血清生物标志物在肺炎支原体肺炎患儿病情发展及预后评估中的应用价值  

Application value of serum biomarkers in the progression and prognosis evaluation of Mycoplasma pneumoniae pneumonia in children

作　　者：王璐[1] 李丹梅 司利钢[1] Wang Lu;Li Danmei;Si Ligang(Department of Pediatrics,the Sixth Affiliated Hospital of Harbin Medical University,Harbin Heilongjiang 150000,China)

机构地区：[1]哈尔滨医科大学附属第六医院儿内科,黑龙江哈尔滨150000

出　　处：《中国医刊》2025年第2期172-176,共5页Chinese Journal of Medicine

基　　金：黑龙江省省属高等学校基本科研业务费科研项目(D420220026)。

摘　　要：目的探究血清生物标志物嘌呤能离子通道型受体7(P2X7R)、T细胞免疫球蛋白黏蛋白分子3(TIM3)表达水平在肺炎支原体肺炎(MPP)患儿病情发展及预后评估中的应用价值。方法选取2021年10月至2023年10月于哈尔滨医科大学附属第六医院就诊的MPP患儿183例作为MPP组,另选取同期来哈尔滨医科大学附属第六医院体检的健康儿童150例作为健康组。将MPP组根据病情严重程度进一步分为重症组(n=82)与轻症组(n=101),根据预后情况进一步分为良好组(n=139)与不良组(n=44)。比较分析MPP组和健康组、重症组和轻症组、良好组与不良组的血清P2X7R、TIM3表达水平,采用多因素logistic回归分析影响MPP患儿病情严重程度的独立危险因素。采用受试者操作特征(ROC)曲线分析血清P2X7R、TIM3对MPP患儿预后的评估价值。结果与健康组相比,MPP组血清P2X7R、TIM3表达水平均显著上升,差异有统计学意义(P<0.05)。重症组血清P2X7R、TIM3表达水平明显高于轻症组,差异有统计学意义(P<0.05)。重症组MPP患儿肺外并发症、肺实变占比以及C反应蛋白、白细胞计数、D-二聚体水平均高于轻症组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,肺实变、C反应蛋白、D-二聚体、血清P2X7R、TIM3是影响MPP患儿病情严重程度的独立危险因素(P<0.05)。不良组血清P2X7R、TIM3表达水平明显高于良好组,差异有统计学意义(P<0.05)。血清P2X7R、TIM3及两者联合评估MPP患儿预后的曲线下面积分别为0.775(95%CI 0.690~0.859)、0.756(95%CI 0.669~0.843)、0.844(95%CI 0.783~0.906),两者联合对MPP患儿预后评估的敏感度及曲线下面积高于血清P2X7R、TIM3单独评估(P<0.05)。结论MPP患儿血清P2X7R、TIM3表达水平与病情发展和预后有关,血清P2X7R、TIM3表达水平升高可加重患儿病情,不利于MPP患儿预后,血清P2X7R、TIM3两者联合对MPP患儿预后评估有一定应用价值。Objective To explore the application value of serum purinergic ligand-gated ion channel 7 receptor(P2X7R)and T cell immunoglobulin and mucin domain-3(TIM3)expression levels in the progression and prognosis evaluation of Mycoplasma pneumoniae pneumonia(MPP)in children.Method MPP children who received treatment at the Sixth Affiliated Hospital of Harbin Medical University from October 2021 to October 2023(MPP group)were gathered,and healthy children who underwent physical examination at the same time(healthy group)were also selected.The MPP group was separated into severe group and mild group according to the condition,and was separated into good group and poor group according to the recovery situation.The expression of serum P2X7R and TIM3 was compared and analyzed.Logistic regression was applied to analyze the factors affecting the prognosis of children with MPP.ROC curve was applied to analyze the prognostic value of serum P2X7R and TIM3 in children with MPP.Result Compared with the healthy group,the expression levels of serum P2X7R and TIM3 in the MPP group were greatly increased(P<0.05).The expression levels of serum P2X7R and TIM3 in the severe group were greatly higher than those in the mild group(P<0.05).There were great differences in extrapulmonary complications,lung consolidation,CPR,WBC,and D-dimer between the severe group and mild group(P<0.05).The results of multivariate logistic regression analysis showed that lung consolidation,CPR,D-dimer,serum P2X7R,TIM3 were risk factors that affected the severity of MPP in children(P<0.05).The expression levels of serum P2X7R and TIM3 in the poor group were greatly higher than those in the good group(P<0.05).The AUC of serum P2X7R for prognosis evaluation of MPP children was 0.775(95%CI 0.690-0.859),that of serum TIM3 for prognosis evaluation of MPP children was 0.756(95%CI 0.669-0.843),and that of serum P2X7R combined with TIM3 for prognosis evaluation of MPP children was 0.844(95%CI 0.783-0.906).The sensitivity and AUC of the combined evaluation of the two for

关 键 词：嘌呤能离子通道型受体7 T细胞免疫球蛋白黏蛋白分子3 肺炎支原体肺炎 生物标志物 儿童 预后 

分 类 号：R725.6[医药卫生—儿科]