不同类型小儿呼吸道感染血清维生素A、IGF-1及SOCS1 mRNA的水平差异及预后影响因素分析

Analysis of Differences in Serum Vitamin A,IGF-1 and SOCS1 mRNA Levels in Different Types of Pediatric Respiratory Tract Infections and Factors Affecting Prognosis

目的:探讨不同类型小儿呼吸道感染血清维生素A、IGF-1及SOCS1 mRNA的水平差异及预后影响因素。方法:选择2021年1月至2023年12月来我院诊治的呼吸道感染患儿80例,根据感染类型将80例患儿分为肺炎组38例、上呼吸道感染组42例。对比两组患儿一般资料及血常规实验室检查结果、血清维生素A、IGF-1及SOCS1mRNA水平,分析两组患儿预后,对比预后良好与预后不良患儿的影响因素,分析血清维生素A、IGF-1及SOCS1mRNA水平对肺炎患儿预后的预测价值。结果:肺炎组患儿的年龄、血清淋巴细胞明显低于上呼吸道感染组,发热、咳嗽比例明显较上呼吸道感染组高,咽痛比例明显较上呼吸道感染组低(P均<0.05)。肺炎组患儿的维生素A、IGF-1水平明显较上呼吸道感染组低,SOCS1 mRNA明显较上呼吸道感染组患儿高(P<0.05)。42例上呼吸道感染患儿均治愈。38例肺炎患儿中治愈者22例,有效者8例,无效者8例,将治愈+有效作为预后良好组,共30例,占比78.95%(30/38),预后不良者8例,占比21.95%(8/38)。多因素Logsitic回归分析结果表明,年龄1-6岁、维生素A水平降低、IGF-1水平降低、SOCS1 mRNA水平升高是肺炎患儿预后不良的危险因素(P<0.05)。维生素A、IGF-1可用于小儿肺炎预后判断,AUC均>0.80,P均<0.05,SOCS1 mRNA对小儿肺炎预后诊断效能较差,P>0.05。结论:与上呼吸道感染患儿相比,肺炎患儿的血清维生素A、IGF-1明显降低,SOCS1 mRNA水平明显升高,维生素A、IGF-1可用于小儿肺炎预后判断,年龄1-6岁、维生素A水平降低、IGF-1水平降低、SOCS1 mRNA水平升高是肺炎患儿预后不良的危险因素。

Objective:To investigate the difference of serum vitamin A,IGF-1 and SOCS1 mRNA levels and prognostic factors in children with different types of respiratory tract infection.Methods:80 children with respiratory tract infections who came to our hospital from January 2021 to December 2023 were selected and divided into pneumonia group(38 cases)and upper respiratory tract infection group(42 cases)according to the types of infection.The general data,laboratory test results of blood routine,serum vitamin A,IGF-1 and SOCS1mRNA levels in two groups were compared,and the prognosis in two groups were analyzed.The influencing factors of good prognosis and poor prognosis were compared,and the predictive value of serum vitamin A,IGF-1 and SOCS1mRNA levels on the prognosis of children with pneumonia was analyzed.Results:The age and serum lymphocytes of pneumonia group were significantly lower than those of upper respiratory tract infection group,the proportion of fever and cough was higher than that of upper respiratory tract infection group,and the proportion of sore throat was lower than that of upper respiratory tract infection group(P<0.05).The levels of vitamin A and IGF-1 in the pneumonia group were lower than those in the upper respiratory tract infection group,and SOCS1 mRNA was higher than those in the upper respiratory tract infection group(P<0.05).All 42 cases of upper respiratory tract infection were cured.Among the 38 children with pneumonia,22 cases were cured,8 cases were effective,and 8 cases were ineffective.The cured+effective group was regarded as the good prognosis group,with a total of 30 cases,accounting for 78.95%(30/38),and 8 cases with poor prognosis,accounting for 21.95%(8/38).Multivariate Logsitic regression analysis showed that age 1-6 years old,decreased vitamin A level,decreased IGF-1 level,and increased SOCS1 mRNA level were risk factors for poor prognosis in children with pneumonia(P<0.05).Vitamin A and IGF-1 can be used to predict the prognosis of pediatric pneumonia,with AUC>0.80,P<0.05.SOCS1 mRNA has poor diagnostic efficacy for the prognosis of pediatric pneumonia,P>0.05.Conclusion:Compared with children with upper respiratory tract infection,the serum vitamin A and IGF-1 are significantly reduced,and the SOCS1 mRNA level is significantly increased.Vitamin A and IGF-1 can be used to judge the prognosis of pediatric pneumonia.Age 1-6 years,vitamin A,IGF-1 and SOCS1 mRNA levels are risk factors for poor prognosis of children with pneumonia.