血清sB7-H3、LTB4对急性牙髓炎患儿根管治疗期间急症发生的预测价值OA
Predictive value of serum sB7-H3 and LTB4 for endodontic interappointment emergencies in children with acute pulpitis
目的:探讨可溶性B7同源体3(sB7-H3)、白三烯B4(LTB4)水平在急性牙髓炎患儿血清中的变化,以及二者对根管治疗期间急症(EIAE)发生的预测价值.方法:选取急性牙髓炎患儿100例作为急性牙髓炎组,另选取同期体检的健康儿童96例作为健康组.行根管治疗后,根据视觉模拟评分法(VAS)评估患儿疼痛情况;根据EIAE发生情况将患儿分为无EIAE组(76例)和EIAE组(24例).使用酶联免疫试剂盒检测血清sB7-H3、LTB4水平.采用Spearman法分析血清sB7-H3、LTB4水平与患儿VAS评分的相关性.采用受试者工作特征(ROC)曲线分析血清sB7-H3、LTB4对急性牙髓炎患儿EIAE发生的预测价值.采用决策曲线分析(DCA)评估血清sB7-H3、LTB4联合预测急性牙髓炎患儿EIAE发生风险的临床实用性.结果:急性牙髓炎组患儿血清sB7-H3、LTB4水平高于健康组(均P＜0.05).EIAE组患儿根尖X线有阴影比例、炎症消退时间及血清sB7-H3、LTB4水平高于无EIAE组(均P＜0.05).与血清sB7-H3、LTB4低水平比较,高水平患儿VAS评分较高(均P＜0.05).血清sB7-H3、LTB4水平与VAS评分呈正相关(均P＜0.05).血清sB7-H3、LTB4单独预测急性牙髓炎患儿EIAE发生的曲线下面积(AUC)分别为0.805、0.842,二者联合预测急性牙髓炎患儿EIAE发生的AUC为0.915,高于单独预测(均P＜0.05).当高风险阈值为0.08～0.97时,血清sB7-H3联合LTB4预测急性牙髓炎患儿EIAE发生风险的净获益率优于两者单独预测.结论:急性牙髓炎患儿血清sB7-H3、LTB4水平升高,与VAS评分有关,二者联合对患儿EIAE发生的预测价值较高.
Objective:To investigate the changes in serum levels of soluble B7-homolog 3(sB7-H3)and leukot-riene B4(LTB4)in children with acute pulpitis,and to evaluate their predictive value for endodontic interappoint-ment emergencies(EIAE).Methods:A total of 100 children with acute pulpitis were enrolled as the acute pulpitis group,and 96 healthy children were selected as the healthy control group.After root canal therapy,pain was evalua-ted using the Visual Analogue Scale(VAS).According to the occurrence of EIAE,the children were divided into a non-EIAE group(76 cases)and an EIAE group(24 cases).Serum levels of sB7-H3 and LTB4 were detected by en-zyme-linked immunosorbent assay kits.Spearman correlation analysis was used to assess the correlation between ser-um sB7-H3 and LTB4 levels and VAS scores.ROC curve analysis was performed to evaluate the predictive value of serum sB7-H3 and LTB4 for EIAE in children with acute pulpitis.DCA was applied to assess the clinical utility of the combined detection of serum sB7-H3 and LTB4 in predicting the risk of EIAE.Results:Serum levels of sB7-H3 and LTB4 in the acute pulpitis group were significantly higher than those in the healthy control group(all P＜0.05).The proportion of apical radiolucency on X-ray,duration of inflammation regression,and serum levels of sB7-H3 and LTB4 in the EIAE group were significantly higher than those in the non-EIAE group(all P＜0.05).Children with high serum levels of sB7-H3 and LTB4 had higher VAS scores than those with low levels(all P＜0.05).Serum sB7-H3 and LTB4 levels were positively correlated with VAS scores(all P＜0.05).The AUC of serum sB7-H3 and LTB4 alone for predicting EIAE was 0.805 and 0.842,respectively,and the combined AUC was 0.915,which was signifi-cantly higher than that of single detection(all P＜0.05).When the high-risk threshold ranged from 0.08 to 0.97,the net benefit rate of the combined prediction of EIAE risk by serum sB7-H3 and LTB4 was superior to that of single prediction.Conclusion:Serum levels of sB7-H3 and LTB4 are elevated in children with acute pulpitis and are associat-ed with VAS scores.The combination of sB7-H3 and LTB4 shows high predictive value for EIAE in these children.
陈锦;李梦
荆门市人民医院荆楚理工学院附属荆门市人民医院口腔科,湖北荆门 448000荆门市人民医院荆楚理工学院附属荆门市人民医院口腔科,湖北荆门 448000
医药卫生
急性牙髓炎可溶性B7同源体3白三烯B4根管治疗期间急症预测价值
Acute pulpitisSoluble B7-homolog 3Leukotriene B4Endodontic interappointment emergenciesPredictive value
《陕西医学杂志》 2026 (5)
628-632,638,6
湖北省卫生健康委员会卫生健康科研立项项目(WJ2021F080)
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