血清IL-6、CAR联合NLR对新生儿呼吸窘迫综合征患儿病情和预后的评估价值

Evaluation Value of Serum IL-6, CAR Combined with NLR in the Condition and Prognosis of Neonatal Respiratory Distress Syndrome

目的:探讨血清白细胞介素-6(IL-6)、C-反应蛋白与白蛋白比值(CAR)联合中性粒细胞与淋巴细胞比值(NLR)对新生儿呼吸窘迫综合征(NRDS)患儿病情和预后的评估价值。方法:选取2020年12月~2022年4月我院收治的102例NRDS患儿(NRDS组),根据病情严重程度分为轻度亚组23例、中度亚组38例、重度亚组41例,根据28 d治疗后结局分为死亡组37例和存活组65例,另选取同期57名健康新生儿(对照组)。检测血清IL-6、CAR、NLR,多因素Logistic回归分析NRDS患儿预后不良的影响因素,采用受试者工作特征(ROC)曲线分析血清IL-6、CAR、NLR对NRDS患儿预后不良的评估价值。结果:NRDS组血清IL-6、CAR、NLR均高于对照组(P均<0.001)。轻度、中度、重度亚组血清IL-6、CAR、NLR依次升高(P均<0.001)。死亡组血清IL-6、CAR、NLR高于存活组(P均<0.001)。多因素Logistic回归分析显示,胎龄和5min Apgar评分增加为NRDS患儿预后不良的独立保护因素,IL-6、CAR、NLR升高为独立危险因素(P均<0.05)。ROC曲线分析显示,血清IL-6、CAR、NLR联合评估NRDS患儿预后不良的曲线下面积(AUC)大于各指标单独评估(P均<0.05)。结论:NRDS患儿血清IL-6、CAR、NLR升高与病情加重和预后不良密切相关,血清IL-6、CAR联合NLR评估NRDS患儿预后不良的价值较高。

Objective:To investigate the evaluation value of serum interleukin-6(IL-6),C-reactive protein to albumin ratio(CAR)combined with neutrophil to lymphocyte ratio(NLR)in the condition and prognosis of neonatal respiratory distress syndrome(NRDS).Methods:102 children with NRDS(NRDS group)who were admitted to our hospital from December 2020 to April 2022 were selected,and they were divided into mild subgroup with 23 cases,moderate subgroup with 38 cases and severe subgroup with 41 cases according to the severity of the disease.According to the outcome at 28 days after treatment,they were divided into death group with 37 cases and survival group with 65 cases,and 57 healthy newborns(control group)were selected during the same period.Serum IL-6,CAR and NLR were detected,the influencing factors of poor prognosis in children with NRDS were analyzed by multivariate Logistic regression and the evaluation value of serum IL-6,CAR and NLR for poor prognosis in children with NRDS was analyzed by receiver operating characteristic(ROC)curve.Results:Serum IL-6,CAR and NLR in the NRDS group were higher than those in the control group(all P<0.001).Serum IL-6,CAR and NLR were increased successively in mild,moderate and severe subgroups(all P<0.001).Serum IL-6,CAR and NLR in the death group were higher than those in the survival group(all P<0.001).Multivariate Logistic regression analysis showed that gestational age and the increase of 5min Apgar score were independent protective factors for poor prognosis in children with NRDS,and the increase of IL-6,CAR and NLR were independent risk factors(all P<0.05).ROC curve analysis showed that the area under curve(AUC)of the combined evaluation of serum IL-6,CAR and NLR for poor prognosis of children with NRDS was greater than that of the independent evaluation of each indicator(all P<0.05).Conclusion:The increase of serum IL-6,CAR and NLR in children with NRDS is closely related to disease exacerbation and poor prognosis,and the combination of serum IL-6 and CAR with NLR has a higher value in evaluating poor prognosis in children with NRDS.