社区获得性肺炎患儿血清基质金属蛋白酶-9、维生素A表达及与病情程度的相关性
| 作者: |
1谢曼芬,
1高燕,
1蔡晨露,
1王肖,
1郭会敏
1 海南省妇女儿童医学中心门急诊科，海口 570000 |
| 通讯: |
谢曼芬
Email: xiemanfen2518@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2022.03.009 |
| 基金: | 海南省卫生健康行业科研项目 (20A200190)。 |
摘要
目的：探讨社区获得性肺炎(community acquired pnuemonia，CAP)患儿血清基质金属蛋白酶-9(matrix metalloproteinase-9，MMP-9)、维生素A(vitamin A，VA)的表达特点以及与病情程度的相关性。方法：选取2020年2月至2021年5月海南省妇女儿童医学中心收治的102例CAP患儿，依据小儿危重病例评分(Pediatric Critical Illness Score，PCIS)评估CAP病情程度，分成重症CAP(severe CAP，SCAP)组54例和轻症CAP组48例。另选取同期来院体检的健康儿童40例，为对照组。对上述儿童血清MMP-9、VA和肺功能检测指标[潮气量(volume tidal，VT)、达峰时间比(ratio of the time to reach peak tidal expiratory flow to total expiratory time，TPTEF/TE)和达峰容积比(ratio of the volume to reach peak tidal expiratory flow to total expiratory volume，VPTEF/VE)]进行测定和分析。结果：3组血清MMP-9、VA水平和VA缺乏(VA deficiency，VAD)发生率比较，差异均有统计学意义(均P<0.05)，其中SCAP组血清MMP-9水平、VAD发生率高于轻症CAP组和对照组，血清VA水平低于轻症CAP组和对照组，轻症CAP组血清MMP-9水平高于对照组，血清VA水平低于对照组，差异均有统计学意义(均P<0.05)。SCAP组TPTEF/TE、VPTEF/VE均低于轻症CAP组，差异均有统计学意义(均P<0.05)，组间VT比较差异不显著(P>0.05)。CAP患儿血清MMP-9与TPTEF/TE、VPTEF/VE、PCIS评分呈负相关(r=−0.671、−0.573、−0.718，P<0.05)，VA水平与TPTEF/TE、VPTEF/VE呈正相关(r=0.669、0.737、0.743，P<0.05)。结论：CAP患儿血清MMP-9异常升高，VA明显偏低，且MMP-9、VA水平与肺功能和CAP病情程度存在相关性，可作为临床病情评估的辅助指标。
关键词：
社区获得性肺炎；重症；患儿；基质金属蛋白酶-9；维生素A；肺功能；相关性
Expression of serum matrix metalloproteinase-9 and vitamin A in children with community-acquired pneumonia and their correlation with disease severity
CorrespondingAuthor: XIE Manfen Email: xiemanfen2518@126.com
DOI: 10.3978/j.issn.2095-6959.2022.03.009
Foundation: This work was supported by Hainan Provincial Health Industry Scienti c Research Project, China (20a200190).
Abstract
Objective: To investigate the expression characteristics of serum matrix metalloproteinase-9 (MMP-9) and vitamin A (VA) in children with community-acquired pneumonia (CAP) and its correlation with the severity of the disease. Methods: A total of 102 children with cap treated in Hainan Women’s and Children’s Medical Center from February 2020 to May 2021 were selected. The severity of cap was evaluated according to the pediatric critical illness score (PCIs). They were divided into 54 cases in severe CAP (SCAP) group and 48 cases in mild CAP group. Another 40 healthy children who came to the hospital for physical examination in the same period were selected as the control group. The serum levels of MMP-9, VA and pulmonary function indexes [tidal volume (VT), ratio of the time to reach peak tidal expiratory flow to total expiratory time (TPTEF/TE) and ratio of the volume to reach peak tidal expiratory flow to total expiratory volume (VPTEF/VE)] were measured and analyzed. Results: There were significant differences in serum MMP-9, VA levels and incidence of VA deficiency (VAD) among the three groups (P<0.05). The level of MMP-9 and the incidence of VAD in SCAP group were higher than those in CAP group and control group, and the level of VA in SCAP group was lower than that in CAP group and control group. The level of MMP-9 in CAP group was higher than that in control group, and the level of VA in CAP group was lower than that in control group. The differences were statistically significant (P<0.05). The TPTEF/TE and VPTEF/VE of SCAP group were lower than those of CAP group (P<0.05), but the VT of SCAP group was not significantly different (P>0.05). Serum MMP-9 was negatively correlated with TPTEF/TE, VPTEF/VE and PCIS scores in children with CAP (r=−0.671, −0.573, −0.718, P<0.05), VA level was positively correlated with TPTEF/TE and VPTEF/VE (r=0.669, 0.737, 0.743, P<0.05). Conclusion: The serum MMP-9 in CAP children was abnormally elevated, VA was significantly lower, and the levels of MMP-9 and VA were correlated with pulmonary function, which could be used as an auxiliary index for clinical condition evaluation.
Keywords：
community acquired pneumonia; severe disease; children; matrix metalloproteinase-9; vitamin A; lung function; relevance