支气管肺泡灌洗液中几丁质酶样蛋白YKL-40对儿童难治性肺炎支原体肺炎的预测价值  

Value of chitinase-like protein YKL-40 in bronchoalveolar lavage fluid for predicting refractory Mycoplasma pneumoniae pneumonia in children

作　　者：黄丽林[1] 黄冬平[1] 鲁灵龙[1] 黎静[1] 彭淑梅[1] HUANG Li-Lin;HUANG Dong-Ping;LU Ling-Long;LI Jing;PENG Shu-Mei(Department of Pediatrics,Guangdong Women and Children's Hospital,Guangzhou 510010,China)

机构地区：[1]广东省妇幼保健院儿科,广东广州510010

出　　处：《中国当代儿科杂志》2021年第5期471-474,共4页Chinese Journal of Contemporary Pediatrics

基　　金：国家自然科学基金青年科学基金项目(81902012)。

摘　　要：目的探讨支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)中几丁质酶样蛋白YKL-40对儿童难治性肺炎支原体肺炎(refractory Mycoplasma pneumoniae pneumonia,RMPP)的预测价值。方法50例普通型肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)和22例RMPP患儿纳入研究。比较两组患儿的临床特征、实验室检查结果、影像学表现及BALF中YKL-40水平的差异;采用受试者工作特征曲线分析BALF YKL-40对RMPP的预测价值。结果RMPP组发热、气促、肺实变及胸腔积液的发生率明显高于普通型MPP组(P<0.05),血清C-反应蛋白和乳酸脱氢酶水平明显高于普通型MPP组(P<0.05)。RMPP组BALF YKL-40水平明显高于普通型MPP组(P<0.05)。以BALF YKL-40水平绘制受试者工作特征曲线,其曲线下面积为0.750,预测RMPP的灵敏度为72.7%,特异度为64.0%。结论RMPP患儿BALF YKL-40表达水平增高;BALF YKL-40对RMPP具有一定的预测价值。Objective To evaluate the value of chitinase-like protein YKL-40 in bronchoalveolar lavage fluid(BALF)for predicting refractory Mycoplasma pneumoniae pneumonia(RMPP)in children.Methods A total of 50 children with common Mycoplasma pneumoniae pneumonia(MPP)and 22 children with RMPP were enrolled.The two groups were compared in terms of clinical features,laboratory examination results,imaging findings,and YKL-40 levels in BALF.The receiver operating characteristic(ROC)curve was used to evaluate the value of YKL-40 in BALF for predicting RMPP.Results Compared with the common MPP group,the RMPP group had significantly higher incidence rates of fever,shortness of breath,lung consolidation,and pleural effusion(P<0.05)and significantly higher serum levels of C-reactive protein and lactate dehydrogenase(P<0.05).The RMPP group had a significantly higher level of YKL-40 in BALF than the common MPP group(P<0.05).The ROC curve plotted based on the level of YKL-40 in BALF had an area under the ROC curve of 0.750,a sensitivity of 72.7%and a specificity of 64.0%for predicting RMPP.Conclusions There is an increase in the level of YKL-40 in BALF in children with RMPP,and the level of YKL-40 in BALF has a certain value for predicting RMPP.

关 键 词：难治性肺炎支原体肺炎 YKL-40 支气管肺泡灌洗液 预测价值 儿童 

分 类 号：R725.6[医药卫生—儿科]