重症MPP患儿外周血Th1/Th2类细胞因子变化及对近期预后不良的预测分析  

Changes of Th1/Th2 cytokines in peripheral blood of children with severe MPP and its prognostic analysis for short-term poor prognosis

作　　者：李娟 颜维孝(指导) 马如海 LI Juan;YAN Weixiao;MA Ruhai(Department of Critical Care Medicine,Qinghai Women and Children's Hospital,Xining 810000,China)

机构地区：[1]青海省妇女儿童医院重症医学科,西宁810000

出　　处：《中国免疫学杂志》2023年第10期2222-2226,共5页Chinese Journal of Immunology

摘　　要：目的:探讨重症肺炎支原体肺炎(MPP)患儿外周血Th1/Th2类细胞因子变化情况及其对近期预后不良的预测价值。方法:选取2016年1月至2021年4月青海省妇女儿童医院收治的185例重症MPP患儿为观察组,另选取同期161例健康体检儿童为对照组,均行外周血Th1/Th2类细胞因子(IL-4、IL-6、IL-10、TNF-α、IFN-γ)水平检测。另根据观察组患儿入院1个月内预后情况将其分为预后良好组、预后不良组,对比两组血清各指标水平,并采用受试者工作特征(ROC)曲线分析各指标单项及联合检测对重症MPP患儿近期预后不良的预测价值。结果:观察组血清IL-4、IL-6、IL-10、TNF-α、IFN-γ水平均明显高于对照组(P<0.05);入院1个月内,185例重症MPP患儿预后不良率为28.65%(53/185),预后不良组血清IL-4、IL-6、IL-10、TNF-α、IFN-γ水平均明显高于预后良好组(P<0.05);经ROC曲线分析,血清IL-4、IL-6、IL-10、TNF-α、IFN-γ水平联合预测重症MPP患儿近期预后不良的灵敏度(96.23%)与曲线下面积(AUC=0.959)均高于各指标单独预测(均P<0.01),联合预测的特异度(80.30%)与各指标单独预测比较差异无统计学意义(P>0.05)。结论:重症MPP患儿外周血IL-4、IL-6、IL-10、TNF-α、IFN-γ水平均异常升高,且可能与重症MPP患儿近期预后不良存在一定的关系,各指标联合预测时对此类患儿近期预后不良具有良好的预测效能。Objective:To investigate the changes of Th1/Th2 cytokines in peripheral blood of children with severe mycoplasma pneumoniae pneumonia(MPP)and its predictive value for short-term poor prognosis.Methods:A total of 185 children with severe MPP admitted to Qinghai Women and Children's Hospital from January 2016 to April 2021 were selected as the observation group,and another 161 healthy children in the same period were selected as the control group,the levels of Th1/Th2 cytokines(IL-4,IL-6,IL-10,TNF-α,IFN-γ)in peripheral blood of them were detected.Then the observation group children were divided into good prognosis group and poor prognosis group according to the prognosis within one month after admission,and the levels of serum index in two groups were compared,and the predictive values of single and combined detection of each index for short-term poor prognosis in children with severe MPP were analyzed by receiver operating characteristic(ROC)curve.Results:The serum levels of IL-4,IL-6,IL-10,TNF-αand IFN-γin the observation group were significantly higher than those in the control group(P<0.05).Within one month after admission,the poor prognosis rate of 185 children with severe MPP was 28.65%(53/185),and the serum levels of IL-4,IL-6,IL-10,TNF-αand IFN-γin poor prognosis group were significantly higher than those in good prognosis group(P<0.05).By ROC curve analysis,the sensitivity(96.23%)and area under the curve(AUC=0.959)of combined prediction of serum levels pf IL-4,IL-6,IL-10,TNF-αand IFN-γfor short-term poor prognosis in children with severe MPP were higher than those of single prediction(all P<0.01),but the specificity of combined prediction(80.30%)was not significantly different from that of single prediction(P>0.05).Conclusion:The levels of IL-4,IL-6,IL-10,TNF-αand IFN-γin peripheral blood of children with severe MPP are abnormally elevated,which may have a certain relationship with the short-term poor prognosis of severe MPP children,and the combined prediction of all indexes has a good predictiv

关 键 词：重症肺炎支原体肺炎 儿童 IL-4 IL-6 IL-10 肿瘤坏死因子-α Γ-干扰素 预后 

分 类 号：R375.2[医药卫生—病原生物学]