摘要 目的: 统计分析儿童细菌性肺炎患儿血清CD40L、VCAM-1水平变化及其与感染严重程度的相关性。方法: 选择2014年9月至2016年3月于我院儿科就诊的125例细菌性肺炎患儿作为研究对象,选择同期就诊的116例非细菌性肺炎患儿和138例门诊健康体检儿童作为对照,比较三组儿童血清CD40L和VCAM-1水平的差异,分析细菌性肺炎患儿血清CD40L和VCAM-1水平与其感染严重程度间的相关性。结果: 统计可知,细菌性肺炎和非细菌性肺炎组患儿血清CRP、PCT、CD40L、VCAM-1水平均与健康组差异明显,具有统计学意义(P<0.05),且细菌性肺炎患儿血清PCT、CD40L、VCAM-1水平高于非细菌性肺炎患儿,差异具有统计学意义(P<0.05);不同感染程度细菌性肺炎患儿血清CRP、PCT、CD40L、VCAM-1水平比较为(67.44±19.26 vs 102.06±39.22)(mg/L)、(3.55±1.38 vs 11.66±2.07)(ng/mL)、(2.47±0.58 vs 3.15±0.99)(ng/mL)、(587.4±165.3 vs 668.1±240.9)(ng/mL)(P<0.05);Pearson分析显示,血清CRP(r=0.58,P<0.05)、PCT(r=0.61,P<0.05)、CD40L(r=0.52,P<0.05)、VCAM-1(r=0.57,P<0.05)水平与感染严重程度均呈现明显的正相关性;多元回归logistic分析显示,血清CRP、PCT、CD40L、VCAM-1均为细菌性肺炎发展的危险因素(P<0.05)。结论: 细菌性肺炎患儿血清CD40L、VCAM-1水平均显著升高,且患儿感染越重血清CD40L、VCAM-1水平越高,CD40L、VCAM-1水平的升高是细菌性肺炎发展的危险因素。
Abstract：Objectives: To analyze the changes of serum CD40L and VCAM-1 levels in children with bacterial pneumonia and their correlation with the severity of infection. Methods: From September 2014 to March 2016, 125 children with bacterial pneumonia were selected as the study subjects, 116 children with non-bacterial pneumonia and 138 children with outpatient health examination were selected as the control group. The differences of serum CD40L and VCAM-1 levels between the three groups were compared. The correlation between the level of serum CD40L and VCAM-1 and the severity of infection in children with bacterial pneumonia were analyzed. Results: Statistics results showed that the levels of CRP, PCT, CD40L and VCAM-1 in serum of children with bacterial pneumonia and non-bacterial pneumonia were significantly different from those of healthy children (P<0.05). The serum levels of PCT, CD40L and VCAM-1 in children with bacterial pneumonia were higher than those in children with non-bacterial pneumonia (P<0.05). The serum levels of CRP, PCT, CD40L and VCAM-1 in children with bacterial pneumonia of different infection degrees were (67.44+19.26 vs 102.06+39.22) (mg/L), (3.55+1.38 vs 11.66+2.07) (ng/mL), (2.47+0.58 vs 3.15+0.99) (ng/mL), (587.4+165.3 vs 668.1+240.9) (ng/mL) (P<0.05). Pearson analysis showed that serum CRP (r=0.58, P<0.05), PCT (r=0.61, P<0.05), CD40L (r=0.52, P<0.05), VCAM-1 (r=0.57, P<0.05) levels were positively correlated with the severity of infection. Multivariate logistic regression analysis showed that serum CRP, PCT, CD40L and VCAM-1 were all risk factors for the development of bacterial pneumonia (P<0.05). Conclusion: The serum levels of CD40L and VCAM-1 in children with bacterial pneumonia were significantly higher, and the more severe the infection was, the higher the levels of serum CD40L and VCAM-1 were. The higher levels of CD40L and VCAM-1 were risk factors for the development of bacterial pneumonia.
张毓娴,温红侠,齐薛浩. 儿童细菌性肺炎患儿血清CD40L VCAM-1水平变化及其与感染严重程度相关性分析[J]. 河北医学, 2018, 24(12): 1987-1990.
ZHANG Yuxian, WEN Hongxia, et al. Changes of Serum CD40L and VCAM-1 Expression in Children with Bacterial Pneumonia and their Correlation with Disease Severity. HeBei Med, 2018, 24(12): 1987-1990.
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2018, Vol. 24 
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