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目的 探讨甲型H1N1流行性感冒（流感）重症肺炎患儿血清白细胞介素-8(interleukin-8, IL-8)、淀粉样蛋白A(starch amyloid A protein, SAA)、转化生长因子β1(transforming growth factor-β1, TGF-β1)水平变化与预后的相关性。方法 选取2023年1月至2024年5月南充市中心医院收治的甲型H1N1流感重症肺炎患儿202例，根据预后分为预后良好组与预后不良组。比较2组基线资料及血清IL-8、SAA、TGF-β1水平，采用Pearson相关系数分析血清IL-8、SAA、TGF-β1与病情程度[急性生理与慢性健康评价系统II(Acute Physiology and Chronic Health Evaluation System II, APACHE II)评分、序贯器官衰竭评估（sequential organ failure assessment, SOFA）评分]的关系，Logistic回归分析血清IL-8、SAA、TGF-β1与预后的独立相关性，受试者工作特征（receiver operating characteristic, ROC）曲线及曲线下面积（area under the curve, AUC）分析血清IL-8、SAA及TGF-β1对预后的预测效能。结果 预后不良组血清IL-8、SAA、TGF-β1水平均高于预后良好组（P均<0.05）；血清IL-8、SAA及TGF-β1与APACHE II、SOFA评分呈正相关（P均<0.05）;Logistic回归分析，将其他因素校正前后，血清IL-8、SAA及TGF-β1均与预后独立相关（P均<0.05）；血清IL-8、SAA及TGF-β1预测预后的AUC分别为0.745、0.762及0.759,3者联合预测预后的AUC为0.928，预测效能显著高于各指标单独预测效能（z=3.782、3.065、3.103,P <0.05）。结论 甲型H1N1流感重症肺炎患儿血清IL-8、SAA及TGF-β1与预后独立相关，具有独立预测能力，且联合预测效能更高。
Abstract：Objective To investigate the correlation between the changes in serum levels of Interleukin-8(IL-8), Starch amyloid A protein(SAA), and Transforming growth factor beta 1(TGF-β1) and the prognosis of children with severe pneumonia caused by H1N1 influenza A(H1N1). Methods A total of 202 children with severe pneumonia caused by influenza A(H1N1)from January 2023 to May 2024 were selected and divided into a good prognosis group and a poor prognosis group according to their prognosis. Baseline data, serum levels of IL-8, SAA, and TGF-β1 were compared between the two groups. Pearson correlation coefficient was used to analyze the relationship between serum IL-8, SAA, TGF-β1 and disease severity [Acute Physiology and Chronic Health Evaluation System II(APACHE II) score, Sequential Organ Failure Assessment(SOFA) score]. Logistic regression was used to analyze the independent correlation between serum IL-8, SAA, TGF-β1 and prognosis. Receiver operating characteristic(ROC) curve and area under the curve(AUC) were used to analyze the predictive efficacy of serum IL-8, SAA, and TGF-β1 on prognosis. Results The levels of serum IL-8, SAA, and TGF-β1 in the poor prognosis group were higher than those in the good prognosis group(P <0.05); serum levels of IL-8, SAA, and TGF-β1 were positively correlated with APACHE II and SOFA scores(P <0.05); Logistic regression analysis showed that serum IL-8, SAA, and TGF-β1 were independently associated with prognosis after adjusting for other factors(P <0.05); the AUC of serum IL-8, SAA, and TGF-β1 for predicting prognosis was 0.745, 0.762, and 0.759, respectively. The AUC of the combination of the three indicators for predicting prognosis was 0.928, which was significantly higher than the predictive efficacy of each indicator alone(z=3.782, 3.065, 3.103, all P <0.000).Conclusion Serum IL-8, SAA, and TGF-β1 in children with severe pneumonia caused by influenza A(H1N1) are independently associated with prognosis and have independent predictive ability, and the combined predictive performance is higher.
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基本信息:
DOI：
中图分类号:R725.6
引用信息:
[1]邓琳琳,宋紫霞,李红彦.甲型H1N1流行性感冒重症肺炎患儿血清白细胞介素-8、淀粉样蛋白A及转化生长因子β1水平变化与预后的相关性分析[J].传染病信息,2025,38(03):235-239.
基金信息:
四川省基层卫生事业发展研究中心项目（SWFZ24-Q-82）