外周血和肺泡灌洗液CARDS TX、TNF-α、SAA对难治性支原体肺炎儿童的鉴别诊断价值  

Value of peripheral blood and alveolar lavage fluid CARDS TX,TNF-αand SAA in differential diagnosis of children with refractory mycoplasma pneumonia

作　　者：梁利红 许丽萍[1] 梁东阁 Liang Li-hong;Xu Li-ping;Liang Dong-ge(Department of Respiratory Medicine,East 3rd Street,Zhengzhou Children's Hospital,Zhengzhou University and Henan Children's Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院﹒河南省儿童医院郑州儿童医院东三街呼吸科,河南郑州450000

出　　处：《四川生理科学杂志》2025年第1期34-36,53,共4页

摘　　要：目的:分析外周血和肺泡灌洗液社区获得性呼吸窘迫综合征毒素(CARDS TX)、肿瘤坏死因子-α(TNF-α)、血清淀粉样蛋白A(SAA)对难治性支原体肺炎(RMPP)儿童的鉴别诊断价值。方法:将2023年06月至2024年06月郑州大学附属儿童医院住院治疗的100例RMPP病儿、100例普通MPP病儿、100例健康查体儿童分别纳入RMPP组、MPP组及对照组。比较MPP组和RMPP组患儿的临床表现、肺外脏器受累情况、影像学变化、支气管镜检查表现,比较三组患儿的血清及肺泡灌洗液内CARDS TX、TNF-α、SAA水平,并ROC曲线分析血清及肺泡灌洗液内CARDS TX、TNF-α、SAA水平对RMPP的诊断价值。结果:与MPP组相比,RMPP组患儿的呼吸音减低、肺外脏器受累、肺实变、胸腔积液、黏膜糜烂、黏膜脱落、黏液栓形成发生率升高(P<0.05)。与对照组相比,MPP组和RMPP组患儿的血清及肺泡灌洗液内CARDS TX、TNF-α、SAA水平均升高,且RMPP组高于MPP组(P<0.05)。ROC曲线分析,肺泡灌洗液CARDS TX诊断RMPP的曲线下面积最大,诊断截点值为,诊断灵敏度和特异度分别为85.02%和78.71%。结论:外周血和肺泡灌洗液CARDS TX、TNF-α、SAA对RMPP患儿均有一定的诊断效能,其中肺泡灌洗液CARDS TX的诊断效能最佳。Objective:To analyze the value of peripheral blood and bronchoalveolar lavage fluid community acquired respiratory distress syndrome toxin(CARDS TX),tumor necrosis factor-α(TNF-α),serum amyloid A(SAA)in the differential diagnosis of children with refractory mycoplasma pneumonia(RMPP).Methods:A total of 100 children with RMPP hospitalized in the Children's Hospital Affiliated to Zhengzhou University from June 2023 to June 2024 were selected as the research objects and included in the RMPP group.Another 100 children with common MPP and 100 healthy children who were treated in the Children's Hospital Affiliated to Zhengzhou University during the same period were included in the MPP group and the control group,respectively.The clinical manifestations,extrapulmonary organ involvement,imaging changes and bronchoscopy findings were compared between the MPP group and the RMPP group.The levels of CARDS TX,TNF-αand SAA in serum and alveolar lavage fluid were compared between the three groups.ROC curve was used to analyze the diagnostic value of CARDS TX,TNF-αand SAA levels in serum and alveolar lavage fluid for RMPP.Results:Compared with the MPP group,the incidence of decreased breath sounds,extrapulmonary organ involvement,lung consolidation,pleural effusion,mucosal erosion,mucosal detachment,and mucus thromus formation were significantly higher in the RMPP group(P<0.05).Compared with the control group,the levels of CARDS TX,TNF-αand SAA in serum and bronchoalveolar lavage fluid of children in the MPP and RMPP groups were increased,and the levels of CARDS TX,TNF-αand SAA in the RMPP group were higher than those in the MPP group,and the differences were significant(P<0.05).ROC curve analysis showed that the area under the curve of CARDS TX in the diagnosis of RMPP was the largest,the diagnostic cut-off value was,and the diagnostic sensitivity and specificity were 85.02%and 78.71%,respectively.Conclusion:Peripheral blood and alveolar lavage fluid CARDS TX,TNF-αand SAA have certain diagnostic efficacy in children with

关 键 词：难治性支原体肺炎 肿瘤坏死因子-α 血清淀粉样蛋白A 诊断 

分 类 号：R725.6[医药卫生—儿科]