血清Cc16、CD62E表达水平与新生儿呼吸窘迫综合征严重程度和肺部超声评分的关系

doi:10.11958/20250321

天津医药 ›› 2025, Vol. 53 ›› Issue (8): 836-839.doi: 10.11958/20250321

血清Cc16、CD62E表达水平与新生儿呼吸窘迫综合征严重程度和肺部超声评分的关系

蒋文静¹(), 郭敬肖², 耿爱桥¹^,^△()

1 衡水市妇幼保健院儿童保健科（邮编053000）
2 河北省儿童医院儿科

收稿日期:2025-01-18 修回日期:2025-05-18 出版日期:2025-08-15 发布日期:2025-08-12
通讯作者: ^△E-mail：18632839929@163.com
作者简介:蒋文静（1983），女，主治医师，主要从事新生儿呼吸窘迫综合征方面研究。E-mail：Jwj13722822912@163.com
基金资助:
河北省卫生健康委医学科研计划课题(20231142);衡水市科技计划项目(2021014046Z)

Relationship between serum Cc16 and CD62E expression levels and the severity of neonatal respiratory distress syndrome and pulmonary ultrasound scores

JIANG Wenjing¹(), GUO Jingxiao², GENG Aiqiao¹^,^△()

1 Department of Child Health Section, Hengshui Maternal and Child Health Care Hospital, Hengshui 053000, China
2 Department of Pediatrics, Hebei Children's Hospital

Received:2025-01-18 Revised:2025-05-18 Published:2025-08-15 Online:2025-08-12
Contact: ^△E-mail：18632839929@163.com

蒋文静, 郭敬肖, 耿爱桥. 血清Cc16、CD62E表达水平与新生儿呼吸窘迫综合征严重程度和肺部超声评分的关系[J]. 天津医药, 2025, 53(8): 836-839.

JIANG Wenjing, GUO Jingxiao, GENG Aiqiao. Relationship between serum Cc16 and CD62E expression levels and the severity of neonatal respiratory distress syndrome and pulmonary ultrasound scores[J]. Tianjin Medical Journal, 2025, 53(8): 836-839.

摘要/Abstract

摘要：

目的分析血清Clara细胞蛋白16（Cc16）、E-选择素（CD62E）表达水平与新生儿呼吸窘迫综合征（NRDS）严重程度和肺部超声评分的关系。方法选取200例NRDS患儿，根据氧合指数（P/F）评估其病情严重程度并将患儿分为轻症组（46例）、中度组（65例）和重症组（89例），比较3组患儿血清Cc16、CD62E表达。另依据肺部超声评分，分为低评分组（评分<12分，127例）、中评分组（评分12~24分，51例）及高评分组（评分>24分，22例）。受试者工作特征（ROC）曲线评价血清Cc16、CD62E、肺部超声评分联合检测对重症NRDS的预测效能。结果与轻症组相比，中度组、重症组患儿血清中Cc16、CD62E表达水平及肺部超声评分升高（P<0.05）。与肺部超声低评分组相比，中评分组和高评分组患儿血清Cc16、CD62E表达升高（P<0.05）。Cc16、CD62E与患儿严重程度呈正相关（r_s分别为0.679、0.680，P<0.01），同时与肺部超声评分亦呈正相关（r分别为0.692、0.685，P<0.01）。ROC曲线分析显示，Cc16、CD62E、肺部超声评分联合检测对重症NRDS的诊断价值较高（P<0.05）。结论 NRDS患儿血清Cc16、CD62E表达水平与严重程度和肺部超声评分呈正相关。

关键词: 新生儿, 呼吸窘迫综合征, E选择素, 克拉拉细胞蛋白16, 肺部超声评分

Abstract:

Objective To analyze the relationship between serum levels of Clara cell protein 16 (Cc16), E-selectin (CD62E), the severity of neonatal respiratory distress syndrome (NRDS) and lung ultrasound scores. Methods A total of 200 neonates with NRDS were selected in this study. The severity of the disease was assessed using oxygenation index (P/F). The neonates were divided into three groups: the mild group (46 cases), the moderate group (65 cases) and the severe group (89 cases). The serum levels of Cc16 and CD62E were compared between the three groups. In addition, based on the lung ultrasound scores, neonates were divided into the low-score group (score<12 points, n=127), the medium-score group (score 12-24 points, n=51) and the high-score group (score > 24 points, n=22). The receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of the combined detection of serum Cc16, CD62E and lung ultrasound score for severe NRDS. Results Compared with the mild group, the serum levels of Cc16 and CD62E, and lung ultrasound scores were higher in the moderate group and the severe group (P<0.05). Compared with the low lung ultrasound score group, the serum levels of Cc16 and CD62E were higher in the moderate lung ultrasound score group and the high lung ultrasound score groups (P<0.05). Cc16 and CD62E were positively correlated with the severity of NRDS (r_s = 0.679 and 0.680, P<0.01), and they were also positively correlated with lung ultrasound scores (r = 0.692 and 0.685, P<0.01). ROC analysis showed that the combined detection of Cc16, CD62E and lung ultrasound scores had a relatively high diagnostic value for severe NRDS (P<0.05). Conclusion The serum levels of Cc16 and CD62E in NRDS neonates are positively correlated with disease severity and lung ultrasound scores.

Key words: neonborn, respiratory distress syndrome, E-selectin, Clara cell protein 16, lung ultrasound score

中图分类号:

R742.1

图/表 6

参考文献 19

[1]	OLICKER A L, RAFFAY T M, RYAN R M. Neonatal respiratory distress secondary to meconium aspiration syndrome[J]. Children(Basel), 2021, 8(3):246. doi:10.3390/children8030246.
[2]	SILVEIRA R C, PANCERI C, MUNÕZ N P, et al. Less invasive surfactant administration versus intubation-surfactant-extubation in the treatment of neonatal respiratory distress syndrome: a systematic review and meta-analyses[J]. J Pediatr(Rio J), 2024, 100(1):8-24. doi:10.1016/j.jped.2023.05.008.
[3]	CHEN I L, CHEN H L. New developments in neonatal respiratory management[J]. Pediatr Neonatol, 2022, 63(4):341-347. doi:10.1016/j.pedneo.2022.02.002.
[4]	MWITA S, JANDE M, KATABALO D, et al. Reducing neonatal mortality and respiratory distress syndrome associated with preterm birth:a scoping review on the impact of antenatal corticosteroids in low- and middle-income countries[J]. World J Pediatr, 2021, 17(2):131-140. doi:10.1007/s12519-020-00398-6.
[5]	RÜEGGER C M, OWEN L S, DAVIS P G. Nasal intermittent positive pressure ventilation for neonatal respiratory distress syndrome[J]. Clin Perinatol, 2021, 48(4):725-744. doi:10.1016/j.clp.2021.07.004.
[6]	许欢, 许超. HFOV联合PS对NICU新生儿呼吸窘迫综合征患儿Cc16和miR-155水平的影响[J]. 中国妇幼保健, 2023, 38(12):2206-2209.
	XU H, XU C. Effects of HFOV combined with PS on the levels of Cc16 and miR-155 in neonatal respiratory distress syndrome in NICU children[J]. China Maternal and Child Health Care, 2023, 38(12):2206-2209. doi:10.19829/j.zgfybj.issn.1001-4411.2023.12.020.
[7]	莘翼翔, 刘恒, 于祯, 等. 参附注射液联合氢化可的松对重症肺炎患者CD62E、vWF水平及心功能的影响[J]. 河北医药, 2023, 45(10):1515-1518.
	XIN Y X, LIU H, YU Z, et al. Effects of Shenfu injection combined with hydrocortisone on CD62E and vWF levels and cardiac function in patients with severe pneumonia[J]. Journal of Hebei Medicine, 2023, 45(10):1515-1518. doi:10.3969/j.issn.1002-7386.2023.10.017.
[8]	中国医师协会新生儿科医师分会. “新生儿急性呼吸窘迫综合征”蒙特勒标准(2017年版)[J]. 中华实用儿科临床杂志, 2017, 32(19):1456-1458.
	Chinese Medical Doctor Association Branch of Neonatologists. Montreux standard for "acute respiratory distress syndrome of newborns" (2017 edition)[J]. Chinese Journal of Practical Pediatrics, 2017, 32(19):1456-1458. doi:10.3760/cma.j.issn.2095-428X.2017.19.004.
[9]	LIU J, COPETTI R, SORANTIN E, et al. Protocol and guidelines for point-of-care lung ultrasound in diagnosing neonatal pulmonary diseases based on international expert consensus[J]. J Vis Exp, 2019(145): e58990. doi:10.3791/58990.
[10]	LI X, GUERRA S, LEDFORD J G, et al. Low CC16 mRNA expression levels in bronchial epithelial cells are associated with asthma severity[J]. Am J Respir Crit Care Med, 2023, 207(4):438-451. doi:10.1164/rccm.202206-1230OC.
[11]	IANNUZO N, INSEL M, MARSHALL C, et al. CC16 Deficiency in the context of early-life mycoplasma pneumoniae infection results in augmented airway responses in adult mice[J]. Infect Immun, 2022, 90(2):e0054821. doi:10.1128/IAI.00548-21.
[12]	RALLIS D, BALTOGIANNI M, DERMITZAKI N, et al. Club cell protein expression amongst infants with respiratory distress syndrome[J]. Pediatr Pulmonol, 2022, 57(6):1543-1546. doi:10.1002/ppul.25897.
[13]	SHAO H, REN X, ZHANG P. Correlations of serum 1,25-hydroxy vitamin D3 level with severity and prognosis of neonatal respiratory distress syndrome[J]. Clin Lab, 2022, 68(12):2509-2516. doi:10.7754/Clin.Lab.2022.220153.
[14]	MONGODI S, DE LUCA D, COLOMBO A, et al. Quantitative lung ultrasound:technical aspects and clinical applications[J]. Anesthesiology, 2021, 134(6):949-965. doi:10.1097/ALN.0000000000003757.
[15]	ZHANG W, LI Z, PANG C, et al. The value of lung ultrasound score in assessing pulmonary complications after radical lung cancer surgery and analysis of its risk factors[J]. Minerva Pediatr(Torino), 2023, 75(4):617-619. doi:10.23736/S2724-5276.23.07239-7.
[16]	RAIMONDI F, MIGLIARO F, CORSINI I, et al. Lung ultrasound score progress in neonatal respiratory distress syndrome[J]. Pediatrics, 2021, 147(4):e2020030528. doi:10.1542/peds.2020-030528.
[17]	DION-ALBERT L, CADORET A, DONEY E, et al. Vascular and blood-brain barrier-related changes underlie stress responses and resilience in female mice and depression in human tissue[J]. Nat Commun, 2022, 13(1):164. doi:10.1038/s41467-021-27604-x.
[18]	HUANG L, YE D, WANG J. Analysis of diagnosing neonatal respiratory distress syndrome with lung ultrasound score[J]. Pak J Med Sci, 2022, 38(5):1101-1106. doi:10.12669/pjms.38.5.5202.
[19]	SZYMAŃSKI P, KRUCZEK P, HOŻEJOWSKI R, et al. Modified lung ultrasound score predicts ventilation requirements in neonatal respiratory distress syndrome[J]. BMC Pediatr, 2021, 21(1):17. doi:10.1186/s12887-020-02485-z.

组别		n	性别（男/女）		胎龄/周		出生时体质量/kg			分娩方式
组别		n	性别（男/女）		胎龄/周		出生时体质量/kg			剖宫产		自然分娩
轻症组		46	24/22		35.52±1.17		2.79±0.21			39（84.8）		7（15.2）
中度组		65	34/31		35.48±1.17		2.77±0.22			57（87.7）		8（12.3）
重症组		89	50/39		35.49±1.08		2.76±0.22			77（86.5）		12（12.5）
χ²或F			0.307		0.021		0.457			0.195
组别	1 min Apgar 评分/分			5 min Apgar 评分/分		IL-6/（ng/L）		IL-1β/（ng/L）	p（O₂）/mmHg		p（CO₂）/mmHg
轻症组	7.48±1.17			8.61±1.13		159.84±44.21		61.54±21.42	74.16±8.54		46.54±3.58
中度组	6.52±1.09^a			7.60±1.16^a		181.45±47.28^a		75.38±24.33^a	66.33±6.52^a		51.02±5.44^a
重症组	6.12±0.85^ab			6.55±1.15^ab		235.28±51.22^ab		87.51±26.12^ab	52.11±5.02^ab		58.17±6.97^ab
F	27.310^＊＊			50.959^＊＊		44.207^＊＊		17.383^＊＊	200.326^＊＊		66.400^＊＊

组别		n	性别（男/女）		胎龄/周		出生时体质量/kg			分娩方式
组别		n	性别（男/女）		胎龄/周		出生时体质量/kg			剖宫产		自然分娩
轻症组		46	24/22		35.52±1.17		2.79±0.21			39（84.8）		7（15.2）
中度组		65	34/31		35.48±1.17		2.77±0.22			57（87.7）		8（12.3）
重症组		89	50/39		35.49±1.08		2.76±0.22			77（86.5）		12（12.5）
χ²或F			0.307		0.021		0.457			0.195
组别	1 min Apgar 评分/分			5 min Apgar 评分/分		IL-6/（ng/L）		IL-1β/（ng/L）	p（O₂）/mmHg		p（CO₂）/mmHg
轻症组	7.48±1.17			8.61±1.13		159.84±44.21		61.54±21.42	74.16±8.54		46.54±3.58
中度组	6.52±1.09^a			7.60±1.16^a		181.45±47.28^a		75.38±24.33^a	66.33±6.52^a		51.02±5.44^a
重症组	6.12±0.85^ab			6.55±1.15^ab		235.28±51.22^ab		87.51±26.12^ab	52.11±5.02^ab		58.17±6.97^ab
F	27.310^＊＊			50.959^＊＊		44.207^＊＊		17.383^＊＊	200.326^＊＊		66.400^＊＊

组别	n	Cc16/（μg/L）	CD62E/（μg/L）	肺部超声评分/分
轻症组	46	40.44±5.12	19.77±8.03	8.42±1.67
中度组	65	47.51±6.22^a	43.27±12.82^a	12.42±3.55^a
重症组	89	54.41±8.04^ab	58.69±22.11^ab	16.87±5.29^ab
F		62.808^＊＊	80.527^＊＊	65.971^＊＊

组别	n	Cc16/（μg/L）	CD62E/（μg/L）	肺部超声评分/分
轻症组	46	40.44±5.12	19.77±8.03	8.42±1.67
中度组	65	47.51±6.22^a	43.27±12.82^a	12.42±3.55^a
重症组	89	54.41±8.04^ab	58.69±22.11^ab	16.87±5.29^ab
F		62.808^＊＊	80.527^＊＊	65.971^＊＊

组别	n	Cc16	CD62E
低评分组	127	41.02±5.09	28.67±9.58
中评分组	51	46.58±5.57^a	46.81±14.01^a
高评分组	22	55.73±8.19^ab	57.91±21.21^ab
F		139.575^＊＊	74.428^＊＊

血清Cc16、CD62E表达水平与新生儿呼吸窘迫综合征严重程度和肺部超声评分的关系

Relationship between serum Cc16 and CD62E expression levels and the severity of neonatal respiratory distress syndrome and pulmonary ultrasound scores

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指标	AUC（95%CI）	敏感度/ %	特异度/ %	准确度/ %	约登指数
Cc16	0.714（0.636~0.792）	77.53	68.47	72.50	0.460
CD62E	0.746（0.672~0.819）	78.65	70.27	74.00	0.489
肺部超声评分	0.725（0.642~0.807）	76.40	77.48	77.00	0.539
联合检测	0.858（0.803~0.914）	96.63	67.57	80.50	0.642

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