IL-6、PCT及补体水平与肺炎支原体肺炎患儿病情严重程度的相关性及对预后的预测价值  

Correlation between IL-6,PCT and complement levels and severity of Mycoplasma pneumoniae pneumonia in children and their predictive value for prognosis

作　　者：郭旭伟[1] 张利果 冯毅[1] GUO Xuwei;ZHANG Liguo;FENG Yi(Department of Pediatrics,the First Affiliated Hospital of Henan University of Science and Technology,Luoy-ang,Henan,China,471000)

机构地区：[1]河南科技大学第一附属医院儿科,河南洛阳471000

出　　处：《分子诊断与治疗杂志》2023年第1期99-102,106,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200587)。

摘　　要：目的 探讨IL-6、PCT及补体水平与肺炎支原体肺炎(MPP)患儿病情严重程度的相关性及对预后的预测价值。方法 选取2019年1月至2021年12月河南科技大学第一附属医院就诊的72例MPP患儿,按照疾病严重程度分为普通MPP组(n=39)和重症MPP组(n=33)。另选取同期于本院健康查体并取得正常结果的健康儿童72名作为对照组。全部MPP患儿根据治疗1个疗程后的效果分为预后良好组(n=58)和预后不良组(n=14)。比较普通MPP组、重症MPP组以及对照组患儿的IL-6、PCT及补体(C3、C4)水平,比较预后良好组和预后不良组的IL-6、PCT及C3、C4水平,采用多因素Logistic回归分析MPP患儿预后不良的独立影响因素,并分析IL-6、PCT及C3、C4水平单独和联合检测预测MPP患儿预后的价值。结果 各组IL-6、PCT、C3、C4水平比较:重症MPP组>普通MPP组>对照组,差异有统计学意义(F=594.700、163.863、415.438、70.751,P<0.05)。Spearman相关性分析显示,IL-6、PCT、C3、C4与MPP患儿的病情严重程度呈正比(r=0.741、0.645、0.691、0.677,P均<0.05)。预后不良组的IL-6、PCT、C3、C4显著高于预后良好组,差异有统计学意义(t=27.991、8.155、11.101、6.264,P<0.05)。多因素Logistic回归分析结果显示,IL-6、PCT、C3及C4均为MPP患儿预后不良的独立危险因素(P<0.05),IL-6、PCT、C3及C4联合检测预测MPP患儿预后的曲线下面积为0.901、灵敏度为87.72%、特异度为90.18%,均高于IL-6、PCT及C3、C4单独检测。结论 IL-6、PCT、C3、C4与MPP患儿病情轻重呈正相关,IL-6、PCT及C3、C4联合检测对MPP患儿的预后评估具有一定的临床应用价值。Objective To investigate the correlation between the levels of IL-6,PCT and complement and the severity of the disease in children with Mycoplasma pneumoniae pneumonia(MPP)and their predictive value for prognosis. Methods A total of 72 children with MPP who visited the First Affiliated Hospital of Henan University of Science and Technology from January 2019 to December 2021 were selected and divided into the ordinary MPP group(n=39)and the severe MPP group(n=33)according to the severity of the disease. Another 72 healthy children who received normal physical check-up in our hospital during the same period were selected as the control group. All MPP children were divided into a good prognosis group(n=58)and a poor prognosis group(n=14)according to the effect of one course of treatment. The levels of IL-6,PCT and complement(C3,C4)of children in the normal MPP group,the severe MPP group and the control group were compared,and the levels of IL-6,PCT,C3 and C4 in the good prognosis group and the poor prognosis group were compared. Factor Logistic regression was used to analyze the independent influencing factors of poor prognosis in children with MPP,and the value of IL-6,PCT,C3,C4 levels alone and combined detection in predicting the prognosis of children with MPP was analyzed. Results Comparison of IL-6,PCT,C3,and C4 levels in each group:severe MPP group > common MPP group > control group(F=594.700,163.863,415.438,70.751,P<0.05). Spearman correlation analysis showed that IL-6,PCT,C3,C4 were proportional to the severity of MPP in children(r=0.741,0.645,0.691,0.677,P<0.05). The levels of IL-6,PCT,C3,and C4 in the poor prognosis group were significantly higher than those in the good prognosis group(t=27.991、8.155、11.101、6.264,P<0.05). The results of multivariate Logistic regression analysis showed that IL-6,PCT,C3 and C4 were all independent risk factors for poor prognosis in children with MPP(P<0.05). The combined detection of IL-6,PCT,C3 and C4 predicted the prognosis of children with MPP. The area under the cu

关 键 词：肺炎支原体肺炎 白细胞介素-6 降钙素原 补体水平 

分 类 号：R725.6[医药卫生—儿科]