重症肺炎支原体肺炎患儿血清sCD163、NLRP3、IL-37的检测及其临床意义  

Detection and clinical significance of serum sCD163,NLRP3,and IL-37 in children with severe pneumonia caused by Mycoplasma pneumoniae pneumonia

作　　者：张大新 吴凯利 付晨 张玉文 ZHANG Da-xin;WU Kai-li;FU Chen;ZHANG Yu-wen(Department of Pediatrics,the Fourth People's Hospital of Shangqiu,Shangqiu 476000,Henan,CHINA;Department of Medical Affairs,the Fourth People's Hospital of Shangqiu,Shangqiu 476000,Henan,CHINA)

机构地区：[1]商丘市第四人民医院儿科,河南商丘476000 [2]商丘市第四人民医院医务科,河南商丘476000

出　　处：《海南医学》2024年第9期1307-1311,共5页Hainan Medical Journal

基　　金：2021年河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20210619)。

摘　　要：目的检测重症肺炎支原体肺炎(MPP)患儿血清可溶性血红蛋白清道夫受体s(sCD163)、NOD样受体蛋白3(NLRP3)、白细胞介素(IL)-37水平并探讨其临床意义。方法选取2021年1月至2023年6月商丘市第四人民医院收治的112例重症MPP患儿作为重症MPP组,另选取同期收治的112例轻症MPP患儿作为轻症MPP组。比较两组患儿的血清sCD163、NLRP3、IL-37水平,以及不同临床表现重症MPP患儿和不同预后患儿的血清sCD163、NLRP3、IL-37水平。采用Spearman相关性分析血清sCD163、NLRP3、IL-37水平与重症MPP患儿预后的关系,绘制受试者工作特征曲线(ROC)评价血清sCD163、NLRP3、IL-37水平对重症MPP患儿预后的预测价值。结果重症MPP组患儿的血清sCD163、NLRP3、IL-37分别为(157.16±45.19)pg/mL、(12.96±3.41)μg/mL、(102.49±30.25)pg/mL,明显高于轻症MPP组的(114.83±37.39)pg/mL、(7.45±2.17)μg/mL、(67.42±24.83)pg/mL,差异均有统计学意义(P<0.05);有肺实变、肺不张、胸腔积液及肺外并发症患儿的血清sCD163、NLRP3、IL-37水平均分别高于无肺实变、肺不张、胸腔积液及肺外并发症患儿,差异均有统计学意义(P<0.05);治疗1个月后,重症MPP患儿中35例预后不良,77例预后良好,预后不良患儿的血清sCD163、NLRP3、IL-37分别为(194.33±58.63)pg/mL、(18.47±6.11)μg/mL、(124.83±30.45)pg/mL,明显高于预后良好患儿的(140.26±40.25)pg/mL、(10.46±3.27)μg/mL、(92.34±25.34)pg/mL,差异均有统计学意义(P<0.05);经Spearman相关性分析结果显示,血清sCD163、NLRP3、IL-37水平与重症MPP患儿预后呈正相关(P<0.05);经ROC分析结果显示,血清sCD163、NLRP3、IL-37水平预测重症MPP患儿预后不良的曲线下面积(AUC)值分别为0.796、0.765、0.737,三者联合预测预后不良的AUC值为0.923,明显高于各指标单独预测,敏感度、特异度分别为88.57%、83.12%。结论重症MPP患儿血清sCD163、NLRP3、IL-37水平升高与预后不良密切相关,三者联合有望成Objective To detect the levels of soluble hemoglobin scavenger receptor CD163(sCD163),NOD like receptor protein 3(NLRP3),interleukin-37(IL-37)in the serum of children with severe Mycoplasma pneumoniae pneumonia(MPP)and explore their clinical significance.Methods A total of 112 children with severe MPP admitted to the Fourth People's Hospital of Shangqiu from January 2021 to June 2023 were selected as the severe MPP group,and another 112 children with mild MPP admitted to the hospital during the same period were selected as the mild MPP group.The levels of serum sCD163,NLRP3,and IL-37 in the two groups of children were compared,as well as the levels of serum sCD163,NLRP3,and IL-37 in children with severe MPP with different clinical manifestations and children with different prognoses.Spearman correlation analysis was used to evaluate the relationship between the levels of serum sCD163,NLRP3,and IL-37 and the prognosis of children with severe MPP.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum sCD163,NLRP3,and IL-37 levels for the prognosis of children with severe MPP.Results The serum levels of sCD163,NLRP3,and IL-37 in children with severe MPP were(157.16±45.19)pg/mL,(12.96±3.41)μg/mL,and(102.49±30.25)pg/mL,respectively,which were significantly higher than(114.83±37.39)pg/mL,(7.45±2.17)μg/mL,and(67.42±24.83)pg/mL in children with mild MPP(P<0.05).The serum levels of sCD163,NLRP3,and IL-37 in children with pulmonary consolidation,atelectasis,pleural effusion,and extrapulmonary complications were significantly higher than those in children without pulmonary consolidation,atelectasis,pleural effusion,and extrapulmonary complications(P<0.05).At one month after treatment,35 children with severe MPP had a poor prognosis and 77 had a good prognosis;the serum levels of sCD163,NLRP3,and IL-37 in children with poor prognosis were(194.33±58.63)pg/mL,(18.47±6.11)μg/mL,and(124.83±30.45)pg/mL,respectively,which were significantly higher than(140.26±40.25)pg/mL,(10.46�

关 键 词：肺炎支原体肺炎 可溶性血红蛋白清道夫受体s NOD样受体蛋白3 白细胞介素-37 病情程度 预后 

分 类 号：R725.5[医药卫生—儿科]