重症肺炎支原体肺炎患儿外周血细胞焦亡相关因子的表达及意义  

Expression and significance of pyroptosis-related factors in peripheral blood of children with severe Mycoplasma pneumoniae pneumonia

作　　者：王艳琼 董利利[1] 陈超辉 张磊[1] 李晓辉[1] 汤昱 WANG Yan-qiong;DONG Li-li;CHEN Chao-hui;ZHANG Lei;LI Xiao-hui;TANG Yu(Department of Respiratory,Children′s Hospital Affiliated of Zhengzhou University/Henan Children′s Hospital/Zhengzhou Children′s Hospital,Zhengzhou,Henan 450018,China)

机构地区：[1]郑州大学附属儿童医院/河南省儿童医院/郑州儿童医院呼吸科,河南郑州450018

出　　处：《临床肺科杂志》2022年第7期1055-1060,共6页Journal of Clinical Pulmonary Medicine

基　　金：2018年河南省医学科技攻关计划联合共建项目(No.2018020614)。

摘　　要：目的探讨重症肺炎支原体肺炎(SMPP)患儿外周血细胞焦亡相关因子表达水平情况,并分析其对SMPP发生的预测价值。方法选取2018年9月~2020年9月在本院接受治疗的180例肺炎支原体肺炎(MPP)患儿,其中SMPP组97例,非SMPP组83例。收集临床资料,使用实时荧光定量PCR检测外周血单个核细胞(PBMC)中核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)mRNA、半胱氨酸天冬氨酸蛋白酶-1(Caspase-1)mRNA表达水平,采用酶联免疫吸附法检测血清白细胞介素-18(IL-18)、白细胞介素-1β(IL-1β)表达水平。采用Pearson检验分析SMPP患儿细胞焦亡相关因子表达水平与发热时间、红细胞沉降率(ESR)、血清C-反应蛋白(CRP)水平的相关关系,采用多因素Logistic回归分析影响SMPP发生的危险因素,采用ROC曲线分析细胞焦亡相关因子表达水平对SMPP发生的预测价值。结果SMPP组患儿发热时间、ESR明显长于非SMPP组(P<0.05),PBMC中NLRP3 mRNA、Caspase-1 mRNA及血清中CRP、IL-18、IL-1β表达水平均明显高于非SMPP组患儿(P<0.05)。SMPP患儿PBMC中NLRP3 mRNA、Caspase-1 mRNA及血清中IL-18、IL-1β表达水平分别与发热时间、ESR、血清CRP水平呈正相关(P<0.05)。PBMC中NLRP3 mRNA、Caspase-1 mRNA及血清中IL-18、IL-1β表达水平升高是影响SMPP发生的独立危险因素(P<0.05)。PBMC中NLRP3 mRNA、Caspase-1 mRNA联合血清中IL-18、IL-1β表达水平预测SMPP发生的曲线下面积为0.937,明显高于四者单独预测,其预测敏感度为80.40%,特异度高达92.80%。结论SMPP患儿外周血细胞焦亡相关因子NLRP3 mRNA、Caspase-1 mRNA、IL-18、IL-1β表达水平升高,均可作为早期预测SMPP发生的有效指标。Objective To investigate the expression level of pyroptosis-related factors in peripheral blood cells of children with severe Mycoplasma pneumoniae pneumonia(SMPP),and to analyze its predictive value for the occurrence of SMPP.Methods A total of 180 cases of Mycoplasma pneumoniae pneumonia(MPP)who were treated in our hospital from September 2018 to September 2020 were selected,including 97 in the SMPP group and 83 in the non-SMPP group.Clinical data were collected,the mRNA levels of nucleotide binding oligomerization domain-like receptor protein 3(NLRP3)and cysteine aspartic proteinase-1(Caspase-1)in peripheral blood mononuclear cells(PBMC)were detected by real-time quantitative PCR.The serum levels of interleukin-18(IL-18)and interleukin-1β(IL-1β)were detected by enzyme-linked immunosorbent assay(ELISA).Pearson test was used to analyze the correlation between the expression level of pyroptosis-related factors and fever time,erythrocyte sedimentation rate(ESR)and serum C-reactive protein(CRP)levels in children with SMPP.Multivariate Logistic regression analysis was used to analyze the risk factors affecting the occurrence of SMPP,and the ROC curve was used to analyze the predictive value of the expression levels of pyroptosis-related factors for the occurrence of SMPP.Results The fever time and ESR in the SMPP group were significantly longer than those in the non-SMPP group(P<0.05),and the levels of NLRP3 mRNA,Caspase-1 mRNA in PBMC and the expressions of CRP,IL-18,IL-1βin serum were significantly higher than those in the non-SMPP group(P<0.05).The expression levels of NLRP3 mRNA,Caspase-1 mRNA in PBMC,and the expression levels of IL-18 and IL-1βin serum of children with SMPP were positively correlated with fever time,ESR,and serum CRP levels(P<0.05).Elevated levels of NLRP3 mRNA and Caspase-1 mRNA in PBMC,as well as the expression levels of IL-18 and IL-1βin serum,were independent risk factors for the occurrence of SMPP(P<0.05).The area under the curve of NLRP3 mRNA,Caspase-1 mRNA in PBMC combined with IL-1

关 键 词：重症肺炎支原体肺炎 细胞焦亡 核苷酸结合寡聚化结构域样受体蛋白3 

分 类 号：R725.6[医药卫生—儿科]