血清sICAM-1和hs-CRP水平在儿童急性病毒性下呼吸道感染病情监测中的意义

doi:10.3969/j.issn.1673-8640.2022.03.007

摘要/Abstract

摘要：

目的探讨血清可溶性细胞间黏附分子-1（sICAM-1）和高敏C反应蛋白（hs-CRP）水平在儿童急性病毒性下呼吸道感染病情监测中的作用。方法选取急性病毒性下呼吸道感染患儿136例,根据患儿病情严重程度分为轻中症组（82例）和重症组（54例）;根据患儿血清病毒特异性IgG抗体水平将患儿病程分为急性期和恢复期;根据急性生理与慢性健康评分Ⅱ（APACHEⅡ）评分将患儿分为低危组（39例）、中危组（57例）和高危组（40例）。检测所有患儿不同病程的血清sICAM-1、hs-CRP水平和氧合指数。以健康体检儿童50名作为正常对照组。采用Pearson相关分析评估各项指标之间的相关性。结果重症组和轻中症组急性期血清sICAM-1和hs-CRP水平显著高于正常对照组（P<0.05）,且重症组急性期血清sICAM-1和hs-CRP水平明显高于轻中症组急性期（P<0.05）。低危组、中危组、高危组血清sICAM-1和hs-CRP水平依次升高（P<0.05）。重症组急性期和恢复期血清sICAM-1和hs-CRP水平均明显高于轻中症组急性期和恢复期（P<0.05）。轻中症组和重症组恢复期血清sICAM-1和hs-CRP水平均低于急性期（P<0.05）。Pearson相关分析结果显示,急性病毒性下呼吸道感染患儿急性期血清sICAM-1和hs-CRP水平与APACHEⅡ评分均呈正相关（r值分别为0.79、0.70,P<0.05）,与治疗前氧合指数均呈负相关（r值分别为-0.54、-0.46,P<0.05）。结论血清sICAM-1和hs-CRP水平可反映急性病毒性下呼吸道感染患儿病情发展和严重程度,或可作为患儿病情监测的重要参考指标。

关键词: 可溶性细胞间黏附分子-1, 高敏C反应蛋白, 氧合指数, 急性病毒性下呼吸道感染, 儿童

Abstract:

Objective To investigate the roles of serum soluble intercellular adhesion molecule-1（sICAM-1） and high-sensitivity C-reactive protein（hs-CRP） levels in monitoring acute viral lower respiratory tract infection in children. Methods Totally,136 children with acute viral lower respiratory tract infection were enrolled and classified into mild-moderate group（82 cases） and severe group（54 cases） according to severity. According to specific IgG antibody level,they were classified into acute phase and recovery phase groups. According to acute physiology and chronic health evaluation Ⅱ（APACHEⅡ）score,children were classified into low-risk group（39 cases）,intermediate-risk group（57 cases） and high-risk group（40 cases）. Serum sICAM-1,hs-CRP levels and oxygenation index were determined. Totally,50 healthy children were enrolled as healthy control group. Pearson correlation analysis was used to evaluate the correlation between various indicators. Results In acute phase,serum sICAM-1 and hs-CRP levels in severe group and mild-moderate group were higher than those in healthy control group（P<0.05）,and serum sICAM-1 and hs-CRP levels in severe group were higher than those in mild-moderate group（P<0.05）. The levels of serum sICAM-1 and hs-CRP in low-risk group,intermediate-risk group and high-risk group increased in turn（P<0.05）. The levels of serum sICAM-1 and hs-CRP in acute and recovery phases of severe group were higher than those of mild-moderate group（P<0.05）. The levels of serum sICAM-1 and hs-CRP in recovery phase were lower than those in acute phase（P<0.05）. The results of Pearson correlation analysis showed that serum sICAM-1 and hs-CRP levels in acute phase of children with acute viral lower respiratory tract infection were positively correlated with APACHE Ⅱ score（r values were 0.79 and 0.70,P<0.05）,and the indicators were negatively correlated to oxygenation index before treatment（r values were -0.54 and -0.46,P<0.05）. Conclusions The levels of serum sICAM-1 and hs-CRP in children with acute viral lower respiratory tract infection can reflect the development and severity of children's condition,and they can be used as reference indicators for monitoring children's condition.

Key words: Soluble intercellular adhesion molecule-1, High-sensitivity C-reactive protein, Oxygenation index, Acute viral lower respiratory tract infection, Children

中图分类号:

446.1

李东秀, 黄健. 血清sICAM-1和hs-CRP水平在儿童急性病毒性下呼吸道感染病情监测中的意义[J]. 检验医学, 2022, 37(3): 226-229.

LI Dongxiu, HUANG Jian. Roles of serum sICAM-1 and hs-CRP levels in monitoring acute viral lower respiratory tract infection in children[J]. Laboratory Medicine, 2022, 37(3): 226-229.

图/表 3

参考文献 16

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组别	例数	sICAM-1/（μg/L）	hs-CRP/（mg/L）
正常对照组	50	120.4±28.6	4.3±0.7
轻中症组	82	259.3±53.1^*	33.1±9.4^*
重症组	54	374.6±85.3^*#	87.4±33.6^*#
F值		235.0	257.7
P值		<0.05	<0.05

组别	例数	sICAM-1/（μg/L）	hs-CRP/（mg/L）
正常对照组	50	120.4±28.6	4.3±0.7
轻中症组	82	259.3±53.1^*	33.1±9.4^*
重症组	54	374.6±85.3^*#	87.4±33.6^*#
F值		235.0	257.7
P值		<0.05	<0.05

组别	例数	sICAM-1/（μg/L）	hs-CRP/（mg/L）
低危组	39	209.72±34.51	24.69±5.00
中危组	57	293.26±17.64^*	43.21±11.56^*
高危组	40	414.97±53.87^*#	100.31±27.17^*#
F值		319.8	224.8
P值		<0.05	<0.05

组别	例数	sICAM-1/（μg/L）	hs-CRP/（mg/L）
低危组	39	209.72±34.51	24.69±5.00
中危组	57	293.26±17.64^*	43.21±11.56^*
高危组	40	414.97±53.87^*#	100.31±27.17^*#
F值		319.8	224.8
P值		<0.05	<0.05

组别	例数	sICAM-1/（μg/L）		hs-CRP/（mg/L）
组别	例数	急性期	恢复期	急性期	恢复期
轻中症组	82	259.3±53.1	183.6±18.4^*	33.1±9.4	12.4±3.1^*
重症组	54	374.6±85.3	198.8±22.5^*	87.4±33.6	13.7±4.2^*
t值		9.8	4.3	14.1	2.1
P值		<0.05	<0.05	<0.05	<0.05