文章摘要
唐才环,薛芳,陈乙云,等.干扰素调节因子 5、粒细胞 -巨噬细胞集落刺激因子在细菌性肺炎病儿血清中的表达及预后价值[J].安徽医药,2024,28(7):1425-1429.
干扰素调节因子 5、粒细胞 -巨噬细胞集落刺激因子在细菌性肺炎病儿血清中的表达及预后价值
Expression and prognostic value of IRF5 and GM-CSF in serum of children with bacterial pneumonia
  
DOI:10.3969/j.issn.1009-6469.2024.07.034
中文关键词: 肺炎,细菌性  干扰素调节因子 5  粒细胞 -巨噬细胞集落刺激因子  表达变化  预后价值
英文关键词: Pneumonia,bacterial  Interferon regulatory factor 5  Granulocyte-macrophage colony-stimulating factor  Changes in expression  Prognostic value
基金项目:海南省卫生健康委员会科研课题项目( 21A200463)
作者单位
唐才环 中国人民解放军联勤保障部队第九二八医院儿科海南海口 570100 
薛芳 中国人民解放军联勤保障部队第九二八医院儿科海南海口 570100 
陈乙云 中国人民解放军联勤保障部队第九二八医院儿科海南海口 570100 
陈霞 中国人民解放军联勤保障部队第九二八医院儿科海南海口 570100 
黄惠敏 海南医学院第一附属医院儿科海南海口 570102 
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中文摘要:
      目的探讨干扰素调节因子 5(interferon regulatory factor 5,IRF5)、粒细胞 -巨噬细胞集落刺激因子( granulocyte-macrophage colony-stimulating factor,GM-CSF)在细菌性肺炎病儿血清中的表达变化及疾病预后价值。方法选取 2019年 4月至 2021年 5月中国人民解放军联勤保障部队第九二八医院收治的细菌感染性肺炎病儿 96例作为细菌组,同期非细菌感染性肺炎病儿 88例作为非细菌组,另外选取健康体检儿童 96例为对照组,收集检测三组病儿基本临床资料。检测血清中 IRF5、GM-CSF及其组间差异;采用 Pearson法分析细菌性肺炎病儿血清 IRF5、GM-CSF水平与病情指标的相关性;应用受试者操作特征曲线(ROC曲线)分析 IRF5、GM-CSF及二者联合预测细菌性肺炎预后的价值。结果细菌组血清 IRF5水平[(38.85±13.86)ng/L]显著高于非细菌组[( 11.15±4.37)ng/L]和对照组[( 10.76±1.55)ng/L],且重症组高于轻症组( P<0.05);细菌组血清 GM-CSF水平[(54.73±16.56)ng/L]显著低于非细菌组[(246.73±28.94)ng/L]和对照组[(250.64±55.67)ng/L],且重症组低于轻症组( P<0.05)。重症组气促、吐沫、三凹征、肺部明显湿啰音比例、 C反应蛋白( C-reactive protein,CRP)、白细胞水平显著高于轻症组、非细菌组(P<0.05)轻症组、非细菌组 CRP水平显著高于对照组( P<0.05),非细菌组 CRP水平显著高于对照组( P<0.05)。血清 IRF5水平与 CRP、,白细胞、临床肺部感染评分( clinical pulmonary infection score,CPIS)均呈正相关( r=0.34、0.36、0.41,P<0.05)血清 GM-CSF水平与 CRP、白细胞、 CPIS均呈负相关( r=-0.40、-0.32、-0.45,P<0.05)。预后不良组血清 IRF5水平高于预后良好,组,血清 GM-CSF水平低于预后良好组( P<0.05)。 ROC曲线显示, IRF5、GM-CSF对预后预测的 AUC分别为 0.90、0.87,二者联合对预后预测的 AUC为 0.96,明显高于二者单独诊断,(Z联合 vs.IRF5=2.86,P=0.004;Z联合 vs.GM-CSF =2.24,P=0.025),其灵敏度、特异度分别为 90.32%、90.77%。结论细菌性肺炎病儿血清 IRF5水平升高, GM-CSF水平降低,二者在评估病情进展及疾病预后预测方面具有较高的价值。
英文摘要:
      Objective To investigate the expression changes of interferon regulatory factor 5 (IRF5) and granulocyte-macrophage colony-stimulating factor (GM-CSF) in serum of children with bacterial pneumonia and their prognostic value.Methods From April 2019 to May 2021, Ninety-six children with bacterial pneumonia, who were admitted to The 928th Hospital of the Joint Logistics SupportForce of the People's Liberation Army of China, were included as the bacterial group. Meantime, 88 children with non-bacterial pneumonia were included as the non-bacterial group. In addition, 96 healthy children were chosen as the control group. The basic clinicaldata of the three groups were collected and detected. Serum IRF5 and GM-CSF were detected and the differences between groups werecompared. Pearson's correlation coefficient was applied to analyze the correlation between serum IRF5 and GM-CSF levels and disease indicators in children with bacterial pneumonia; ROC curve was applied to analyze the values of IRF5, GM-CSF and their combination in predicting the prognosis of bacterial pneumonia.Results The serum IRF5 level [(38.85±13.86) ng/L] in the bacterial group was obviously higher than that in the non-bacterial group [(11.15±4.37) ng/L] and the control group [(10.76±1.55) ng/L], and the severe group higher than the mild group (P<0.05); the serum GM-CSF level [(54.73±16.56) ng/L] in the bacterial group was obviously lower than that in the non-bacterial group [(246.73±28.94) ng/L] and the control group [(250.64±55.67) ng/L], and the severe group was lower than themild group (P<0.05). The severe group had obviously higher proportions of shortness of breath, spit, three concave signs, the obviousmoist rales in the lungs, and levels of C-reactive protein (CRP), white blood cell (WBC) than the mild group and the non-bacterial group (P<0.05), and the mild group and non-bacterial group had obviously higher levels of CRP than the control group (P<0.05), the level of CRP in the non-bacterial group significantly higher than that in the control group (P<0.05). Serum IRF5 level was positively correlated with CRP, WBC, and pulmonary infection score (CPIS) (r=0.34, 0.36, 0.41, respectively; P<0.05), and serum GM-CSF level was negatively correlated with CRP, WBC, and CPIS scores (r=-0.40,-0.32,-0.45, respectively; P<0.05). The serum IRF5 level in the poor prognosis group was higher than that in the good prognosis group, and the serum GM-CSF level was lower than that in the good prognosis group (P<0.05). The ROC curve showed that the AUCs of IRF5 and GM-CSF for prognosis prediction were 0.90 and 0.87, respectively,and the AUC of the combination of the two was 0.96, which was obviously higher than that of the two alone, (Z combined vs. IRF5=2.86, P=0.004 ; Z combined vs. GM-CSF=2.24, P=0.025), and the sensitivity and specificity were 90.32% and 90.77%, respectively.Conclusion Serum IRF5 level is increased and GM-CSF level is decreased in children with bacterial pneumonia, both of which have high value in evaluating disease progression and predicting disease prognosis.
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