钙卫蛋白S100A8/A9对肺炎支原体肺炎儿童高凝状态的诊断价值及其加重内皮细胞功能紊乱的机制探讨  

Exploration on the diagnostic value of S100 calcium⁃binding protein A8/A9 in hypercoagulation state of children with Mycoplasma pneumoniae pneumonia and its mechanism in exacerbating endothelial cell dysfunction

作　　者：徐露 彭力[1] 周佩 奉秀琴 Duane Wang 钟礼立[1] XU Lu;PENG Li;ZHOU Pei;FENG Xiuqin;Duane Wang;ZHONG Lili(Children′s Medical Center,the First Affiliated Hospital of Hunan Normal University(People′s Hospital of Hunan Province),Hunan Provincial Key Laboratory of Pediatric Respiratory Medicine,Changsha 410005,China)

机构地区：[1]湖南师范大学附属第一医院(湖南省人民医院)儿童医学中心,儿童呼吸病学湖南省重点实验室,长沙410005

出　　处：《中国临床新医学》2024年第11期1198-1203,共6页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：国家临床重点专科重大科研专项项目(编号:Z2023029);湖南省自然科学基金项目(编号:2024JJ9130);湖南省科技创新人才计划湖湘高层次人才聚集工程创新团队项目(编号:2021RC5014);湖南省教育厅科学研究项目(编号:22B0058);儿童呼吸病学湖南省重点实验室(编号:2019TP1043)

摘　　要：目的探究钙卫蛋白S100A8/A9对肺炎支原体肺炎(MPP)患儿高凝状态的诊断价值及对内皮细胞功能的影响。方法纳入2023年9月至2024年2月湖南师范大学附属第一医院(湖南省人民医院)收治的87例MPP患儿作为MPP组,另选30名健康儿童作为对照组。根据凝血功能指标[D-二聚体(D-D)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、抗凝血酶-Ⅲ(AT-Ⅲ)]检测结果将MPP组进一步分为非高凝组(n=45)和高凝组(n=42)。比较各组的中性粒细胞/淋巴细胞比值(NLR)、C反应蛋白(CRP)、降钙素原(PCT)、白介素-6(IL-6)、干扰素-γ(IFN-γ)、S100A8/A9水平差异,并分析S100A8/A9在评估MPP高凝状态的作用。用100 ng/mL的人重组S100A8/A9刺激人脐静脉内皮细胞(HUVECs)24 h,观察其对CD31、组织因子(TF)、血管内皮钙黏附蛋白(VE-cadherin)表达的影响。结果MPP组CRP、PCT、IL-6、IFN-γ水平显著高于对照组(P<0.05),NLR显著低于对照组(P<0.05)。高凝组CRP、PCT、IFN-γ水平显著高于非高凝组(P<0.05)。MPP组的S100A8/A9水平显著高于对照组,高凝组的S100A8/A9水平显著高于非高凝组(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,S100A8/A9诊断MPP患儿高凝状态的曲线下面积为0.860,灵敏度为71.4%,特异度为93.9%。细胞实验结果显示,经S100A8/A9干预后,HUVECs的CD31、VE-cadherin表达水平显著降低,TF表达水平显著升高,P<0.05。结论S100A8/A9与MPP患儿的高凝状态密切相关,其可破坏内皮细胞结构的完整性并驱动血栓形成。Objective To explore the diagnostic value of S100 calcium⁃binding protein A8/A9(S100A8/A9)in hypercoagulation state of children with Mycoplasma pneumoniae pneumonia(MPP)and its effect on endothelial cell function.Methods A total of 87 MPP pediatric patients admitted to the First Affiliated Hospital of Hunan Normal University(People′s Hospital of Hunan Province)from September 2023 to February 2024 were included as the MPP group,and other 30 healthy children were selected as the control group.The MPP group was further divided into non⁃hypercoagulation group(n=45)and hypercoagulation group(n=42)according to the detection results of blood coagulation indicators[D⁃dimer(D⁃D),thrombin time(TT),activated partial thromboplastin time(APTT),prothrombin time(PT),antithrombin⁃Ⅲ(AT⁃Ⅲ)].The differences in the levels of neutrophil⁃to⁃lymphocyte ratio(NLR),C⁃reactive protein(CRP),procalcitonin(PCT),interleukin⁃6(IL⁃6),interferon⁃gamma(IFN⁃γ)and S100A8/A9 were compared among all the groups,and the role of S100A8/A9 in evaluating MPP hypercoagulation state was analyzed.Human umbilical vein endothelial cells(HUVECs)were stimulated with 100 ng/mL of recombinant human S100A8/A9 for 24 hours to observe its effects on CD31,tissue factor(TF),and vascular endothelial(VE)⁃cadherin expressions.Results The levels of CRP,PCT,IL⁃6 and IFN⁃γin the MPP group were significantly higher than those in the control group(P<0.05),and NLR in the MPP group was significantly lower than that in the control group(P<0.05).The levels of CRP,PCT and IFN⁃γin the hypercoagulation group were significantly higher than those in the non⁃hypercoagulation group(P<0.05).The S100A8/A9 level in the MPP group was significantly higher than that in the control group,and the S100A8/A9 level in the hypercoagulation group was significantly higher than that in the non⁃hypercoagulation group(P<0.05).The results of receiver operating characteristic(ROC)curve analysis showed that the area under the curve of S100A8/A9 was 0.860,with t

关 键 词：肺炎支原体肺炎 钙卫蛋白S100A8/A9 人脐静脉内皮细胞 高凝状态 儿童 

分 类 号：R725.6[医药卫生—儿科]