在儿科急性肺部感染中风险分层的循环表面活性蛋白-D:系统性审查
Ramona Chelcea1, Ioana Mihaiela Ciuca2, Naresh Reddy Mudireddy3
1Doctoral School, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Diagnostics (Basel, Switzerland)
|November 27, 2025
概括
患有肺部感染的儿童中表面活性蛋白-D (SP-D) 的升高表明疾病严重,预示着更糟糕的结果. 需要进一步验证,但SP-D显示了儿童肺炎和病毒性肺损伤风险分层的前景.
科学领域:
- 儿科肺病学 儿科肺病学
- 传染病中的生物标志物
- 关键护理医学 关键护理医学
背景情况:
- 表面活性蛋白-D (SP-D) 在膜-毛囊屏障受伤时释放到循环中.
- 儿童的急性传染性肺病可能会破坏这种屏障,导致SP-D释放.
研究的目的:
- 综合关于急性传染性肺病儿童循环SP-D的诊断和预后表现的证据.
- 评估SP-D在区分疾病严重程度和预测儿科呼吸道感染结果方面的作用.
主要方法:
- 在人体研究中对MEDLINE,Embase和Scopus (启动时间:2025年6月1日) 的系统文献搜索.
- 包括小儿患者 (18岁以下) 患有社区获得性肺炎 (CAP),病毒性肺炎或小儿急性呼吸困扰综合征 (PARDS) 的研究.
- 由于测试和结果定义的异质性而导致叙述合成;使用ROBINS-I.评估的偏差风险.
主要成果:
- 五项研究 (n=723) 报告了严重CAP中更高的入院SP-D水平 (AUC 0.699-0.802).
- SP-D 值 (110-180 ng/mL) 显示灵敏度为67-85%,特异性为45-70%.
- 在流感相关的呼吸衰竭中,SP-D与呼吸器日 (r≈0.45) 和ICU停留 (r≈0.44) 相对应;每10 ng/mL的SP-D增加与严重PARDS和死亡的更高几率相关 (aOR1.02).
结论:
- 循环SP-D的升高与疾病严重程度,X光学发现以及儿科肺部感染的短期不良结果相关.
- SP-D显示出作为儿童肺炎和病毒性肺损伤风险分层的生物标志物的潜力.
- 建议进行测试标准化和外部验证,以便将SP-D临床整合到多参数风险算法中.
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