新生儿感染性肺炎25(OH)D3和IL-6/STAT3信号通路及其与疾病进展和预后的关系

25(OH)D3 and IL-6/STAT3 signaling pathways in neonatal infectious pneumonia and their relationship with disease progression and prognosis

目的探讨新生儿感染性肺炎25羟维生素D3[25(OH)D3]、白细胞介素(IL)-6/信号转导激活因子(STAT)3信号通路及疾病进展、预后的关系.方法选取2020年7月-2022年12月宁波明州医院收治的93例新生儿感染性肺炎(研究组)与95例同期健康体检新生儿(对照组)作为研究对象;比较两组25(OH)D3、1L-6、外周血STAT3信使核糖核酸(mRNA)水平,比较不同病情程度和不同预后组患儿25(OH)D3、IL-6、STAT3 mRNA水平,分析25(OH)D3、IL-6、STAT3 mRNA表达水平与病情程度、预后的相关性,分析25(OH)D3、IL-6、STAT3 mRNA对新生儿感染性肺炎的预测价值.结果研究组25(OH)D3低于对照组,IL-6、STAT3 mRNA高于对照组(P<0.05);重症组血清25(OH)D3低于轻症组,IL-6、STAT3 mRNA高于轻症组(P<0.05);预后不良组25(OH)D3低于预后良好组,IL-6、STAT3 mRNA高于预后良好组(P<0.05);血清25(OH)D3与病情程度、预后呈负相关(r=-0.552;-0.581,P<0.05),IL-6及STAT3 mRNA与病情程度、预后呈正相关(r=0.648;0.663;r=0.692;0.732,P均<0.05);25(OH)D3、IL-6、STAT3 mRNA联合检测对新生儿感染性肺炎的诊断曲线下面积(AUC)值高于单独检测的AUC值(P<0.05).结论新生儿感染性肺炎,25(OH)D3表达水平降低,IL-6、STAT3 mRNA升高,新生儿感染性肺炎重症与预后不良患儿趋势变化更为明显,25(OH)D3、IL-6、STAT3 mRNA与病情程度、预后密切相关;25(OH)D3、IL-6、STAT3 mRNA联合检测对新生儿感染性肺炎具有较高的预测价值.

OBJECTIVE To investigate the changes of 25 hydroxyvitamin D3[25(OH)D3] and interleukin(IL)-6/(STAT)3 signaling pathways in neonatal infectious pneumonia and their relationship with disease progression and prognosis.METHODS Totally 93 cases of neonatal infectious pneumonia treated in Ningbo Mingzhou Hospital from Jul.2020 to Dec.2022(the study group)and 95 healthy newborns(the control group)during the same period for physical examination were selected as the study subjects.The levels of 25(OH)D3,IL-6 and STAT3 mRNA in peripheral blood were compared between the study group and the control group,as well as those in children with different disease severity and different prognosis groups.The correlation between the expression levels of 25(OH)D3,IL-6 and STAT3 mRNA and the severity and prognosis of the disease were analyzed,as well as the predictive value of those indicators in neonatal infectious pneumonia.RESULTS The levels of 25(OH)D3 in the study group were lower than those in the control group,while levels of IL-6 and STAT3 mRNA were higher than those in the control group(P<0.05).Serum 25(OH)D3 in the severe group was lower than that in the mild group,while the levels of IL-6 and STAT3 mRNA were higher than those in the mild group(P<0.05).25(OH)D3 in the poor prognosis group was lower than that in the good prognosis group,while IL-6 and STAT3 mRNA were higher than those in the good prognosis group(P<0.05).Serum 25(OH)D3 was negatively correlated with the severity of disease and prognosis(r=-0.552;-0.581,P<0.05),while IL-6 and STAT3 mRNA was positively correlated with the severity of disease and prognosis(r=0.648;0.663;and r=0.692;0.732,respectively,all P<0.05).The area under the curve(AUC)value of 25(OH)D3,IL-6 and STAT3 mRNA combined detection for the prediction of neonatal infectious pneumonia was higher than that of single detection(P<o.05).CONCLUSION The expression level of serum 25(OH)D3 of the neonates with infectious pneumonia is decreased,while expression levels of of IL-6 and STAT3 mRNA are increased,the trend of neonatal infectious pneumonia in severe cases and bad prognosis was more obvious,and the expression levels of 25(OH)D3,IL-6 and STAT3 mRNA were closely related to the severity and prognosis of the disease.The combined detection of 25(OH)D3,IL-6 and STAT3 mRNA had high predictive value for neonatal infectious pneumonia.