LAIR-1联合NEWS评分对新生儿感染性肺炎继发呼吸窘迫综合征的预测价值分析

Predictive value of LAIR-1 combined with NEWS score for respiratory distress syndrome secondary to neonatal infectious pneumonia

摘要:

目的 分析白细胞相关免疫球蛋白样受体-1（LAIR-1）联合国家早期预警评分（NEWS评分）对新生儿感染性肺炎继发呼吸窘迫综合征（RDS）的预测价值。方法 选取2022年1月—2024年12月安徽医科大学第二附属医院收治的116例新生儿感染性肺炎患儿。所有患儿在给予治疗后监测病情变化，根据是否继发RDS分为RDS组和未继发组。比较两组患儿的临床资料、NEWS评分及血清LAIR-1水平；采用多因素一般Logistic回归模型分析新生儿感染性肺炎继发RDS的影响因素；绘制受试者工作特征（ROC）曲线分析LAIR-1联合NEWS评分对新生儿感染性肺炎继发RDS的预测价值。结果 116例新生儿感染性肺炎中继发RDS的发生率为25.0%（29/116）。RDS组出生胎龄低于未继发组（P <0.05），RDS组的机械通气构成、NEWS评分、血清PCT水平、CRP水平和LAIR-1水平均高于未继发组（P <0.05）；多因素一般Logistic回归分析结果显示：机械通气［O^R =2.431（95% CI：1.025，5.768）］、出生胎龄低［O^R =0.633（95% CI：0.477，0.840）］、高NEWS评分［O^R =2.957（95% CI：1.910，4.576）］、高PCT［O^R =1.964（95% CI：1.299，2.968）］、高CRP［O^R =1.418（95% CI：1.173，1.714）］、高LAIR-1［O^R =7.695（95% CI：2.457，24.096）］均为新生儿感染性肺炎继发RDS的危险因素（P <0.05）。ROC曲线分析结果显示：LAIR-1水平、NEWS评分预测新生儿感染性肺炎继发RDS的敏感性分别为79.3%（95% CI：0.687，0.874）和81.9%（95% CI：0.744，0.885），特异性分别为87.8%（95% CI：0.796，0.951）和78.5%（95% CI：0.698，0.875）；两项联合的敏感性为95.8%（95% CI：0.897，0.997），特异性为89.7%（95% CI：0.812，0.962）。结论 LAIR-1水平、NEWS评分越高，新生儿感染性肺炎继发RDS的风险越大，且两者联合可更好地预测新生儿感染性肺炎继发RDS。

Abstract:

Objective To analyze the predictive value of leukocyte-associated immunoglobulin-like receptor-1 (LAIR-1) combined with the National Early Warning Score (NEWS) for respiratory distress syndrome (RDS) secondary to neonatal infectious pneumonia (NIP).Methods NIP patients admitted from January 2022 to December 2024 were selected. They were divided into an RDS group and a non-RDS group based on whether secondary RDS occurred. The baseline data, NEWS score, and serum LAIR-1 level were compared. Multivariate logistic regression analyzed influencing factors. The predictive value of LAIR-1 combined with NEWS was analyzed using ROC curves.Results The incidence of secondary RDS was 25.0% (29/116). The RDS group had lower gestational age, and higher rates of mechanical ventilation, NEWS score, PCT, CRP, and LAIR-1 levels than the non-RDS group (P < 0.05). Multivariate analysis showed that mechanical ventilation [O^R = 2.431 (95% CI: 1.025, 5.768) ], low gestational age [O^R = 0.633 (95% CI: 0.477, 0.840) ], high NEWS score [O^R = 2.957 (95% CI: 1.910, 4.576) ], high PCT [O^R = 1.964 (95% CI: 1.299, 2.968) ], high CRP [O^R = 1.418 (95% CI: 1.173, 1.714) ], and high LAIR-1 [O^R = 7.695 (95% CI: 2.457, 24.096) ] were risk factors for secondary RDS (P < 0.05). ROC analysis showed that the combination of LAIR-1 and NEWS had an AUC of 0.906, sensitivity of 90.91%, and specificity of 93.85% for predicting secondary RDS.Conclusion Higher levels of LAIR-1 and NEWS score are associated with a greater risk of secondary RDS in NIP, and their combination can better predict it.