血清MBL、IL-1R1、Nrf2与肺炎支原体感染诱发哮喘的患儿肺功能和预后的关系  

Serum MBL,IL-1R1,and Nrf2 levels and their correlations with pulmonary function and prognosis in children with asthma induced by mycoplasma pneumoniae infection

作　　者：魏江玲 袁洁[2] 葛胜华 WEI Jiang-ling;YUAN Jie;GE Sheng-hua(Department of Pediatrics,Shijiazhuang Medical College Affiliated Hospital,Shijiazhuang 050017,Hebei,China;不详)

机构地区：[1]石家庄医学高等专科学校附属医院儿科,河北石家庄050017 [2]河北省儿童医院儿科,河北石家庄050031 [3]石家庄市人民医院儿科,河北石家庄050017

出　　处：《广东医学》2025年第1期1-7,共7页Guangdong Medical Journal

基　　金：河北省医学科学研究课题计划(20200634)。

摘　　要：目的探讨肺炎支原体(mycoplasma pneumoniae,MP)感染诱发哮喘患儿血清甘露糖结合凝集素(mannose-binding lectin,MBL)、白细胞介素-1受体1型(interleukin-1 receptor type 1,IL-1R1)、核因子E2相关因子2(nuclear factor E2-related factor 2,Nrf2)与肺功能的相关性,并分析血清MBL、IL-1R1、Nrf2与患儿预后的关系。方法选取2020年2月至2023年2月石家庄医学高等专科学校附属医院收治的MP感染诱发哮喘患儿126例(哮喘组),另选取同期体检健康儿童(健康组)及MP感染的肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)患儿(MP感染组)各126例分别作为对照。检测血清MBL、IL-1R1、Nrf2水平及肺功能[用力肺活量(forced vital capacity,FVC)、第1秒用力呼气容积(forced expiratory volume in the first second,FEV_(1))、FEV_(1)/FVC及最大呼气峰流量(peak expiratory flow,PEF)占预计值的百分比(PEF%pred)]。采用Pearson相关性分析法分析血清MBL、IL-1R1、Nrf2水平与肺功能的相关性。采用多因素logistic回归分析MP感染诱发哮喘患儿预后的影响因素,采用受试者工作特征(receiver operating characteristic,ROC)曲线分析血清MBL、IL-1R1、Nrf2对预后不良的预测价值。结果哮喘组血清MBL、IL-1R1水平高于MP感染组和健康组,血清Nrf2水平、FEV_(1)、FVC、FEV_(1)/FVC及PEF%pred低于MP感染组和健康组。血清Nrf2水平与FEV_(1)、FVC、FEV_(1)/FVC及PEF%pred呈正相关(r=0.484、0.521、0.569、0.481,P<0.001),血清MBL、IL-1R1与FEV_(1)、FVC、FEV_(1)/FVC及PEF%pred呈负相关(r=-0.531、-0.533,-0.611、-0.545,-0.549、-0.564,-0.574、-0.597,P<0.05)。126例MP感染诱发哮喘患儿预后不良率为37.30%,logistic回归分析结果显示:过敏史、血清MBL、IL-1R1高水平及血清Nrf2低水平是MP感染诱发哮喘患儿预后不良的独立危险因素(P<0.05)。血清MBL、IL-1R1、Nrf2联合预测MP感染诱发哮喘患儿预后不良的ROC曲线下面积(AUC)为0.880(95%CI:0.810~0.934),高于各项单独预测的0.71Objective To explore the correlation between serum levels of mannose-binding lectin(MBL),interleukin-1 receptor type 1(IL-1R1),and nuclear factor E2-related factor 2(Nrf2)with pulmonary function in children with asthma induced by mycoplasma pneumoniae(MP)infection,and to analyze the relationship between these biomarkers and the prognosis of the affected children.Methods A total of 126 children with asthma induced by MP infection(Asthma group)admitted to the Shijiazhuang Medical College Affiliated Hospital from February 2020 to February 2023 were enrolled.Additionally,126 healthy children(Healthy group)and 126 children with Mycoplasma pneumoniae pneumonia(MPP group)were included as controls.Serum levels of MBL,IL-1R1,and Nrf2 were measured,along with pulmonary function parameters,including forced vital capacity(FVC),forced expiratory volume in the first second(FEV_(1)),FEV_(1)/FVC ratio,and peak expiratory flow(PEF)as a percentage of predicted values(PEF%pred).Pearson correlation analysis was used to assess the relationships between serum levels of MBL,IL-1R1,Nrf2,and pulmonary function.Multivariate logistic regression was performed to analyze the factors influencing prognosis in children with MP-induced asthma.Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of serum MBL,IL-1R1,and Nrf2 for poor prognosis.Results Serum MBL and IL-1R1 levels were significantly higher in the Asthma group compared to the MP infection and Healthy groups,while serum Nrf2 levels,FEV_(1),FVC,FEV_(1)/FVC,and PEF%pred were lower in the Asthma group.Serum Nrf2 levels were positively correlated with FEV_(1),FVC,FEV_(1)/FVC,and PEF%pred(r=0.484,0.521,0.569,0.481;P<0.001),while serum MBL and IL-1R1 were negatively correlated with these pulmonary function parameters(r=-0.531,-0.533,-0.611,-0.545,-0.549,-0.564,-0.574,-0.597;P<0.05).The rate of poor prognosis in the Asthma group was 37.30%.Logistic regression analysis revealed that a history of allergies,high serum levels of MBL and IL-1R1,and low serum lev

关 键 词：肺炎支原体感染 哮喘 甘露糖结合凝集素 白细胞介素-1受体1型 核因子E2相关因子2 肺功能 预后 

分 类 号：R725.6[医药卫生—儿科] R44[医药卫生—临床医学]