肺炎支原体感染患儿TBIL、VCAM-1、Th17/Treg水平变化及与病情转归的关联  

Variation levels of TBIL, VCAM-1 and Th17/Treg in children with Mycoplasma pneumoniae infection and their relationship with disease outcome

作　　者：唐静[1] 刘咏梅[1] 桑艳峰 冯会颖 李涛[1] TANG Jing;LIU Yong-mei;SANG Yan-feng;FENG Hui-ying;LI Tao(Chengde Central Hospital,Chengde,Hebei 067000,China)

机构地区：[1]承德市中心医院儿科,河北承德067000

出　　处：《中华医院感染学杂志》2022年第16期2524-2528,共5页Chinese Journal of Nosocomiology

基　　金：河北省科技研究基金资助项目(201706A028);承德市科学技术研究与发展计划项目(202201A007)。

摘　　要：目的 探究肺炎支原体(MP)感染患儿总胆红素(TBIL)、血管细胞黏附分子-1(VCAM-1)、辅助型T细胞17(Th17)/调节型T细胞(Treg)水平变化及与病情转归的关联。方法 选取2019年5月-2021年4月承德市中心医院60例MP感染患儿为研究组,另选取同期60名健康体检儿童为对照组。比较两组TBIL、VCAM-1、Th17/Treg水平,分析TBIL、VCAM-1、Th17/Treg水平与MP感染患儿MP-IgM滴度的相关性,比较不同病情转归患儿临床资料、TBIL、VCAM-1、Th17/Treg水平,分析TBIL、VCAM-1、Th17/Treg水平与MP感染患儿病情转归的关系,并绘制受试者工作特征(ROC)曲线,评价TBIL、VCAM-1、Th17/Treg对MP感染患儿病情转归的预测价值。结果 研究组高、中、低MP-IgM滴度患者TBIL均低于对照组,VCAM-1、Th17/Treg水平高于对照组(P<0.05);MP感染患儿TBIL与MP-IgM滴度呈负相关关系,VCAM-1、Th17/Treg水平与MP-IgM滴度呈正相关关系(P<0.05);疗效不佳患儿TBIL均低于疗效良好患儿,VCAM-1、Th17/Treg水平高于疗效良好患儿(P<0.05);Logistic回归分析显示,TBIL、VCAM-1、Th17/Treg水平均为MP感染患儿病情转归影响因素(P<0.05);ROC曲线结果显示,TBIL、VCAM-1、Th17/Treg对MP感染患儿病情转归的预测价值的AUC分别为0.670、0.676、0.798,应用Logistic二元回归拟合,构建各指标联合预测病情转归的AUC,结果显示各指标联合的AUC为0.856。结论 MP感染患儿TBIL下降,VCAM-1、Th17/Treg升高,临床检测其水平,可用于预测患儿病情转归,指导临床治疗方案制定,有望改善患儿预后。OBJECTIVE To investigate the changes of levels of total bilirubin(TBIL), vascular cell adhesion molecule-1(VCAM-1) and Th17/Treg in children with Mycoplasma pneumoniae(MP) infection and their relationship with the outcome of the disease. METHODS 60 children with MP infection in Chengde Central Hospital from May 2019 to Apr 2021 were recruited as the observation group, and 60 children with healthy physical examination during the same period were enrolled as the control group. The levels of TBIL, VCAM-1, Th17/Treg between the two groups were compared, and the correlation between the levels of TBIL, VCAM-1 and Th17/Treg and the MP-IgM titer in children with MP infection were analyzed. The clinical data, VCAM-1 and Th17/Treg levels among patients with different outcomes were compared and their correlations with the outcome of children with MP infection were analyzed. Receiver operating characteristic(ROC) curves were used to evaluate the predictive value of TBIL, VCAM-1 and Th17/Treg in the prognosis of children with MP infection. RESULTS The TBIL level in the observation group with high, medium and low MP-IgM titers were all significantly lower in than that in the control group, while the levels of VCAM-1 and Th17/Treg were significantly higher than those in the control group(P<0.05).Correlation analysis showed that TBILwas negatively correlated with MP-IgM titer in children with MP infection, and VCAM-1, Th17/Treg levels were positively correlated with MP-IgM titer(P<0.05). The levels of TBIL in children with poor curative effect were significantly lower than those in children with good curative effect, while the levels of VCAM-1 and Th17/Treg were significantly higher than those in children with good curative effect(P< 0.05). Logistic regression analysis showed that TBIL, VCAM-1, Th17/Treg levels were all factors influencing the disease outcome in children with MP infection(P<0.05). ROC analysis showed that the AUCs of TBIL, VCAM-1 and Th17/Treg for predicting the disease outcome of children with MP infection were

关 键 词：肺炎支原体感染 病情转归 总胆红素 血管细胞黏附分子-1 辅助型T细胞17/调节型T细胞 

分 类 号：R725.6[医药卫生—儿科]