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目的探讨不同程度肺炎患儿血清肺表面活性蛋白A(SP-A)水平与临床病情程度的关系。方法选择2007年1月-2008年12月首都儿科研究所附属儿童医院重症监护病房收治的符合肺炎诊断标准的肺炎患儿45例,重症肺炎组20例;普通肺炎组25例,另选择择期手术的非肺炎患儿14例为对照组。分别于治疗前取静脉血2mL,应用ELISA定量法检测各组患儿血清SP-A水平,同时行血气分析检测其动脉血氧分压[pa(O2)]。应用SPSS11.5软件进行统计学分析。结果重症肺炎组及普通肺炎组血清SP-A水平均较对照组明显增高,pa(O2)较对照组均显著下降;重症肺炎组血清SP-A水平较普通肺炎组显著升高,pa(O2)较普通肺炎组显著下降;重症肺炎组和普通肺炎组患儿血清SP-A水平与pa(O2)呈显著负相关(r=-0.801,P<0.001)。结论 SP-A水平能够有效反映儿童肺炎后肺损伤的严重程度,有利于指导临床治疗,对于儿童肺炎预后的判断亦具有一定临床意义。
Objective To investigate the relationship between the level of serum pulmonary surfactant protein A (SP-A) and the clinical severity in children with different degrees of pneumonia. Methods From January 2007 to December 2008, 45 children with pneumonia, 20 severe pneumonia patients and 25 pneumonia patients were enrolled in the Children’s Hospital ICU affiliated to Capital Institute of Pediatrics. In addition, patients undergoing elective surgery Of non-pneumonia in children as control group. Blood samples were collected before treatment in 2 mL of venous blood. Serum SP-A levels were measured by ELISA in all groups. Blood gas analysis was performed to determine the arterial partial pressure of oxygen [pa (O2)]. Application SPSS11.5 software for statistical analysis. Results Serum SP-A levels in severe pneumonia group and ordinary pneumonia group were significantly higher than those in control group, pa (O2) significantly decreased compared with that in control group. Serum SP-A level in severe pneumonia group was significantly higher than that in common pneumonia group, pa (O2) ) Was significantly lower than that of common pneumonia group. Serum SP-A level was significantly negatively correlated with pa (O2) in severe pneumonia group and common pneumonia group (r = -0.801, P <0.001). Conclusions The level of SP-A can effectively reflect the severity of lung injury after pneumonia in children and is helpful to guide the clinical treatment. It also has certain clinical significance for judging the prognosis of children with pneumonia.