传染病信息

目的 研究病毒性肺炎患儿涎液化糖链抗原-6(krebs von den lungen-6, KL-6)、乳酸脱氢酶(lactate dehydrogenase, LDH)、血清淀粉样蛋白A(serum amyloid A, SAA)及白细胞介素-6(interleukin-6, IL-6)水平变化与病情严重程度的相关性。方法 选取2022年3月至2023年3月期间新疆维吾尔自治区儿童医院收治的50例诊断为病毒性肺炎患儿作为研究对象，根据儿童临床症状及影像学资料等评估病毒性肺炎的严重程度将患儿分为轻症组(27例)和重症组(23例)。收集2组患儿一般资料和临床相关指标，采用Logistic回归分析筛选儿童病毒性肺炎疾病严重程度的独立危险因素，采用受试者工作特征(receiver operating characteristic, ROC)曲线分析独立危险因素预测儿童病毒性肺炎疾病严重程度的效能。结果重症组的发热持续时间及CD4⁺T淋巴细胞、KL-6、LDH、SAA、IL-6水平与轻症组比较，差异均有统计学意义(t=10.719、7.881、51.402、56.190、17.716、14.510,P均<0.05)。发热持续时间长、CD4⁺T淋巴细胞低水平、KL-6高水平、LDH高水平、SAA高水平、IL-6高水平均为影响儿童重症病毒性肺炎的危险因素(P均<0.05)。ROC曲线结果显示，发热持续时间、CD4⁺T淋巴细胞、KL-6、LDH、SAA及IL-6均具有较高的预测能力(曲线下面积=0.678、0.691、0.666、0.669、0.688、0.672,P均<0.05)。结论 KL-6、LDH、SAA及IL-6水平在病毒性肺炎患儿中均明显增高，CD4⁺T淋巴细胞水平明显降低，且与疾病的严重程度有关，对分析疾病的严重程度具有重要的预测价值。

Objective To investigate the correlation between changes in salivary liquefied glycan antigen(KL-6),lactate dehydrogenase(LDH), serum amyloid A(SAA), and interleukin-6(IL-6) levels and the severity of viral pneumonia in children. Methods Fifty cases of children with viral pneumonia admitted to our hospital between March 2022 and March 2023were selected as study subjects. The severity of viral pneumonia was assessed according to the children's clinical symptoms and imaging data, etc. The children were divided into a mild group and a severe group, with 27 cases in the mild group and 23 cases in the severe group. Two sets of general data and clinically relevant indicators were collected, multivariate logistic regression analysis was used to screen for independent risk factors for the severity of viral pneumonia in children, and ROC curve analysis was used to predict the effectiveness of independent risk factors in predicting the severity of viral pneumonia in children. Results Duration of fever and levels of CD4⁺ T-lymphocytes, KL-6, LDH, SAA, and IL-6 were statistically significant in the severe group compared with the mild group(t=10.719, 7.881, 51.402, 56.190, 17.716, 14.510, P <0.05).Prolonged fever duration, low CD4⁺ T levels, high KL-6 levels, high LDH levels, high SAA levels, and high IL-6 levels were all risk factors affecting severe viral pneumonia in children(OR=4.453, 5.937, 4.121, 4.500, 5.236, 5.115, P <0.05). The ROC curve results showed that fever duration, CD4⁺ T-lymphocytes, KL-6, LDH, SAA, and IL-6 all had high predictive power(AUC=0.678, 0.691, 0.666, 0.669, 0.688, 0.672, P <0.05). Conclusion KL-6, LDH, SAA, and IL-6 levels are significantly increased in children with viral pneumonia, while CD4⁺ T-lymphocytes levels are significantly decreased, and these changes are related to the severity of the disease, providing important predictive value for analyzing the severity of the disease.