Department of Pediatrics, Menoufia University, Shebin El Kom, Egypt
Department of Medical Biochemistry and Molecular Biology, Menoufia University, Shebin El Kom, Egypt.
BMJ Paediatr Open. 2024 Jan 3;8(1):e002395. doi: 10.1136/bmjpo-2023-002395.
Diagnosing hospital-acquired pneumonia (HAP) (ventilator-associated pneumonia (VAP) and non-ventilator associated pneumonia (Non-VAP)) is still a hot issue. Soluble urokinase plasminogen activator receptor (suPAR) is prognostic in critically ill children with sepsis regarding mortality prediction. Our aim was to evaluate suPAR levels in children with HAP.
An observational, prospective study was conducted on 45 children diagnosed HAP (VAP and Non-VAP) and 40 healthy controls. Paediatric Sequential Organ Failure assessment Score (pSOFA) was assessed for each patient. Plasma suPAR levels were measured with ELISA on the day of diagnosis.
On comparison levels of plasma suPAR for the children with HAP with the healthy control group, no statistically significant difference was observed (148 pg/mL (22.4-1939.7) and 184.4 pg/mL (31.6-1311.7), respectively, (p=0.32). suPAR was significantly increased in children with elevated pSOFA score on the day of diagnosis of pneumonia (p=0.034). suPAR was significantly increased in children with shock (p=0.005). suPAR levels was negatively correlated with oxygen saturation (rs=0.31,p=0.048). suPAR was not significantly correlated with C reactive protein.
suPAR can be used as a predictor for severity of illness in children with HAP. We firmly know that plasma suPAR, a novel marker, could indicate the disease if carried out on larger patient groups.
诊断医院获得性肺炎（HAP）（呼吸机相关性肺炎（VAP）和非呼吸机相关性肺炎（Non-VAP））仍然是一个热点问题。可溶性尿激酶型纤溶酶原激活物受体（suPAR）在脓毒症危重症儿童中对死亡率预测具有预后价值。我们的目的是评估 HAP 患儿的 suPAR 水平。
对 45 例诊断为 HAP（VAP 和 Non-VAP）的患儿和 40 例健康对照者进行了一项观察性、前瞻性研究。对每位患者进行小儿序贯器官衰竭评估评分（pSOFA）评估。在诊断当天，采用 ELISA 法测定血浆 suPAR 水平。
HAP 患儿与健康对照组的血浆 suPAR 水平比较，差异无统计学意义（分别为 148pg/mL（22.4-1939.7）和 184.4pg/mL（31.6-1311.7），p=0.32）。在肺炎诊断当天，pSOFA 评分升高的患儿 suPAR 显著升高（p=0.034）。休克患儿 suPAR 显著升高（p=0.005）。suPAR 水平与氧饱和度呈负相关（rs=0.31，p=0.048）。suPAR 与 C 反应蛋白无显著相关性。
suPAR 可作为 HAP 患儿病情严重程度的预测指标。我们坚信，如果在更大的患者群体中进行，新型标志物血浆 suPAR 可以指示疾病。
