MP P患儿血浆sB7-H3水平与疾病严重程度及临床和影像学特征的关系  

Relationship between plasma sB7-H3 and disease severity,clinical and chest radiographic characteristics in MP P children

作　　者：董磊 曹凤侠 郁智慧 DONG Lei;CAO Fengxia;YU Zhihui(Department of Pediatrics,Jieshou People's Hospital,Jieshou 236500,China)

机构地区：[1]界首市人民医院儿科,安徽界首236500

出　　处：《东南大学学报（医学版）》2023年第3期369-376,共8页Journal of Southeast University(Medical Science Edition)

基　　金：安徽省卫生健康委科研项目(FY2020-105)。

摘　　要：目的:分析肺炎支原体肺炎(MP P)患儿血浆可溶性B7-H3(sB7-H3)水平与疾病严重程度及临床和影像学特征的关系。方法:收集2018年1月至2022年6月在我院诊断为MP P的14岁以下住院儿童共382例,采集入院后24 h内的外周血样本。同时选择200例在我院接受择期手术的无任何感染证据的儿童作为对照组。采用酶联免疫吸附试验法检测血浆sB7-H3和细胞炎症因子水平。分析MP P患儿的临床特征和胸片影像学表现。结果:与对照组相比,MP P患儿基线血浆sB7-H3水平显著升高(P<0.001),且重度MP P患儿基线血浆sB7-H3水平显著高于轻度MP P患儿(P<0.001)。血浆sB7-H3高水平亚组患儿咳痰、低氧血症、心动过速、肺部湿啰音、肺外表现、胸腔积液等临床症状和体征更常见,且白细胞计数、血小板计数、C反应蛋白水平更高(P<0.05)。经多因素Logistic回归分析,基线血浆sB7-H3水平升高是重度MP P的独立危险因素(P<0.05)。经受试者工作特征曲线分析,基线血浆sB7-H3(AUC:0.855)水平对于区分轻度MP P和重度MP P患儿有良好的价值。此外,经Spearman相关性分析,MP P患儿基线血浆sB7-H3水平与发热持续时长,抗生素使用时长,住院时长,炎症细胞因子γ-干扰素、白细胞介素-17、粒细胞-巨噬细胞集落刺激因子均呈正相关(P<0.001)。实变亚组患儿基线血浆sB7-H3水平显著高于非实变亚组(P<0.001)。结论:MP P患儿基线血浆sB7-H3水平普遍升高,高sB7-H3水平预示着机体炎症反应更严重,肺叶或节段性实变可能性更高,sB7-H3可作为区分重度MP P和轻度MP P的有价值的生物标志物。Objective:To analyze the relationship between serum soluble B7-H3(sB7-H3)and disease severity,clinical and imaging characteristics in children with Mycoplasma pneumoniae pneumonia(MP P).Methods:A total of 382 hospitalized children under 14 years old diagnosed with MP P in our hospital from January 2018 to June 2022 were collected,and peripheral blood samples were collected within 24 hours after admission.At the same time,200 children who received elective surgery in our hospital without any evidence of infection were selected as the control group.Plasma of sB7-H3 level and inflammatory cytokines were detected by enzyme linked immunosorbent assay.The clinical features and chest radiographic findings of children with MP P were analyzed.Results:Compared with the control group,the baseline plasma sB7-H3 level in children with MP P was significantly increased(P<0.001),and the baseline plasma sB7-H3 level in children with severe MP P was significantly higher than that in children with mild MP P(P<0.001).Sputum,hypoxemia,tachycardia,pulmonary rurgis,extrapulmonary manifestations,pleural effusion and other clinical symptoms were more common in the subgroup with high level of sB7-H3,and the levels of white blood cell count,platelet count and C-reactive protein were higher(P<0.05).Multivariate Logistic regression analysis showed that elevated baseline plasma sB7-H3 level was an independent risk factor for severe MP P(P<0.05).According the receiver operating characteristic,baseline plasma sB7-H3(AUC:0.855)was of good value in differentiating mild MP P from severe MP P.In addition,Spearman correlation analysis showed that the baseline plasma sB7-H3 level of MP P children were positively correlated with the duration of fever,duration of antibiotic use,length of hospital stay,inflammatory cytokineγ-interferon,interleukin-17 and granulocytemacrophage colony-stimulating factors(P<0.001).The baseline plasma sB7-H3 level in the consolidation subgroup was significantly higher than that in the non-consolidation subgroup(P<0.001).Co

关 键 词：肺炎支原体肺炎 可溶性B7-H3 疾病严重程度 临床特征 胸部X线检查结果 儿童 

分 类 号：R563.1[医药卫生—呼吸系统] R725.6[医药卫生—内科学]