| 王鑫鑫,童 玲,张 舒,尹晓光,王慧琴.早产儿急性呼吸窘迫综合征血清1,25-(OH)2D3、PGRN、SIRT1、CTRP3水平与炎症反应和预后的关系研究[J].,2023,(6):1169-1174 |
| 早产儿急性呼吸窘迫综合征血清1,25-(OH)2D3、PGRN、SIRT1、CTRP3水平与炎症反应和预后的关系研究 |
| Relationship Study between the Levels of Serum 1,25-(OH)2D3, PGRN, SIRT1, CTRP3 and Inflammatory Response and Prognosis in Premature Infants with Acute Respiratory Distress Syndrome |
| 投稿时间：2022-07-27 修订日期：2022-08-23 |
| DOI：10.13241/j.cnki.pmb.2023.06.034 |
| 中文关键词: 急性呼吸窘迫综合征 早产儿 1,25-(OH)2D3 PGRN SIRT1 CTRP3 炎症反应 预后 |
| 英文关键词: Acute respiratory distress syndrome Premature infants 1,25-(OH)2D3 PGRN SIRT1 CTRP3 Inflammatory response Prognosis |
| 基金项目:安徽省临床重点专科建设项目（201730） |
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| 中文摘要: |
| 摘要 目的：探讨不同病情严重程度早产儿急性呼吸窘迫综合征（ARDS）血清1,25-二羟维生素D3（1,25-(OH) 2D3）、颗粒体蛋白前体（PGRN）、沉默信息调节因子2相关酶1（SIRT1）、C1q/肿瘤坏死因子相关蛋白3（CTRP3）的变化，分析其与炎症反应和预后的关系。方法：选择2018年10月至2019年12月安徽省妇幼保健院收治的ARDS早产儿100例作为ARDS组，另选取同期在我院出生的健康新生儿60例作为对照组。根据《"新生儿急性呼吸窘迫综合征"蒙特勒标准（2017年版）》的病情判定标准将ARDS早产儿分为轻度组（n=40）、中度组（n=32）、重度组（n=28），比较不同病情严重程度ARDS早产儿血清1,25-(OH) 2D3、PGRN、SIRT1、CTRP3、炎症反应指标肿瘤坏死子因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）水平变化，采用Pearson法分析ARDS早产儿血清1,25-(OH) 2D3、PGRN、SIRT1、CTRP3与炎症反应指标的相关性。另根据ARDS组患儿预后情况分为预后良好组（n=65）和预后不良组（n=35），采用单因素和多因素Logistic回归分析影响ARDS早产儿预后不良的危险因素。结果：ARDS组血清1,25-(OH) 2D3、SIRT1、CTRP3、PGRN水平明显低于对照组（P<0.05），ARDS组血清TNF-α、IL-6、IL-1β水平明显高于对照组（P<0.05）。不同病情严重程度ARDS早产儿血清1,25-(OH) 2D3、PGRN、SIRT1、CTRP3、炎症反应指标比较差异有统计学意义（P<0.05）。ARDS早产儿血清1,25-(OH) 2D3、PGRN、SIRT1、CTRP3水平与TNF-α、IL-6、IL-1β水平呈负相关（P<0.05）。多因素Logistic回归分析结果显示，低出生体重、肺表面活性物质（PS）使用次数≥3次、出现低白蛋白血症是影响ARDS早产儿预后不良的危险因素（P<0.05），血清1,25-(OH)2D3（较高）、PGRN（较高）、SIRT1（较高）、CTRP3（较高）是ARDS早产儿预后不良的保护因素（P<0.05）。结论：血清1,25-(OH) 2D3、PGRN、SIRT1、CTRP3可能参与ARDS早产儿的炎症反应过程，与ARDS早产儿的病情进展及预后密切相关，检测血清1,25-(OH) 2D3、PGRN、SIRT1、CTRP3有助于评估ARDS早产儿的预后。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the changes of serum 1, 25-dihydroxyvitamin D3 (1,25-(OH) 2D3), progranulin (PGRN), silencing information regulation factor 2-related enzyme 1 (SIRT1), C1q/tumor necrosis factor related protein 3 (CTRP3) in premature infants with acute respiratory distress syndrome (ARDS) of different severity, and to analyze its relationship with inflammatory response and prognosis. Methods: 100 ARDS premature infants who were admitted to our hospital from October 2018 to December 2019 were selected as the ARDS group, and 60 healthy newborns born in our hospital during the same period were selected as the control group. According to the disease assessment criteria of MONTREux Criteria for Neonatal Acute Respiratory Distress Syndrome (2017 edition), ARDS premature infants were divided into mild group (n=40), moderate group (n=32) and severe group (n=28). The levels of serum 1,25-(OH) 2D3, PGRN, SIRT1, CTRP3, inflammatory response indexes tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1β (IL-1β) in ARDS premature infants with different severity of disease were compared. Pearson method was used to analyze the correlation between serum 1,25-(OH) 2D3, PGRN, SIRT1, CTRP3 and inflammatory response indexes in ARDS premature infants. In addition, according to the prognosis of ARDS group, the infants were divided into good prognosis group (n=65) and poor prognosis group (n=35). Univariate and multivariate Logistic regression were used to analyze the risk factors affecting the poor prognosis of ARDS premature infants. Results: The levels of serum 1,25-(OH) 2D3, SIRT1, CTRP3 and PGRN in the ARDS group were significantly lower than those in the control group (P<0.05), and the levels of serum TNF-α, IL-6 and IL-1β in the ARDS group were significantly higher than those in the control group (P<0.05). There were statistically significant differences in serum 1,25-(OH) 2D3, PGRN, SIRT1, CTRP3 and inflammatory response indexes in ARDS premature infants with different severity of disease (P<0.05). The levels of serum 1,25-(OH) 2D3, PGRN, SIRT1 and CTRP3 were negatively correlated with the levels of TNF-α, IL-6 and IL-1β in ARDS preterm infants (P<0.05). Multivariate Logistic regression analysis showed that low birth weight, lung surfactant (PS) use times ≥3 times and hypoalbuminemia occured were the risk factors for poor prognosis of ARDS premature infants (P<0.05). Serum 1,25-(OH) 2D3 (higher), PGRN (higher), SIRT1 (higher), CTRP3 (higher) were protective factors for poor prognosis of ARDS premature infants (P<0.05). Conclusion: Serum 1,25-(OH) 2D3, PGRN, SIRT1 and CTRP3 may participate in the inflammatory reaction process of ARDS premature infants and are closely related to the disease progression and prognosis of ARDS premature infants. Detection of serum 1,25-(OH) 2D3, PGRN, SIRT1 and CTRP3 is helpful to evaluate the prognosis of ARDS premature infants. |
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