呼吸道念珠菌定植与儿童细菌性VAP及SIL-2R、IL-18、sTREM-1水平的关系

Relationship between Candida colonization in respiratory tract with bacterial VAP and levels of SIL-2R,IL-18 and sTREM-1 in children

目的 分析呼吸道念珠菌定植与儿童细菌性呼吸机相关性肺炎(VAP)及可溶性白细胞介素-2受体(SIL-2R)、白细胞介素-18(IL-18)、可溶性髓系细胞触发受体-1(sTREM-1)水平的关系。方法 选择保定市竞秀区妇幼保健院2020年6月至2022年6月期间80例VAP患儿作为研究对象,根据有无呼吸道念珠菌定植分为定植组、未定植组,比较两组患儿血清β-葡聚糖水平、肺部感染程度(CPIS)评分,常规实验室指标及血清SIL-2R、IL-18、sTREM-1水平,采用Pearson相关性分析血清β-葡聚糖水平与CPIS评分常规实验室指标及血清SIL-2R、IL-18、sTREM-1的相关性。结果 植组血清β-葡聚糖水平、CPIS评分及血清SIL-2R、IL-18、sTREM-1水平分别为(78.63±7.17)ng/L、(7.01±1.65)分、(476.79±73.42)kU/L、(327.43±50.85)pg/mL、(146.79±31.72)ng/mL,高于未定植组的(61.09±4.22)ng/L、(4.85±1.24)分、(331.06±66.15)k U/L、(262.19±48.27)pg/mL、(102.64±27.68)ng/L,定植组白蛋白水平(25.75±3.28)g/L,低于未定植组的(28.92±2.73),差异有统计学意义(P<0.05);Pearson相关性分析显示,血清β-葡聚糖与CPIS、血肌酐、白细胞计数及血清SIL-2R、IL-18、sTREM-1水平均呈正相关(r=0.630、0.759、0.707、0.748、0.730、0.702,P均<0.05)。结论 呼吸道念珠菌定植可加重儿童细菌性VAP病情,且与血清SIL-2R、IL-18、sTREM-1表达上调有关。

Objective To analyze the relationship between respiratory tract Candida colonization with bacterial ventilator-associated pneumonia(VAP)in children and levels of soluble interleukin-2 receptor(SIL-2R),interleukin-18(IL-18)and soluble triggering receptor expressed on myeloid cells-1(sTREM-1).Methods 80 children with VAP from June 2020 to June 2022 in Jingxiu District Maternal and Child Health Hospital of Baoding City were selected as the research subjects. According to the presence or absence of Candida colonization in the respiratory tract,the children were divided into the colonization group and the non-colonization group. Serum β-glucan level,clinical pulmonary infection score(CPIS)and levels of serum SIL-2R,IL-18and s TREM-1 were compared between the two groups. Pearson correlation analysis was used to analyze the correlation of serum β-glucan level with CPIS score,routine laboratory indicators and serum SIL-2R,IL-18 and sTREM-1. Results Serum β-glucan level,CPIS score and levels of serum SIL-2R,IL-18 and sTREM-1with(78.63±7.17)ng/L,(7.01±1.65)points,(476.79±73.42)kU/L,(327.43±50.85)pg/mL and(146.79±31.72)ng/mL in the colonization group were higher than thos(61.09 ± 4.22)ng/L,(4.85 ± 1.24)points,(331.06 ±66.15)kU/L,(262.19±48.27)pg/mL and(102.64±27.68)ng/L in the non-colonization group(P<0.05)while the albumin with(25.75±3.28)g/L was lower than(28.92±2.73)g/L in the non-colonization group(P<0.05).Pearson correlation analysis showed that serum β-glucan was positively correlated with CPIS,serum creatinine,white blood cell count,and serum SIL-2R,IL-18 and sTREM-1(r=0.630,0.759,0.707,0.748,0.730,0.702,P<0.05). Conclusion Respiratory tract Candida colonization can aggravate the bacterial VAP in children,and it is related to the up-regulations of expressions of serum SIL-2R,IL-18 and sTREM-1.