿预后。结果 与正常组相比,骨髓炎组ctsg表达水平升高,lf表达水平下降,差异有统计学意义(t=55.140、8.367,P<0.05)。与0~15分相比,>15分ctsg表达水平升高,lf表达水平下降,差异有统计学意义(t=24.360、16.370,P<0.05)。与不良预后相比,预后优良患儿ctsg表达水平降低,lf表达水平升高,差异有统计学意义(t=26.260、P<0.05)。ctsg与APACHEⅡ分呈正相关(r=0.814,P=0.001),lf与APACHEⅡ分呈负相关(r=-0.786,P=0.001)。结论 ctsg、lf在骨髓炎患儿血清中表达异常,其表达高低与病情严重程度以及患者预后具有一定相关性,由此表明,ctsg、lf参与骨髓炎的发展,对之后儿童骨髓炎临床诊断中具有重要意义。

Objective To study the correlation between the expression of serum cathepsin G(ctsg) and lactoferrin(LF) and the severity of osteomyelitis. Methods A total of 60 children with osteomyelitis treated in the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from November 2020 to November 2021 were selected and divided into the osteomyelitis group,20 patients with good prognosis and 40 patients with poor prognosis. A total of 50 children in the hospital for health examination during the same period were selected as the normal control group. The levels of ctsg and LF were determined by an enzyme-linked immunosorbent assay. The acute physiology and chronic health status scoring system(APACHE Ⅱ)was used,and the pediatric critical care score(PCIS)and the child death risk score (PRISM)were used. Results In the osteomyelitis group,the ctsg expression level was increased,and the LF expression level was decreased,as compared with the control group(t=55.140,8.367,P<0.05). Compared with0~15 points,the expression level of ctsg increased and the expression level of LF decreased in points > 15,the difference was statistically significant(t=24.360,16.370,P<0.05). Compared with poor prognosis,the children with good prognosis showed lower ctsg expression level and increased LF expression level,which was statistically significant(t=26.260,P<0.05). ctsg was positively correlated with APACHEⅡ score(r=0.814,P=0.001),and LF was negatively correlated with APACHE Ⅱ score(r=-0.786,P=0.001). Conclusion The expression of ctsg and LF is abnormal in the serum of children with osteomyelitis,and is correlated with the severity of the disease and the patient prognosis. This shows that ctsg and LF are involved in the development of osteomyelitis,which is of great significance to the clinical diagnosis of osteomyelitis in children.