重症肺炎支原体肺炎患儿血清增殖诱导配体、C-X-C基序趋化因子配体表达与疾病转归的关系  

Relationship between serum a proliferation-inducing ligand and C-X-C motif-chemokine ligand 14 expression and disease outcome in children with severe mycoplasma pneumoniae pneumonia

作　　者：刘滢 朱荣平 张琳 Liu Ying;Zhu Rongping;Zhang Lin(Department of Neonatology,Changzhou Maternal and Child Health Care Hospital,Changzhou 213000,China)

机构地区：[1]常州市妇幼保健院新生儿科,213000

出　　处：《中国小儿急救医学》2024年第11期846-850,共5页Chinese Pediatric Emergency Medicine

基　　金：常州市卫健委科技项目(QN202049)。

摘　　要：目的探讨重症肺炎支原体肺炎(SMPP)患儿血清增殖诱导配体(APRIL)、C-X-C基序趋化因子配体(CXCL14)表达与疾病转归的关系。方法选取2021年1月至2022年12月常州市妇幼保健院收治的112例SMPP患儿作为研究对象。治疗28 d后根据患儿的疾病转归情况分为预后良好组(n=87)和预后不良组(n=25),另选取本院同期收治的100例肺炎支原体肺炎患儿作为对照组。采用酶联免疫吸附法测定所有患儿血清APRIL、CXCL14的表达。采用受试者工作特征(ROC)曲线评估血清APRIL、CXCL14对SMPP患儿疾病转归的预测价值,采用多因素Logistic逐步回归分析SMPP患儿疾病转归的影响因素。结果SMPP组患儿血清APRIL、CXCL14水平均高于对照组(均P<0.05);预后不良组SMPP患儿血清APRIL、CXCL14水平均高于预后良好组(均P<0.05);血清APRIL、CXCL14预测SMPP患儿预后的曲线下面积(AUC)(95%CI)分别为0.783(0.721~0.835)、0.835(0.789~0.882),截断值分别为34.47 ng/mL、289.32 pg/mL,特异度分别为53.61%、65.43%,敏感度分别为93.20%、93.20%,二者联合检测的AUC(95%CI)为0.913(0.872~0.954),特异度为85.59%,敏感度为86.35%。预后不良组患儿发热天数>7 d、入院美国国立卫生研究院卒中量表(NIHSS)评分>30分比例高于预后良好组(P<0.05)。多因素Logistic逐步回归分析显示,发热天数>7 d(OR=2.273,95%CI 1.403~3.681),入院NIHSS评分>30分(OR=2.088,95%CI 1.327~3.283),APRIL≥34.47 ng/mL(OR=3.093,95%CI 1.711~5.590)、CXCL14≥289.32 pg/mL(OR=5.013,95%CI 2.079~12.086)是SMPP患儿死亡的危险因素(P<0.05)。结论血清APRIL、CXCL14在SMPP患儿中呈高表达,且与疾病转归有关,有望作为预测SMPP患儿预后的潜在标志物。ObjectiveTo investigate the relationship between the expression of serum a proliferation inducing ligand(APRIL),C-X-C motif-chemokine ligand 14(CXCL14)and disease regression in children with severe Mycoplasma pneumoniae pneumonia(SMPP).MethodsA total of 112 children with SMPP admitted to Changzhou Maternal and Child Health Hospital from January 2021 to December 2022 were selected as study subjects.After 28 d of treatment,the children were divided into the good prognosis group(n=87)and the poor prognosis group(n=25)according to their disease regression,and 100 children with Mycoplasma pneumoniae pneumoniae(MPP)admitted to our hospital during the same period were selected as the control group.Serum APRIL and CXCL14 expression were measured by enzyme-linked immunosorbent assay in all children.The predictive value of serum APRIL and CXCL14 for disease regression in children with SMPP was assessed by receiver operating characteristic(ROC)curve,and the factors influencing disease regression in children with SMPP were analyzed by multifactorial Logistic stepwise regression.ResultsSerum APRIL and CXCL14 levels in the study group were higher than those in the control group(all P<0.05).Serum APRIL and CXCL14 levels of children with SMPP in the poor prognosis were higher than those in the good prognosis group(all P<0.05).The area under the curve(AUC)(95%CI)of serum APRIL and CXCL14 for predicting the prognosis of SMPP children were 0.783(0.721-0.835)and 0.835(0.789-0.882),respectively,and the cut-off values were 34.47 ng/mL and 289.32 pg/mL,respectively.The specificity was 53.61%,65.43%,and the sensitivity was 93.20%,93.20%,respectively.The AUC(95%CI)of the combined detection of both was 0.913(0.872-0.954),with a specificity of 85.59%and a sensitivity of 86.35%.The proportions of children in the poor prognosis group with fever days>7 d and admission National Institute of Health Stroke Scale(NIHSS)score>30 points were higher than those in the good prognosis group(P<0.05).Multifactorial Logistic stepwise regression analysis s

关 键 词：重症肺炎 支原体肺炎 增殖诱导配体 C-X-C基序趋化因子配体 疾病转归 儿童 

分 类 号：R725.6[医药卫生—儿科]