急性呼吸窘迫综合征患儿血清ELK1、RUNX1水平与病情严重程度及预后的关系OA

Objective To investigate the relationship between the levels of serum erythroblast transforma-tion-specific transcription factor-like gene 1(ELK1)and Runt-related transcription factor 1(RUNX1)in chil-dren with acute respiratory distress syndrome(ARDS)and the severity of the disease and prognosis.Methods A total of 205 children with ARDS admitted to the hospital from January 2021 to January 2023 were selected as the ARDS group,and 112 healthy children who underwent physical examination at the the hospital during the same period were selected as the control group.The children with ARDS were divided into mild ARDS group(53 cases),moderate ARDS group(83 cases)and severe ARDS group(69 cases)according to the severity of the disease.The children with ARDS were divided into poor prognosis group and good progno-sis group according to whether death occurred within 28 d after admission.Serum ELK1 and RUNX1 levels were detected by enzyme-linked immunosorbent assay.Spearman correlation analysis was used to analyze the correlation between serum ELK1 and RUNX1 levels and the severity of the disease in children with ARDS.Multivariable Logistic regression analysis was used to analyze the influencing factors of poor prognosis in chil-dren with ARDS.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum ELK1 and RUNX1 for poor prognosis in children with ARDS.Results The serum ELK1 level in the ARDS group was higher than that in the control group,and the serum RUNX1 level in the ARDS group was lower than that in the control group,and the differences were statistically significant(P<0.05).The serum ELK1 level in the severe ARDS group was higher than that in the mild ARDS group and the moderate ARDS group,and that in the moderate ARDS group was higher than that in the mild ARDS group,and the differ-ences were statistically significant(P<0.05).The serum RUNX1 level in the severe ARDS group was lower than that in the mild ARDS group and the moderate ARDS group,and that in the moderate ARDS group was lower than that in the mild ARDS group,and the differences were statistically significant(P<0.05).Spearman correlation analysis showed that the serum ELK1 level in children with ARDS was positively corre-lated with the severity of the disease(rs=0.797,P<0.001),and the serum RUNX1 level was negatively cor-related with the severity of the disease(rs=-0.783,P<0.001).The end-expiratory positive pressure and serum ELK1 level in the poor prognosis group were higher than those in the good prognosis group,and the ox-ygenation index,albumin,RUNX1 level were lower than those in the good prognosis group,and the differences were statistically significant(P<0.05).Multivariable Logistic regression analysis showed that the elevated oxygenation index,albumin,and RUNX1 level were protective factors for poor prognosis in children with ARDS(P<0.05),and the elevated serum ELK1 level was a risk factor for poor prognosis in children with ARDS(P<0.05).The ROC curve analysis showed that the area under the curve(AUC)of serum ELK1 and RUNX1 combined for predicting poor prognosis in children with ARDS was 0.875,which was larger than the AUC of serum ELK1 and RUNX1 alone(Z=3.215,3.376,P=0.001,0.001).Conclusion The serum ELK1 level is elevated and the serum RUNX1 level is decreased in children with ARDS,and the levels of both are re-lated to the severity of the disease and prognosis.The combined detection of serum ELK1 and RUNX1 has a high predictive value for poor prognosis in children with ARDS.