血清YKL-40、HMGB1和E选择素检测在小儿肺炎支原体肺炎严重程度和预后中的临床价值  

Clinical value of serum YKL-40,HMGB1 and E-selectin in the severity and prognosis of children with mycoplasma pneumonia

作　　者：宋玲妹 季翠红 SONG Lingmei;JI Cuihong(Department of Pediatrics,Shanghai Fengxian District Central Hospital,Shanghai 201400 China)

机构地区：[1]上海市奉贤区中心医院儿科,上海201400

出　　处：《检验医学与临床》2023年第3期353-357,共5页Laboratory Medicine and Clinic

摘　　要：目的评估血清人软骨糖蛋白40(YKL-40)、高迁移率族蛋白1(HMGB1)和E选择素检测在小儿肺炎支原体肺炎严重程度和预后中的临床价值。方法选择2018年1月至2020年3月在该院诊治的小儿肺炎支原体肺炎患儿238例作为肺炎支原体感染组。选择同期该院健康体检儿童60例作为健康对照组。比较肺炎支原体感染组和健康对照组的血清YKL-40、HMGB1和E选择素水平,采用单因素和多因素Logistic回归分析肺炎支原体肺炎患儿发生预后不良的危险因素,观察血清YKL-40、HMGB1和E选择素水平与肺炎支原体肺炎严重程度的关系及预测预后不良的效能。结果肺炎支原体感染组血清YKL-40、HMGB1和E选择素水平明显高于健康对照组(P<0.05),并随着肺炎支原体肺炎严重程度升高而升高(P<0.05)。肺炎支原体肺炎患儿预后不良组的胸腔积液者占比、疗程≥7 d者占比、白细胞计数、抗菌药物使用时间、血清YKL-40、HMGB1和E选择素水平明显高于预后良好组(P<0.05),而性别、年龄和CRP水平差异无统计学意义(P>0.05)。多因素分析发现血清YKL-40、HMGB1和E选择素水平升高是肺炎支原体肺炎预后的独立危险因素(P<0.05)。血清YKL-40、HMGB1和E选择素水平对预测肺炎支原体肺炎发生预后不良具有较高的效能。三者联合检测的灵敏度为97.6%,特异度为90.9%,曲线下面积为0.783,明显高于YKL-40、HMGB1和E选择素单独检测(Z=3.254、3.426、4.657,P<0.05)。结论血清YKL-40、HMGB1和E选择素水平是反映肺炎支原体肺炎严重程度的指标,联合检测对预测肺炎支原体肺炎发生预后不良具有较高的效能。Objective To evaluate the clinical value of serum human cartilage glycoprotein 40(YKL-40),high mobility group box 1(HMGB1)and E-selectin levels in the severity and prognosis of children with mycoplasma pneumonia.Methods Totally 238 children with mycoplasma pneumonia diagnosed and treated in Shanghai Fengxian District Central Hospital from January 2018 to March 2020 were selected as the mycoplasma infection group,and 60 healthy children who received physical examination in the hospital during the same period were selected as the healthy control group.The serum YKL-40,HMGB1 and E-selectin levels were compared between the mycoplasma pneumonia group and the healthy control group,the risk factor of poor prognosis of mycoplasma pneumonia was performed by the univariate and multivariate Logistic analysis,while the relationship between serum YKL-40,HMGB1 and E-selectin levels and the severity of mycoplasma pneumonia,and their efficacy in predicting poor prognosis were also observed.Results The serum levels of YKL-40,HMGB1 and E-selectin in the mycoplasma infection group were significantly higher than those in the healthy control group(P<0.05),and they increased with the severity of mycoplasma pneumonia(P<0.05).The proportion of patients with pleural effusion,proportion of patients with course of treatment no less than 7 days,white blood cell count,antibiotic use time,YKL-40,HMGB1 and E-selectin levels in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05),but there was no statistically significant difference in the gender,age and CRP level between the two groups(P>0.05).The multivariate analysis found that the increases of serum YKL-40,HMGB1 and E-selectin levels were independent risk factors for the prognosis of mycoplasma pneumonia(P<0.05).The serum levels of YKL-40,HMGB1 and E-selectin had high efficacy in predicting poor prognosis of mycoplasma pneumonia.The sensitivity of the combined detection was 97.6%,the specificity was 90.9%,and the AUC was 0.783,which was significa

关 键 词：人软骨糖蛋白40 高迁移率族蛋白1 E选择素 肺炎支原体肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]