| 摘要: |
| 目的：观察血清氨基末端B型脑钠肽前体（NT-proBNP）及肺泡沉默调节蛋白6（SIRT6）与急性呼吸窘迫综合征（ARDS）严重程度的相关性。方法：选取2017年6月30日至2019年6月30日青海省妇女儿童医院收治的146例ARDS患儿，根据病情严重程度将其分为轻度ARDS组（65例）、中度ARDS组（50例）及重度ARDS组（31例），选取同期收治的下呼吸道感染患儿40例作为对照组，检测并比较患儿空腹外周血NT-proBNP、TNF-α、IL-6水平以及肺泡灌洗液中SIRT6含量，分析NT-proBNP、SIRT6对重度ARDS的预测价值。结果：ARDS患儿血清NT-proBNP、TNF-α、IL-6水平高于对照组，肺泡灌洗液SIRT6水平高于对照组，差异有统计学意义（P<0.05）。重度ARDS组NT-proBNP、TNF-α、IL-6、SIRT6水平高于轻、中度ARDS组（P<0.05）；中度ARDS组NT-proBNP、TNF-α、IL-6、SIRT6水平高于轻度ARDS组（P<0.05）。相关性分析显示，NT-proBNP与ARDS患儿PaO2/FiO2呈负相关（P<0.05）；SIRT6与TNF-α、IL-6水平呈正相关（P<0.05），与PaO2/FiO2呈负相关（P<0.05）。ROC分析结果显示，NT-proBNP预测重度ARDS的AUC为0.71（P<0.05），特异度为64.5%，灵敏度为72.1%；SIRT6预测重度ARDS的AUC为0.74（P<0.05），特异度为63.9%，灵敏度为78.3%。结论：ARDS患儿血清NT-proBNP及肺泡SIRT6水平增高，且与ARDS病情严重程度密切相关，NT-proBNP、SIRT6对重度ARDS均有一定预测价值。 |
| 关键词: 氨基末端B型脑钠肽前体 沉默调节蛋白6 急性呼吸窘迫综合征 严重程度 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2020.06.001 |
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| 基金项目: |
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| Predictive Value of N-Terminal B-Type Pro-Brain Natriuretic Peptide and Silencing Regulatory Protein 6 on Severity of Acute Respiratory Distress Syndrome in Children |
| Wang Zhengling, Yang Zhiquan |
| (Qinghai Women and Children’s Hospital, Qinghai Xining 810007, China) |
| Abstract: |
| Objective: To observe the correlation between N-terminal B-type pro-brain natriuretic peptide (NT-proBNP) and silencing regulatory protein 6 (SIRT6) and severity of acute respiratory distress syndrome (ARDS) in children. Methods: A total of 146 children with ARDS admitted into Qinghai Women and Children’s Hospital from Jun. 30th, 2017 to Jun. 30th, 2019 were extracted to be divided into the mild ARDS group (n=65), medium ARDS group (n=50) and severe ARDS group (n=31) according to severity of the disease. And 40 children with lower respiratory tract infection were selected as the control group. The serum levels of NT-proBNP, TNF-α, IL-6 and SIRT6 in alveolar lavage fluid were measured and compared. The predictive value of NT-proBNP and SIRT6 on severe ARDS were observed. Results: The serum levels of NT-proBNP, TNF-α and IL-6 in children with ARDS were higher than those in the control group, and the levels of SIRT6 in alveolar lavage fluid were higher than those in the control group, with statistically significant difference (P<0.05). The levels of NT-proBNP, TNF-α, IL-6 and SIRT6 in the severe ARDS group were higher than those in the mild and medium ARDS group (P<0.05). The levels of NT-proBNP, TNF-α, IL-6 and SIRT6 in the medium ARDS group were higher than those in the mild ARDS group (P<0.05). Correlation analysis showed that NT-proBNP was negatively correlated with PaO2/FiO2 in children with ARDS (P<0.05). SIRT6 was positively correlated with levels of TNF-α and IL-6 (P<0.05), and negatively correlated with PaO2/FiO2 (P<0.05). ROC analysis showed that the AUC of NT-proBNP diagnosis of severe ARDS was 0.71 (P<0.05), the specificity was 64.5%, and the sensitivity was 72.1%. The AUC of SIRT6 diagnosis of severe ARDS was 0.74 (P<0.05), the specificity was 63.9%, and the sensitivity was 78.3%. Conclusion: Serum levels of NT-proBNP and alveolar SIRT6 are elevated in children with ARDS, which are closely related to the severity of ARDS. NT-proBNP and SIRT6 have certain predictive value for severe ARDS. |
| Key words: N-terminal B-type pro-brain natriuretic peptide silencing regulatory protein 6 acute respiratory distress syndrome severity |
