腺病毒肺炎儿童血清Presepsin、Ang-2水平及对闭塞性细支气管炎的预测价值OA

Objective To investigate the serum levels of soluble CD 14 subtype(Presepsin)and angiopoietin-2(Ang-2)in children with adenovirus pneumonia(AP)and to evaluate their predictive value for the development of bron-chiolitis obliterans(BO).Methods A total of 158 children diagnosed with AP between May 2023 and July 2024 were enrolled(AP group).According to the occurrence of BO during the recovery period,patients were divided into a BO group(n=52)and a non-BO group(n=106).Meanwhile,158 age-matched healthy children undergoing physical examinations were included as the control group.Clinical data were collected for all participants.Serum Presepsin and Ang-2 levels were measured using enzyme-linked immunosorbent assay(ELISA).Multivariate logistic regression anal-ysis was performed to identify independent risk factors for BO.Receiver operating characteristic(ROC)curve analysis and clinical decision curve analysis(DCA)were used to assess the predictive performance of Presepsin,Ang-2,and their combination.Results Serum Presepsin and Ang-2 levels in the AP group were significantly higher than those in the control group(P＜0.05).Children in the BO group showed markedly higher levels of Presepsin and Ang-2 compared with the non-BO group(P＜0.05).The proportions of intensive care unit(ICU)admission and mechanical ventilation,as well as levels of procalcitonin(PCT)and C-reactive protein(CRP),were significantly higher in the BO group,whereas age and serum albumin(ALB)levels were significantly lower(P＜0.05).Multivariate logistic regression identi-fied ICU admission,mechanical ventilation,elevated PCT,CRP,Presepsin,and Ang-2 levels as independent risk fac-tors for BO,while higher age and ALB levels were protective factors(P＜0.05).The area under the ROC curve(AUC)for predicting BO was 0.734 for Presepsin,0.752 for Ang-2,and 0.839 for their combination(95％CI:0.688-0.809,0.677-0.817,and 0.772-0.893,respectively).The combined model demonstrated significantly better predic-tive performance than either biomarker alone(P＜0.05).Decision curve analysis showed favorable clinical net benefit across a predicted probability range of 8％-92％.Conclusion Serum Presepsin and Ang-2 levels are significantly ele-vated in children with adenovirus pneumonia and are closely associated with the occurrence of bronchiolitis obliterans.Combined detection of Presepsin and Ang-2 provides superior predictive value compared with either biomarker alone and may serve as an effective early prediction tool for BO in pediatric AP patients.