血清CXCL10、Ghrelin及SOCS3对小儿支气管肺炎病情诊断的临床意义

Clinical significance of serum CXCL10, Ghrelin, and SOCS3 for diagnosis of severity of bronchopneumonia in children

摘要

目的 探究血清CXC趋化因子配体10(CXCL10)、饥饿素(Ghrelin)、细胞因子信号抑制因子3(SOCS3)对支气管肺炎患儿病情诊断的临床意义。方法 选取2022年1月至2024年1月在宿迁市第一人民医院接受诊治的支气管肺炎患儿228例为肺炎组,根据患儿的病情程度分为轻度组156例和重度组72例。另选取同期的健康体检儿童70例为对照组。收集患儿的临床检查指标;利用ELISA试剂盒检测血清CXCL10、Ghrelin、SOCS3;采用多因素Logistic回归分析支气管肺炎患儿病情加重的影响因素;采用受试者工作特征(ROC)曲线分析血清CXCL10、Ghrelin、SOCS3对重度支气管肺炎患儿的诊断价值。结果 肺炎组血清CXCL10、Ghrelin、SOCS3水平高于对照组,差异有统计学意义(t值分别为10.652、8.554、12.727,P<0.05);重度组的白细胞计数(WBC)、中性粒细胞计数(NEUT)、C反应蛋白(CRP)、前降钙素(PCT)、CXCL10、Ghrelin、SOCS3水平高于轻度组,差异有统计学意义(t值介于7.621~27.635之间,P<0.05);CRP、PCT、CXCL10、Ghrelin、SOCS3是支气管肺炎患者病情加重的危险因素(OR值介于2.063~2.861之间,P<0.05);血清CXCL10、Ghrelin、SOCS3单独诊断重度支气管肺炎患儿的曲线下面积(AUC)分别为0.798、0.719、0.786,联合诊断的AUC为0.923,高于单独诊断(Z值分别为3.459、5.179、4.126,P<0.05)。结论 重度支气管肺炎患儿的血清CXCL10、Ghrelin、SOCS3水平较高,三者均是支气管肺炎病情加重的危险因素,三者联合诊断重度支气管肺炎的价值较高。

Abstract

Objective To explore clinical significance of serum CXC chemokine ligand 10 (CXCL10), Ghrelin and suppressor of cytokine signaling 3 (SOCS3) for diagnosis of severity of bronchopneumonia in children. Methods A total of 228 children with bronchopneumonia who were treated in The First People's Hospital of Suqian City from January 2022 to January 2024 were selected as bronchopneumonia group. According to severity of the children's disease condition, they were divided into mild bronchopneumonia group (156 cases) and severe bronchopneumonia group (72 cases). Another 70 healthy children who underwent physical examination during the same period were selected as the control group. The clinical data of the patients were collected. Enzyme linked immunosorbent assay (ELISA) was applied to detect serum CXCL10, Ghrelin and SOCS3 levels. Multivariate Logistic regression analysis was applied to analyze influencing factors for exacerbation of bronchopneumonia in children. Receiver operating characteristic (ROC) was applied to analyze diagnostic value of serum CXCL10, Ghrelin and SOCS3 for severe bronchopneumonia in children. Results The serum levels of CXCL10, Ghrelin and SOCS3 of the children in the bronchopneumonia group were higher than those in the control group, and the differences were statistically significant (t=10.652, 8.554 and 12.727 respectively, all P<0.05). The levels of white blood cell count (WBC), neutrophil count (NEUT), C-reactive protein (CRP), procalcitonin (PCT), CXCL10, Ghrelin and SOCS3 of the children in the severe bronchopneumonia group were higher than those in the mild bronchopneumonia group, and the differences were statistically significant (t=7.621-27.635, all P<0.05). CRP, PCT, CXCL10, Ghrelin, and SOCS3 were risk factors for exacerbation of bronchopneumonia in children (OR=2.063-2.861, all P<0.05). The areas under the curve (AUCs) of CXCL10, Ghrelin and SOCS3 for diagnosing severe bronchopneumonia in children were 0.798, 0.719 and 0.786 respectively, while the AUC of combination of the three indexes for diagnosing severe bronchopneumonia in children was 0.923, which was higher than those of individual diagnosis of the three indexes (Z=3.459, 5.179 and 4.126 respectively, all P<0.05). Conclusion The serum levels of CXCL10, Ghrelin and SOCS3 of children with severe bronchopneumonia are relatively high. Serum CXCL10, Ghrelin, and SOCS3 are risk factors for exacerbation of bronchopneumonia in children. The combined detection of the three indexes has high diagnostic value for severe bronchopneumonia.

关键词

儿童 / 支气管肺炎 / CXC趋化因子配体10 / 饥饿素 / 细胞因子信号抑制因子3 / 病情

Key words

children / bronchopneumonia / CXC chemokine ligand 10 / Ghrelin / suppressor of cytokine signaling 3 / disease condition

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基金资助

江苏省2021年省基础研究计划(自然科学基金)(BK20210002)