重症肺炎患儿血清8-iso-PGF2α、IL-21、SIRT3变化及其与患儿病情和预后的关系-现代医学

重症肺炎患儿血清8-iso-PGF2α、IL-21、SIRT3变化及其与患儿病情和预后的关系

单位：1. 中国科学院大学附属北京怀柔医院儿内科, 北京 101400;
2. 鄂尔多斯市中心医院儿科, 内蒙古鄂尔多斯 017000

关键词：重症肺炎 8-异前列腺素F2α 白介素-21 沉默信息调节因子相关酶3 预后

分类号：R725.6

出版年·卷·期（页码）：2022·50·第二期（213-218）

摘要：

目的:探讨重症肺炎患儿血清8-异前列腺素F2α(8-iso-PGF2α)、白介素-21(IL-21)、沉默信息调节因子相关酶3(SIRT3)水平变化,分析其与患儿病情和临床预后的关系。方法:选取2017年1月至2020年1月在中国科学院大学附属北京怀柔医院儿内科接受治疗的185例肺炎患儿作为研究对象,根据患儿的病情分为重症肺炎组(n=95)和普通肺炎组(n=90)。另选取体检健康儿童60例作为对照组。采用酶联免疫吸附法检测血清8-iso-PGF2α、IL-21、SIRT3水平。重症肺炎患儿随访6个月,根据患儿的预后情况将其分为预后良好组(n=69)和预后不良组(n=26)。采用多因素Logistic回归分析影响重症肺炎患儿不良预后的危险因素;绘制受试者工作特征(ROC)曲线,分析血清8-iso-PGF2α、IL-21、SIRT3对重症肺炎患儿临床预后的预测价值。结果:重症肺炎组、普通肺炎组血清8-iso-PGF2α、IL-21水平高于对照组;重症肺炎组血清8-iso-PGF2α、IL-21水平高于普通肺炎组;重症肺炎组、普通肺炎组血清SIRT3水平低于对照组,重症肺炎组血清SIRT3水平低于普通肺炎组,差异均有统计学意义(P<0.05)。重症肺炎患儿预后不良组血清8-iso-PGF2α、IL-21、APACHEⅡ评分高于预后良好组,血清SIRT3水平、PCIS低于预后良好组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,血清8-iso-PGF2α、IL-21升高,SIRT3降低是重症肺炎患儿预后不良的独立危险因素(P<0.05)。ROC曲线示,血清8-iso-PGF2α、IL-21、SIRT3及三者联合检测预测重症肺炎患儿不良预后的曲线下面积分别为0.747、0.785、0.801、0.899。结论:血清8-iso-PGF2α、IL-21、SIRT3表达水平与重症肺炎患儿病情严重程度及不良预后密切相关,入院时三者联合检测对评估重症肺炎患儿的临床预后有一定参考价值。

Objective:To investigate the changes of serum 8-isoprostaglandin F2α(8-iso-PGF2α),interleukin-21(IL-21),and silent information regulator-related enzyme 3(SIRT3) levels in children with severe pneumonia,and to analyze its relationship with children's condition and clinical prognosis.Methods:A total of 185 children with pneumonia who were treated in the Department of Pediatric Internal Medicine,Beijing Huairou Hospital,University of Chinese Academy of Sciences from January 2017 to January 2020 were selected as the research objects.The children were divided into severe pneumonia group (n=95) and common pneumonia group (n=90) according to their condition.In addition,60 healthy childrenwere selected as the control group.Enzyme-linked immunosorbent assay was used to detect serum 8-iso-PGF2α,IL-21,and SIRT3 levels.Children with severe pneumonia were followed up for 6 months.According to their prognosis,they were divided into good prognosis group (n=69) andpoor prognosis group (n=26).Multivariate Logistic regression was used to analyze the risk factors affecting the poor prognosis of children with severe pneumonia.Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum 8-iso-PGF2α,IL-21,SIRT3 on the clinical prognosis of children with severe pneumonia.Results:The serum levels of 8-iso-PGF2α and IL-21 in the severe pneumonia group and the common pneumonia group were higher than those in the control group,and the serum 8-iso-PGF2α and IL-21 levels in the severe pneumonia group were higher than those in the common pneumonia group,the difference was statistically significant (P<0.05).The serum SIRT3 level of the group was lower than that of the control group,and the serum SIRT3 level of the severe pneumonia group was lower than that of the normal pneumonia group,the difference was statistically significant (P<0.05).The serum levels of 8-iso-PGF2α,IL-21,and score of APACHEⅡ in the poor prognosis group of children with severe pneumonia were higher than those in the good prognosis group,and the serum SIRT3 and PCIS levels were lower than those in the good prognosis group,the difference was statistically significant (P<0.05).Multivariate Logistic regression analysis showed that increased serum 8-iso-PGF2α,IL-21,and decreased SIRT3 were independent risk factors for poor prognosis in children with severe pneumonia (P<0.05).The ROC curve showed that the area under the curve of serum 8-iso-PGF2α,IL-21,SIRT3 and the combined detection of the three to predict the poor prognosis of children with severe pneumonia were 0.747,0.785,0.801,and 0.899,respectively.Conclusion:The expression levels of serum 8-iso-PGF2α,IL-21 and SIRT3 are closely related to the severity and poor prognosis of children with severe pneumonia.The combined detection of the three at admission has certain reference value for evaluating the clinical prognosis of children with severe pneumonia.

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