RMPP患儿血清IL-17A、RANTES、GM-CSF水平变化及临床意义  

Changes and clinical significance of serum IL⁃17A,RANTES and GM⁃CSF in children with RMPP

作　　者：尹莉 张丽 商树芹 YIN Li;ZHANG Li;SHANG Shuqin(Departmet of Supply Room,Xingtai General Hospital of North China Medical and Health Group,Xingtai,Hebei,China,054000;Department of Pediatrics,Xingtai General Hospital of North China Medical and Health Group,Xingtai,Hebei,China,054000)

机构地区：[1]华北医疗健康集团邢台总医院供应室,河北邢台054000 [2]华北医疗健康集团邢台总医院儿科,河北邢台054000

出　　处：《分子诊断与治疗杂志》2024年第4期760-764,共5页Journal of Molecular Diagnostics and Therapy

基　　金：邢台市科技计划项目(2019ZC121)。

摘　　要：目的探讨难治性肺炎支原体肺炎(RMPP)患儿血清白细胞介素-17A(IL-17A)、受激活调节正常T细胞表达和分泌因子(RANTES)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)水平变化及临床意义。方法选取华北医疗健康集团邢台总医院2019年12月至2021年12月162例RMPP患儿作为研究组,另取同期120例普通肺炎支原体肺炎(GMPP)患儿作为对照组。收集两组一般资料,检测并比较两组血清IL-17A、RANTES、GM-CSF水平,采用受试者工作特征曲线(ROC)分析血清IL-17A、RANTES、GM-CSF水平对RMPP患儿的诊断价值,采用单因素及多因素Logistic模型分析影响RMPP的因素。结果研究组肺不张、肺实变、胸腔积液占比、FEV1、FVC、CRP及D-D均高于对照组,差异有统计学意义(P<0.05);研究组血清IL-17A、RANTES、GM-CSF水平均高于对照组,差异有统计学意义(P<0.05);Pearson相关性分析显示,RMMP患儿FEV1、FVC均与血清IL-17A、RANTES、GM-CSF水平呈负相关(P<0.05);Pearson相关性分析显示,RMMP患儿血清IL-17A与RANTES、GM-CSF呈正相关,RANTES与GM-CSF呈正相关(P<0.05);ROC曲线显示,血清IL-17A、RANTES、GM-CSF水平联合诊断RMPP患儿的AUC为0.906,显著高于各自单独诊断的0.785、0.752和0.765(P<0.05);Logistic模型分析显示,存在肺不张(OR=2.052,P<0.001)、存在肺实变(OR=2.591)、存在胸腔积液(OR=2.309)、血清IL-17A≥10.77 pg/mL(OR=1.984)、RANTES≥32.95μg/L(OR=1.833,P<0.001)、GM-CSF10.58μg/L(OR=1.902)均为影响RMPP的独立危险因素。结论IL-17A、RANTES、GM-CSF在RMPP患儿血清中呈高表达,三指标联合检测的诊断效能较高,可为临床尽早诊断、尽早干预RMPP提供一定的帮助。Objective To explore the changes and clinical significance of serum interleukin⁃17A(IL⁃17A),regulated upon activation normal T cell expressed and secreted(RANTES)and granulocyte⁃macro⁃phage colony⁃stimulating factor(GM⁃CSF)in children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods A total of 162 children with RMPP and 120 children with general Mycoplasma pneumoni⁃ae pneumonia(GMPP)were enrolled as study group and control group between at Xingtai General Hospital of North China Medical and Health Group from December 2019 to December 2021.General data from both groups were collected.The levels of serum IL⁃17A,RANTES and GM⁃CSF were detected and compared between the two groups.Their diagnostic value for children with RMPP was analyzed using receiver operating characteristic(ROC)curves.The influencing factors of RMPP were analyzed using univariate and multivariate logistic model analysis.Results The proportions of atelectasis,lung consolidation and pleural effusion,FEV1,FVC,CRP and D⁃D in the study group were higher than those in the control group(P<0.05),and levels of serum IL⁃17A,RANTES and GM⁃CSF were also higher than those in the control group(P<0.05).Pearson correlation analysis showed that FEV1 and FVC were negatively correlated with serum IL⁃17A,RANTES and GM⁃CSF in RMMP children(P<0.05).Furthermore,serum IL⁃17A was positively correlated with RANTES and GM⁃CSF,and RAN⁃TES was also positively correlated with GM⁃CSF(P<0.05).ROC curve analysis showed that the AUC of serum IL⁃17A combined with RANTES and GM⁃CSF in the diagnosis of RMPP was 0.906,significantly higher than that of any single indicator(0.785,0.752,0.765).Logistic model analysis showed that atelectasis(OR=2.052),lung consolidation(OR=2.591,P=0.002),pleural effusion(OR=2.309,P=0.001),serum IL⁃17A≥10.77 pg/mL(OR=1.984,P<0.001),RANTES≥32.95μg/L(OR=1.833)and GM⁃CSF≥10.58μg/L(OR=1.902)were in⁃dependent risk factors for RMPP.Conclusion The levels of serum IL⁃17A,RANTES and GM⁃CSF are i

关 键 词：难治性肺炎支原体肺炎 白细胞介素-17A 受激活调节正常T细胞表达和分泌因子 粒细胞-巨噬细胞集落刺激因子 

分 类 号：R725.6[医药卫生—儿科]