文章摘要
血清YKL-40、CRP水平与新生儿呼吸窘迫综合征严重程度及预后的关系
Relationship between serum YKL-40 and CRP levels and the severity and prognosis of neonatal respiratory distress syndrome
投稿时间：2023-04-10  
DOI：10.3969/j.issn.1000-0399.2024.02.009
中文关键词: 呼吸窘迫综合征  甲壳质酶蛋白40  C反应蛋白
英文关键词: Respiratory distress syndrome  Chitinase protein 40  C-reactive protein
基金项目:
作者单位
杜云龙 277500 山东滕州 滕州市中心人民医院新生儿科 
付德龙 277500 山东滕州 滕州市中心人民医院新生儿科 
樊小如 277500 山东滕州 滕州市中心人民医院新生儿科 
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中文摘要:
      目的 探究血清甲壳质酶蛋白40(YKL-40)、C反应蛋白(CRP)水平与新生儿呼吸窘迫综合征(NRDS)严重程度及预后的关系。方法 选取2016年1月至2021年7月在滕州市中心人民医院就诊的140例NRDS患儿作为研究组,根据病情的严重程度将所有NRDS患者分为轻度NRDS组(77例)和重度NRDS组(63例),依据预后情况分为生存组(105例)和死亡组(35例)。另选取同时期在我院分娩的140例健康出产儿为对照组。采用酶联免疫吸附法(ELISA)检测血清YKL-40、CRP的表达水平;经Pearson法分析NRDS患儿血清YKL-40、CRP水平与新生儿急性生理学评分围生期补充II (SNAPPE-II)评分的相关性;使用受试者工作特征(ROC)曲线分析血清YKL-40、CRP对NRDS患儿预后的预测价值;采用多因素logistic回归分析影响NRDS患儿预后的危险因素。结果 与对照组比较,研究组NRDS患儿血清YKL-40、CRP水平明显升高(P<0.05);与轻度NRDS组比较,重度NRDS组患者血清YKL-40、CRP水平明显升高(P<0.05);经Pearson法分析结果显示,NRDS患儿血清YKL-40与CRP水平、SNAPPE-II评分均呈正相关(r=0.572、0.509,P<0.05)。CRP水平与SNAPPE-II评分呈正相关(r=0.543,P<0.05);死亡组患儿血清YKL-40、CRP水平高于生存组(P<0.05);多因素logistic回归分析显示,YKL-40(OR=1.994,95% CI:1.116~3.562)、CRP (OR=2.015,95% CI:1.074~3.780)是NRDS患儿预后的独立危险因素(P<0.05);ROC曲线分析显示,血清YKL-40、CRP预测NRDS患儿预后死亡的AUC为0.848(95% CI:0.768~0.928)、0.829(95% CI:0.734~0.923),血清YKL-40联合CRP预测NRDS患儿预后死亡的AUC为0.931(95% CI:0.890~0.972),灵敏度分别为80.00%、80.00%、94.30%,特异度分别为81.00%、80.00%、79.00%。结论 血清YKL-40、CRP表达与新生儿NRDS病情严重程度及预后密切相关,二者联合可作为NRDS患儿预后预测的生物标志物。
英文摘要:
      Objective To explore the relationship between serum chitinase protein 40 (YKL-40),C-reactive protein (CRP) levels and the severity and prognosis of neonatal respiratory distress syndrome (NRDS).Methods A total of 140 children with NRDS treated in Tengzhou Central People's Hospital from January 2016 to July 2021 were selected as the study group.According to the severity of the disease,all NRDS patients were divided into mild NRDS group (77 cases) and severe NRDS group (63 cases),and according to the prognosis,they were divided into survival group (105 cases) and death group (35 cases).And 92 healthy newborns who gave birth at the same time were selected as the control group.Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of serum YKL-40 and CRP; Pearson method was used to analyze the correlation between the serum YKL-40 and CRP levels of children with NRDS and the Score for Neonatal Acute Physiology,Perinatal Extension,Version Ⅱ (SNAPPE-II) score; The receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum YKL-40 and CRP on the prognosis and death of children with NRDS.Multivariate logistic regression analysis was used to analyze the risk factors affecting the prognosis of children with NRDS.Results Compared with the control group,the study group had significantly higher serum YKL-40 and CRP levels (P<0.05); compared with the mild NRDS group,the severe NRDS group had significantly higher serum YKL-40 and CRP levels (P<0.05); The results of Pearson method analysis showed that serum YKL-40 in children with NRDS was positively correlated with CRP level and SNAPE-Ⅱ score (r=0.572,0.509,P<0.05).CRP level was positively correlated with SNAPE-Ⅱ score (r=0.543,P<0.05); the levels of serum YKL-40 and CRP in the death group were higher than those in the survival group (P<0.05).Multi?variate logistic regression analysis showed that YKL-40（OR=1.994 ，95% CI: 1.116~3.562)and CRP（OR=2.015，95% CI: 1.074~3.780) were independent risk factors for the prognosis of children with NRDS (P<0.05).ROC curve analysis showed that the AUC of serum YKL-40 and CRP in predicting the prognosis and death of children with NRDS was 0.848 (95%CI: 0.768~0.928) and 0.829 (95%CI: 0.734~0.923),respectively,and the AUC of serum YKL-40 combined with CRP in predicting prognosis and death in children with NRDS was 0.931 (95%CI: 0.890~ 0.972),the sensitivity was 80.00%,80.00%,and 94.30% respectively,and the specificity was 81.00%,80.00%,and 79.00%,respectively.Conclusions The expression of serum YKL-40 and CRP are closely related to the severity and prognosis of neonatal NRDS.The combination of YKL-40 and CRP can be used as biomarkers for predicting the prognosis of children with NRDS.
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