| 李佳.血清sCD163、ANGPTL4与肺炎链球菌肺炎患儿病情严重程度相关性及临床指导意义[J].安徽医药,待发表. |
| 血清sCD163、ANGPTL4与肺炎链球菌肺炎患儿病情严重程度相关性及临床指导意义 |
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| 投稿时间：2025-03-03 录用日期：2025-04-09 |
| DOI： |
| 中文关键词: sCD163 ANGPTL4 肺炎链球菌肺炎 病情 相关性 |
| 英文关键词: |
| 基金项目:河北省医学科学研究重点课题计划项目（编号：20240471） |
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| 中文摘要: |
| 目的? 探讨血清可溶性血红蛋白清道夫受体(sCD163)、血管生成素样蛋白4(ANGPTL4)与肺炎链球菌(SP)肺炎患儿病情严重程度相关性及临床指导意义。方法? 选取2023年2月～2025年1月我院收治的187例SP肺炎患儿进行前瞻性研究,其中轻度106例(轻度组),重度81例(重度组)。采用倾向性评分匹配法(PSM)降低组间偏倚。比较两组血清sCD163、ANGPTL4,采用多因素Logistic回归分析血清sCD163、ANGPTL4对SP肺炎病情的影响,并对结果进行敏感性检验；平滑曲线拟合分析血清sCD163、ANGPTL4与SP肺炎病情严重程度的相关性及其曲线类型,受试者工作特征曲线(ROC)分析血清sCD163、ANGPTL4评估SP肺炎病情的价值。结果? PSM前两组年龄、SP肺炎类型、PCIS评分比较差异有统计学意义(P＜0.05),PSM后两组以上资料比较差异均无统计学意义(P＞0.05),具有均衡可比性。重度组血清sCD163、ANGPTL4高于轻度组,差异有统计学意义(P＜0.05)。多因素Logistic回归分析显示,sCD163、ANGPTL4升高均是SP肺炎病情严重程度的相关影响因素(P＜0.05),敏感性分析仍保持这一结论,提示研究结果较为稳定。平滑曲线拟合显示,血清sCD163、ANGPTL4与SP肺炎病情严重程度均正向的线性相关关系(P趋势＜0.05,P非线性＞0.05)。ROC分析显示,血清sCD163、ANGPTL4及联合评估SP肺炎病情的AUC分别为0.748、0.759、0.863(P＜0.001),联合的AUC显著大于血清sCD163、ANGPTL4(Z=2.416、2.442,P=0.016、0.015)。结论 血清sCD163、ANGPTL4与SP肺炎患儿病情严重程度有关,检测两者水平有助于评估感染严重程度,早期识别重症高危儿,为临床诊治提供指导,促进患儿病情的良好转归。 |
| 英文摘要: |
| Objective? To explore the correlation between serum soluble hemoglobin scavenger receptor (sCD163), angiopoietin-like protein 4 (ANGPTL4) and the severity of Streptococcus pneumoniae (SP) pneumonia in children, as well as its clinical significance. Methods?? A prospective study was conducted on 187 children with SP pneumonia admitted to our hospital from February 2023 to January 2025, including 106 mild patients (mild group) and 81 severe patients (severe group). The propensity score matching (PSM) method was used to reduce the bias between groups. The serum levels of sCD163 and ANGPTL4 were compared between the two groups, and the effects of serum sCD163 and ANGPTL4 on the severity of SP pneumonia were analyzed using multivariate Logistic regression analysis, and the results were subjected to sensitivity testing; the correlation between serum sCD163, ANGPTL4, and the severity of SP pneumonia was analyzed using smooth curve fitting, and the value of serum sCD163 and ANGPTL4 in evaluating the severity of SP pneumonia was analyzed using receiver operating characteristic (ROC) curve analysis. Results ? There were significant differences in age, SP pneumonia type, and PCIS score between the first two groups of PSM (P<0.05), while there were no significant differences in the above data between the two groups after PSM (P>0.05), indicating balanced comparability. The levels of serum sCD163 and ANGPTL4 in the severe group were higher than those in the mild group, and the differences were statistically significant (P<0.05). Multivariate Logistic regression analysis showed that the increase in sCD163 and ANGPTL4 were both related factors affecting the severity of SP pneumonia (P<0.05). Sensitivity analysis also maintained this conclusion, suggesting that the research results were relatively stable. Smooth curve fitting showed that serum sCD163 and ANGPTL4 were positively correlated with the severity of SP pneumonia (P trend <0.05, P nonlinear >0.05). ROC analysis showed that the AUCs of serum sCD163, ANGPTL4, and the combined assessment of SP pneumonia severity were 0.748, 0.759, and 0.863, respectively (P<0.001), and the combined AUC was significantly greater than that of serum sCD163 and ANGPTL4 (Z=2.416, 2.442, P=0.016, 0.015). Conclusion Serum sCD163 and ANGPTL4 are associated with the severity of pneumonia in children with SP pneumonia. Detecting the levels of both can help assess the severity of infection, identify high-risk infants at an early stage, provide guidance for clinical diagnosis and treatment, and promote a favorable outcome for children with the disease. |
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