临床误诊误治2026，Vol.39Issue(8)：73-79,7.DOI:10.3969/j.issn.1002-3429.2026.08.013
血清TNFSF14、HO-1、APC对儿童重症肺炎预后的影响及预测效能分析
Effects of serum TNFSF14,HO-1 and APC on the prognosis of severe pneumonia in children and their predictive efficacy
摘要
Abstract
Objective To investigate the effects of serum tumor necrosis factor superfamily member 14(TNFSF14),heme oxygenase-1(HO-1)and activated protein C(APC)on the prognosis of children with severe pneumonia,as well as their predictive value for the prognosis.Methods A prospective study was conducted on 144 children with severe pneumonia admitted from January 2023 to January 2025,all of whom were treated with conventional symptomatic treatment.According to the prognosis of treatment,they were divided into good group(n=104)and poor group(n=40).The general data and serum TNFSF14,HO-1 and APC were compared between the two groups.Multivariate logistic regression analysis was used to analyze the effect of serum TNFSF14,HO-1 and APC on the prognosis of children with severe pneumonia.The restrictive cubic spline model(RCS)was used to analyze the relationship between serum TNFSF14,HO-1 and APC and the prognosis of children with severe pneumonia.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum TNFSF14,HO-1 and APC on the prognosis of children with severe pneumonia.Results The oxygen partial pressure,oxygen partial pressure/inhaled oxygen concentration and serum APC level in the poor group were lower than those in the good group,and the carbon dioxide partial pressure,positive end-expiratory pressure ventilation,serum TNFSF14 and HO-1 levels were higher than those in the good group(P＜0.01).Serum TNFSF14,HO-1 and APC were the influencing factors of poor prognosis in children with severe pneumonia(P＜0.01).Serum TNFSF14 and HO-1 were non-linearly positively correlated with poor prognosis in children with severe pneumonia,and APC level was non-linearly negatively correlated with poor prognosis in children with severe pneumonia(P＜0.01).When APC level was＜32.00 pmol/L,the risk of poor prognosis was not affected by APC level;when APC was＞32.00 pmol/L,the risk of poor prognosis decreased with the increase of APC level.The area under the ROC curve(0.909)of combined serum TNFSF14,HO-1 and APC levels in predicting the prognosis of children with severe pneumonia was higher than that of TNFSF14(0.785),HO-1(0.746)and APC(0.776)alone(P＜0.01).Conclusion Abnormal levels of serum TNFSF14,HO-1 and APC may lead to poor prognosis in children with severe pneumonia.The combined detection of each index can provide reference for clinical prediction of prognosis.关键词
重症肺炎/儿童/肿瘤坏死因子超家族成员14/血红素加氧酶-1/活化蛋白C/限制性立方样条模型/预后Key words
severe pneumonia/children/tumor necrosis factor superfamily member 14/heme oxygenase-1/activated protein C/restricted cubic spline model/prognosis引用本文复制引用
刘静,程阔菊,张旭铭,张中翠,李欣颖..血清TNFSF14、HO-1、APC对儿童重症肺炎预后的影响及预测效能分析[J].临床误诊误治,2026,39(8):73-79,7.基金项目
2023年四川省中医药管理局面上项目(2023MS275) （2023MS275）
