血清hBD-2、NT-proBNP、sICAM-1在急性下呼吸道感染患儿中的表达水平及对其病情预测的研究

Expression levels of serum hBD-2,NT-proBNP and sICAM-1 in children with acute lower respiratory tract infection and their prediction in the disease

目的 观察急性下呼吸道感染患儿血清β-防御素-2(hBD-2)、N末端脑钠肽前体(NT-proBNP)、可溶性细胞间黏附分子1(sICAM-1)表达水平,并分析3项指标对其病情检测的意义。方法 纳入2020年10月至2022年10月该院80例急性下呼吸道感染患儿为急性期组,另选取该院同期60例缓解期下呼吸道感染患儿为缓解期组,所有患儿入院时均接受血清hBD-2、NT-proBNP、sICAM-1检测,对比急性期组与缓解期组患儿血清hBD-2、NT-proBNP、sICAM-1表达水平。依据临床肺部感染评分(CPIS)将急性期组患儿分为轻症组和重症组,对比轻症组和重症组临床资料及实验室指标,分析血清hBD-2、NT-proBNP、sICAM-1表达水平与急性下呼吸道感染患儿病情的相关性,并绘制受试者工作特征(ROC)曲线分析3项指标对患儿病情的预测价值。结果 急性期组血清hBD-2、NT-proBNP、sICAM-1表达水平高于缓解期组,差异有统计学意义(P<0.05);经CPIS评分结果显示,80例急性下呼吸道感染患儿CPIS评分为(5.83±1.92)分,其中重症32例(40.00%),轻症48例(60.00%);经Pearson相关性分析,结果显示,CPIS评分与血清hBD-2、NT-proBNP、sICAM-1表达水平呈正相关(r=0.337、0.325、0.386,P=0.002、0.003、<0.001);重症组血清hBD-2、NT-proBNP、sICAM-1表达水平高于轻症组,差异有统计学意义(P<0.05);经Logistic回归分析发现,血清hBD-2、NT-proBNP、sICAM-1表达水平是急性下呼吸道感染患儿病情加重的危险因素(OR>1,P<0.05);绘制ROC曲线,血清hBD-2、NT-proBNP、sICAM-1表达水平对重症急性下呼吸道感染具有一定预测价值,曲线下面积(AUC)分别为0.728、0.769、0.786,联合检测预测价值更高(AUC=0.830)。结论 急性下呼吸道感染患儿血清hBD-2、NT-proBNP、sICAM-1表达水平升高,3项指标水平与患儿病情严重程度密切相关,可用于预测重症急性下呼吸道感染。

Objective To observe the serum expression levels ofβ-defensin-2(hBD-2),N-terminal pro-brain natriuretic peptide(NT-proBNP)and soluble intercellular adhesion molecule-1(sICAM-1)in children with acute lower respiratory tract infection,and to analyze the significance of three indicators for its disease detection.Methods From October 2020 to October 2022,a total of 80 children with acute lower respiratory tract infection in the hospital were selected as the acute stage group,and 60 children with lower respiratory tract infection in remission period were selected as the remission stage group.All the children were tested for serum hBD-2,NT-proBNP and sICAM-1 at the time of admission,and the serum hBD-2,NT-proBNP and sICAM-1 were compared between the acute stage group and the remission stage group.According to the clinical pulmonary infection score(CPIS),children in acute stage were divided into mild group and severe group.The clinical data and laboratory indexes of mild group and severe group were compared,the correlation between serum hBD-2,NT-proBNP and sICAM-1 expression levels and the condition of children with acute lower respiratory tract infection was analyzed,and the predictive value of the three indexes was analyzed by drawing the receiver operating characteristic(ROC)curve.Results The expression levels of serum hBD-2,NT-proBNP and sICAM-1 in acute stage group were higher than those in remission stage group,and the differences were statistically significant(P<0.05).The evaluation results of CPIS score showed that the CPIS score of 80 children with acute lower respiratory tract infection was(5.83±1.92),of which 32 cases were severe(40.00%)and 48 cases were mild(60.00%).Pearson correlation analysis showed that CPIS score was positively correlated with serum hBD-2,NT-proBNP and sICAM-1 expression levels(r=0.337,0.325,0.386,P=0.002,0.003,<0.001).The expression levels of serum hBD-2,NT-proBNP and sICAM-1 in severe group were higher than those in mild group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that serum expression levels of hBD-2,NT-proBNP and sICAM-1 were the risk factors for the aggravation of acute lower respiratory tract infection in children(OR>1,P<0.05).The ROC curve shows that the serum expression levels of hBD-2,NT-proBNP and sICAM-1 had certain predictive value for severe acute lower respiratory tract infection,the area under the curve(AUC)was 0.728,0.769 and 0.786,and the combined detection had higher predictive value(AUC=0.830).Conclusion The expression levels of hBD-2,NT-proBNP and sICAM-1 in serum of children with acute lower respiratory tract infection are increased,and the levels of the three indexes are closely related to the severity of the disease,which could be used to predict severe acute lower respiratory tract infection.