血清IL-6、KLF2、SP-D与新生儿急性呼吸窘迫综合征严重程度及预后的相关性

Correlation of serum IL⁃6,KLF2,and SP⁃D with the severity and prognosis of neonatal acute respiratory distress syndrome

目的 探究血清白细胞介素-6(IL-6)、Krüppel样转录因子2(KLF2)、血清肺表面活性蛋白D(SP-D)与新生儿急性呼吸窘迫综合征(ARDS)严重程度及预后的相关性。方法 分析2022年1月至2023年6月期间北京市通州区妇幼保健院收治的ARDS资料224例;根据氧指数将ARDS组患儿分为轻度组(n=87)、中度组(n=74)和重度组(n=63);根据患儿结局分为预后良好组(n=145)和预后不良组(n=79)。比较不同病情严重程度患儿血清IL-6、KLF2、SP-D水平差异;分析血清IL-6、KLF2、SP-D水平与氧指数的相关性及对ARDS患儿预后情况的预测价值。结果 随ARDS患儿病情加重血清IL-6、SP-D水平逐渐升高,KLF2水平逐渐下降,差异均具有统计学意义(F=155.041、56.005、198.070,P<0.05);相比预后良好组,预后不良组患儿血清IL-6、SP-D水平更高,KLF2水平更低,差异具有统计学意义(t=8.681、8.038、7.823,P<0.05);ARDS患儿病情严重程度与血清IL-6、SP-D水平正相关(r=0.823、0.786,P<0.05),与KLF2水平负相关(r=-0.761,P<0.05),ROC曲线结果显示三者单独及联合检测预测ARDS患儿预后的曲线下面积分别为:0.806、0.794、0.767、0.914,优于单一检测(P<0.05)。结论 血清IL-6、KLF2、SP-D水平与新生儿急性呼吸窘迫综合征病情严重程度密切相关,对于ARDS患儿预后具有一定预测价值,三者联合检测具有更高预测效能。

Objective To explore the correlation between serum interleukin-6(IL-6),Kruppel-like transcription factor 2(KLF2),serum pulmonary surfactant protein D(SP-D),and the severity and prognosis of neonatal acute respiratory distress syndrome(ARDS).Methods A total of 224 children with ARDS were admitted to Tongzhou District Maternal and Child Health Hospital from January 2022 to June 2023 and were retrospectively selected.Based on their oxygen index,the ARDS group was divided into three categories:mild group(87 cases),moderate group(74 cases)and severe group(63 cases).Additionally,based on prognosis,the ARDS group was divided into two groups:a good prognosis group(145 cases)and a poor prognosis group(79 cases).The serum levels of IL-6,KLF2,and SP-D were compared among children with different severity of the disease.Theaim was to analyze the correlation between serum IL-6,KLF2,SP-D levels,and oxygen index and the prognostic value of ARDS children.Results Serum IL-6 and SP-D levels increased gradually,while KLF2 levels decreased with the worsening of ARDS,showing statistical significance(F=155.041,56.005,198.070,P<0.05).Serum IL-6 and SP-D levels were higher in the poor prognosis group than those in the good prognosis group,and KLF2 levels were lower than those in the good prognosis group,with statistical significance(t=8.681,8.038,7.823,P<0.05).The severity of ARDS in children was positively correlated with serum IL-6 and SP-D levels(r=0.823,0.786,P<0.05),and negatively correlated with KLF2 level(r=-0.761,P<0.05).Results from ROC curve analysis indicated that the areas under the curve for the three independent and combined detection to predict the prognosis of ARDS children were:0.806,0.794,0.767 and 0.914,respectively,which weresuperior to individual tests(P<0.05).Conclusion Serum IL-6,KLF2 and SP-D levels are closely related to the severity of neonatal acute respiratory distress syndrome,and have prognostic value for children with ARDS.The combined detection of these three factors has higher predictive efficiency.