血清CC16及SP-D与重度肺炎儿童病情程度的关系研究
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摘要
目的探讨血清Clara细胞蛋白(CC16)及肺表面活性蛋白D(SP-D)与重度肺炎儿童病情程度的关系。方法收集2012年2月至2016年2月在温州医科大学附属育英儿童医院救治的58例重度肺炎患儿作为A组,分别选取同时期的轻度肺炎患儿与在保健门诊进行体检的健康儿童各60例,并作为B组与C组。测定3组研究对象血清CC16及SP-D水平,分析血清CC16及SP-D的水平与患儿病情程度的关系。结果血清SP-D的浓度A组明显高于B组与C组(q值分别为-92.58、-142.73),且B组明显高于C组(q=-50.57);血清CC16的浓度A组明显低于B组与C组(q值分别为12.05、21.79),且B组明显低于C组(q=9.82),差异均有统计学意义(均P<0.05)。A组中临床肺部感染评分(CPIS)>6分的患儿血清SP-D的浓度明显高于CPIS≤6分者(t=2.148,P<0.05);A组中CPIS>6分的患儿血清CC16的浓度明显低于CPIS≤6分者(t=2.524,P<0.05)。相关性分析显示,A、B组肺炎患儿血清SP-D浓度与CPIS评分呈正相关(r值分别为0.91、0.87);CC16浓度与CPIS评分呈负相关(r值分别为-0.95、-0.93),差异均有统计学意义(均P<0.05)。结论肺炎患儿的病情程度与血清CC16及SP-D的水平密切相关,根据血清CC16及SP-D水平不仅能判定重度肺炎患儿的病情程度,还能很好地来预测患儿的预后。
Objective To explore the relationship between serum Clara cell protein 16(CC16)and pulmonary surfactant protein D(SP-D)and the severity of severe pneumonia in children.Methods Fifty-eight cases of severe pneumonia were collected as group A from February 2012 to February 2016 in Yuying Children's Hospital Affiliated to Wenzhou Medical University.Sixty cases of mild pneumonia and 60 healthy children in the same period were collected as group B and group C respectively.The levels of CC16 and SP-D in the serum of three groups were measured to analyze the relationship between the levels of CC16 and SP-D and the severity of disease.Results The concentration of SP-D in serum of the subjects in group A was significantly higher than in group B and group C(q value was-92.58 and-142.73,respectively),and that in group B was significantly higher than in group C(q=-50.57).The concentration of CC16 in group A was lower than in group B and group C(q value was 12.05 and 21.79,respectively)and that in group B was lower than in group C(q=9.82)with statistical significance(all P<0.05).The concentration of SP-D in the serum of cases with CPIS>6 scores was significantly higher than that of cases with CPIS≤6 scores in group A(t=2.148,P<0.05),but the concentration of CC-6 in the serum of cases with CPIS>6 scores was significantly lower(t=2.524,P<0.05).Correlation analysis showed that the serum SP-D concentration was positively correlated with CPIS scores in group A and group B(r value was0.91 and 0.87,respectively)and that CC16 concentration was negatively correlated with CPIS scores(r value was-0.95 and-0.93,respectively)with statistical significance(all P<0.05).Conclusion The levels of CC16 and SP-D in the serum of children with pneumonia are closely related to the severity of the children's disease,which not only determine the severity of severe pneumonia,but predict the prognosis of children.
Objective To explore the relationship between serum Clara cell protein 16(CC16)and pulmonary surfactant protein D(SP-D)and the severity of severe pneumonia in children.Methods Fifty-eight cases of severe pneumonia were collected as group A from February 2012 to February 2016 in Yuying Children's Hospital Affiliated to Wenzhou Medical University.Sixty cases of mild pneumonia and 60 healthy children in the same period were collected as group B and group C respectively.The levels of CC16 and SP-D in the serum of three groups were measured to analyze the relationship between the levels of CC16 and SP-D and the severity of disease.Results The concentration of SP-D in serum of the subjects in group A was significantly higher than in group B and group C(q value was-92.58 and-142.73,respectively),and that in group B was significantly higher than in group C(q=-50.57).The concentration of CC16 in group A was lower than in group B and group C(q value was 12.05 and 21.79,respectively)and that in group B was lower than in group C(q=9.82)with statistical significance(all P<0.05).The concentration of SP-D in the serum of cases with CPIS>6 scores was significantly higher than that of cases with CPIS≤6 scores in group A(t=2.148,P<0.05),but the concentration of CC-6 in the serum of cases with CPIS>6 scores was significantly lower(t=2.524,P<0.05).Correlation analysis showed that the serum SP-D concentration was positively correlated with CPIS scores in group A and group B(r value was0.91 and 0.87,respectively)and that CC16 concentration was negatively correlated with CPIS scores(r value was-0.95 and-0.93,respectively)with statistical significance(all P<0.05).Conclusion The levels of CC16 and SP-D in the serum of children with pneumonia are closely related to the severity of the children's disease,which not only determine the severity of severe pneumonia,but predict the prognosis of children.
引文
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[11]张玉婷.联合检查血清CC-16及SP-D对COPD意义的研究[D].石河子大学,2015.
[12]王辉,王瑞.矽肺早期诊断的生物标志物CC16和SP-D[J].中国工业医学杂志,2012,25(4):271-273.
[13]王秋波.慢性阻塞性肺疾病患者血清中Clara细胞分泌蛋白CC16和SP-D浓度与肺功能的相关性[J].中国老年学杂志,2016,6(36):2980-2983.
[2]孙鬼玉.急性Severe pneumonia患儿临床免疫及其医疗成本研究[R].大连医科大学,2013:29.
[3]Jakhar S K,Pandey M,Shah D,et al.Etiology and risk factors determining poor outcome of severe pneumonia in under-five children[J].The Indian Journal of Pediatrics,2018,85(1):20-24.
[4]郁志伟,钱俊,顾晓红,等.婴幼儿喘息性社区获得性肺炎患儿血清炎症因子的变化[J].中国当代儿科杂志,2015,17(8):815-818.
[5]Provost E B,Chaumont A,Kicinski M,et al.Serum levels of club cell secretory protein(Clara)and short-and long-term exposure to particulate air pollution in adolescents[J].Environment International,2014,68:66-70.
[6]中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童社区获得性肺炎管理指南(试行)(上)[J].中华儿科杂志,2007,45(2):83-90.
[7]中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童社区获得性肺炎管理指南(2013修订)(上)[J].中华儿科杂志,2013,51(10):745-752.
[8]Komurian-Pradel F,Endtz H,Rakoto-Andrianarivelo M,et al.Severity of pneumonia in under 5-year-old children from developing countries:A multicenter,prospective,observational study[J].American Journal of Tropical Medicine&Hygiene,2017,97(1):68-76.
[9]Ye Q,Shao W,Shang S,et al.Epidemiological characteristics and immune status of children with respiratory syncytial virus[J].J Med Virol,2015,87(2):323-326.
[10]Vestbo J,Edwarda L D,Scanlon P D,et al.Changes in forced expiratory volume in1 second over time in COPD[J].N Engl J Med,2011,365(13):1184-1192.
[11]张玉婷.联合检查血清CC-16及SP-D对COPD意义的研究[D].石河子大学,2015.
[12]王辉,王瑞.矽肺早期诊断的生物标志物CC16和SP-D[J].中国工业医学杂志,2012,25(4):271-273.
[13]王秋波.慢性阻塞性肺疾病患者血清中Clara细胞分泌蛋白CC16和SP-D浓度与肺功能的相关性[J].中国老年学杂志,2016,6(36):2980-2983.