YKL-40、sTREM-1、HMGB1在重症肺炎患儿支气管肺泡灌洗液中的表达及意义

Expression and Significance of YKL-40,sTREM-1 and HMGB1 in Bronchoalveolar Lavage Fluid of Children with Severe Pneumonia

目的:探究甲壳质酶蛋白40(YKL-40)、可溶性髓系细胞触发受体-1(sTREM-1)、高迁移率族蛋白B1(HMGB1)在重症肺炎患儿支气管肺泡灌洗液中的表达及意义。方法:选取2020年4月—2022年4月西藏自治区人民医院接收的重症肺炎患儿100例为研究对象。所有患儿均采集血清、支气管肺泡灌洗液,并对血清、支气管肺泡灌洗液中的YKL-40、sTREM-1、HMGB1水平进行检测,分析不同情况患儿YKL-40、sTREM-1、HMGB1水平,并探讨三个因子之间的相关性。结果:与血清比较,支气管肺泡灌洗液中YKL-40、sTREM-1、HMGB1水平均明显更高,差异均有统计学意义(P<0.05)。不同性别、年龄重症肺炎患儿支气管肺泡灌洗液中YKL-40、sTREM-1、HMGB1水平比较,差异均无统计学意义(P>0.05);不同感染类型、胸腔积液、发绀情况的重症肺炎患儿支气管肺泡灌洗液中YKL-40、sTREM-1、HMGB1水平比较,差异均有统计学意义(P<0.05);细菌性肺炎、有胸腔积液、有发绀重症肺炎患儿支气管肺泡灌洗液中YKL-40、sTREM-1、HMGB1水平均明显高于支原体肺炎、病毒性肺炎、无胸腔积液、无发绀重症肺炎患儿,差异均有统计学意义(P<0.05)。支气管肺泡灌洗液中,YKL-40与sTREM-1呈正相关(r=0.487,P<0.001);YKL-40与HMGB1呈正相关(r=0.607,P<0.001);sTREM-1与HMGB1呈正相关(r=0.544,P<0.001)。结论:YKL-40、sTREM-1、HMGB1在重症肺炎患儿支气管肺泡灌洗液中异常升高,三者可能共同参与此病的进展。

Objective:To investigate the expression and significance of chitinase protein 40(YKL-40),soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and high mobility group box 1(HMGB1)in bronchoalveolar lavage fluid of children with severe pneumonia.Method:A total of 100 children with severe pneumonia admitted to Tibet Autonomous Region People's Hospital from April 2020 to April 2022 were selected as the study objects.Serum and bronchoalveolar lavage fluid were collected from all children,and YKL-40,sTREM-1 and HMGB1 levels in serum and bronchoalveolar lavage fluid were detected,and the levels of YKL-40,sTREM-1 and HMGB1 in children with different conditions were analyzed,and the correlation among the three factors was explored.Result:Compared with serum,YKL-40,sTREM-1 and HMGB1 levels in bronchoalveolar lavage fluid were significantly higher,the differences were statistically significant(P<0.05).There were no significant differences of YKL-40,sTREM-1 and HMGB1 levels in bronchoalveolar lavage fluid of severe pneumonia children with of different gender and age(P>0.05).The levels of YKL-40,sTREM-1 and HMGB1 in bronchoalveolar lavage fluid of severe pneumonia children with different infection types,hydrothorax and cyanosis condition were statistically significant(P<0.05).The levels of YKL-40,sTREM-1 and HMGB1 in bronchoalveolar lavage fluid of children with severe pneumonia of bacterial pneumonia,with hydrothorax and cyanosis were significantly higher than those of children with mycoplasma pneumonia of mycoplasmal pneumonia,viral pneumonia,no hydrothorax and cyanosis,the differences were statistically significant(P<0.05).In bronchoalveolar lavage fluid,YKL-40 was positively correlated with sTREM-1(r=0.487,P<0.001),YKL-40 was positively correlated with HMGB1(r=0.607,P<0.001)and sTREM-1 was positively correlated with HMGB1(r=0.544,P<0.001).Conclusion:YKL-40,sTREM-1 and HMGB1 are abnormally elevated in bronchoalveolar lavage fluid in children with severe pneumonia,which may be involved in the progression of the disease.