中国现代医学杂志2025，Vol.35Issue(18)：26-31,6.DOI:10.3969/j.issn.1005-8982.2025.18.005
血清1,25(OH)2D3、EOS％联合APACHE Ⅱ评分评估小儿肺炎病情严重程度的价值
Clinical value of serum 1,25-dihydroxyvitamin D3,eosinophil percentage,and APACHE Ⅱ score in assessing the severity of pediatric pneumonia
摘要
Abstract
Objective To analyze the clinical value of serum 1,25-dihydroxyvitamin D3[1,25(OH)2D3]and eosinophil percentage(EOS％)combined with the Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱ score in assessing the severity of pediatric pneumonia.Methods A total of 123 pediatric pneumonia patients admitted to Qinhuangdao Maternal and Child Health Hospital from October 2019 to December 2023 were enrolled and divided into the mild(n=79)and severe(n=44)groups based on disease severity.Additionally,60 healthy children undergoing routine health examinations in the hospital during the same period served as controls.Serum levels of 1,25(OH)2D3,EOS％,and APACHE Ⅱ scores were compared among the groups,and their correlations with pulmonary function parameters[tidal volume(VT),respiratory rate(RR),inspiratory-to-expiratory ratio(TI/TE),and time to peak expiratory flow as a percentage of total expiratory time(TPTEF/TE)]were analyzed.The predictive efficacy of combining 1,25(OH)2D3,EOS％,and APACHE Ⅱ scores for disease severity was evaluated using the receiver operating characteristic(ROC)curve analysis.Results Compared with the controls,the pneumonia patients exhibited significantly lower serum 1,25(OH)2D3 levels and higher EOS％(P＜0.05).The severe group showed lower 1,25(OH)2D3 levels but higher EOS％and APACHE Ⅱ scores than the mild group(P＜0.05).The children in the severe group had reduced VT,TI/TE,and TPTEF/TE,along with elevated RR,compared with the mild group(P＜0.05).Pearson correlation analysis indicated positive correlations between 1,25(OH)2D3 levels and VT,TI/TE,and TPTEF/TE(r=0.395,0.478 and 0.344,all P＜0.05),but a negative correlation with RR(r=-0.236,P＜0.05).EOS％was negatively correlated with VT,TI/TE,and TPTEF/TE(r=-0.319,-0.290 and-0.308,all P＜0.05),and positively correlated with RR(r=0.301,P＜0.05).APACHE Ⅱ scores were negatively correlated with VT,TI/TE,and TPTEF/TE(r=-0.285,-0.503 and-0.302,all P＜0.05),and positively correlated with RR(r=0.324,P＜0.05).ROC curve analysis showed that the combined prediction using 1,25(OH)2D3,EOS％,and APACHE Ⅱ scores yielded the largest area under the curve 0.993(95％CI:0.983,1.000),with the highest sensitivity 90.9％(95％CI:0.783,0.975)and specificity 100.0％(95％CI:0.954,1.000).Conclusion Serum 1,25(OH)2D3,EOS％and the APACHE Ⅱ score are closely associated with the severity of pediatric pneumonia,and their combination could serve as effective biomarkers for clinical assessment.关键词
小儿肺炎/1,25二羟维生素D3/EOS％/APACHE Ⅱ评分Key words
pediatric pneumonia/1,25-dihydroxyvitamin D3/EOS％/APACHE Ⅱ score分类
医药卫生引用本文复制引用
宋小宇,田大伟,张淑平..血清1,25(OH)2D3、EOS％联合APACHE Ⅱ评分评估小儿肺炎病情严重程度的价值[J].中国现代医学杂志,2025,35(18):26-31,6.基金项目
河北省卫生健康委员会科研基金项目(No:20231401) （No:20231401）
