细胞因子在肺炎支原体肺炎合并胸腔积液患儿血清中的表达及其与肺功能的关系  

Serum expressions of cytokines in children with mycoplasma pneumoniae pneumonia complicated with pleural effusion and their correlations with pulmonary function

作　　者：魏红艳 王帅 王培文 冯艳芳 滕艳妹 田佩佩 WEI Hong-yan;WANG Shuai;WANG Pei-wen;FENG Yan-fang;TENG Yan-mei;TIAN Pei-pei(Department of Pediatrics,People′s Hospital of Cangzhou,Cangzhou 061002,Hebei,China)

机构地区：[1]沧州市人民医院儿科,河北沧州061002

出　　处：《广东医学》2025年第1期15-20,共6页Guangdong Medical Journal

基　　金：沧州市科技计划自筹经费项目(222106030)。

摘　　要：目的探讨细胞因子[白细胞介素(interleukin,IL)-10、IL-1β、γ干扰素(interferon-γ,IFN-γ)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]在肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)合并胸腔积液(pleural effusion,PE)患儿血清中的表达及其与肺功能的关系。方法选取2022年1月至2023年7月期间于沧州市人民医院就诊的MPP患儿100例纳入研究,根据是否合并PE,将患儿分为合并PE组(21例)及未合并PE组(79例)。另选取体检健康儿童30例纳入对照组。采集患儿血清标本并检测血清IL-10、IL-1β、IFN-γ及TNF-α水平,应用儿童肺功能仪测定患儿肺功能相关指标,采用临床肺部感染评分(clinical pulmonary infection score,CPIS)评价MPP合并PE患儿肺炎严重程度,应用Pearson相关分析血清IL-10、IL-1β、IFN-γ、TNF-α与患儿肺功能相关指标及CPIS评分的相关性,采用多因素logistic法分析MPP并发PE的影响因素,采用受试者工作特征(ROC)曲线分析血清IL-10、IL-1β、IFN-γ、TNF-α诊断MPP合并PE的临床价值。结果与对照组比较,合并PE组和未合并PE组患儿血清IL-10、IL-1β、IFN-γ、TNF-α水平明显升高(t=14.280/29.595、24.898/21.110、15.317/9.328、34.357/37.029,P<0.05);与未合并PE组比较,合并PE组患儿血清IL-10、IL-1β、IFN-γ、TNF-α水平明显升高(t=5.379、20.821、7.907、10.972,P<0.05)。与未合并PE组比较,合并PE组患儿记录潮气量(VT)、呼出75%潮气量时的瞬间流速与潮气呼气峰流速比(TEF25/PTEF%)、呼吸比(Ti/Te)及达峰时间比(TPTEF/TE)检测值较低,CPIS评分较高,且差异有统计学意义(P<0.05)。血清IL-10、IL-1β、IFN-γ、TNF-α与MPP合并PE患儿肺功能相关指标及CPIS评分均呈负相关(P<0.001)。多因素logistic分析结果显示,IL-10、IL-1β、IFN-γ、TNF-α是影响MPP患儿并发PE的危险因素(P<0.05)。ROC曲线分析显示,血清IL-10、IL-1β、IFN-γ、TNF-α联合诊断MPP并发PE的敏感度和特异度最高(P<0.05)。结�Objective To investigate the expression of IL-1β,IL-10,TNF-αand IFN-γin serum of children with mycoplasma pneumoniae pneumonia(MPP)and pleural effusion(PE)and their correlations with pulmonary function.Methods A total of 100 children with MPP were selected from Cangzhou People′s Hospital between January 2022 and July 2023.Based on the presence of pleural effusion,the children were divided into two groups:the PE group(21 cases)and the non-PE group(79 cases).Additionally,30 healthy children were selected as the control group.Serum samples were collected to detect IL-10,IL-1β,IFN-γ,and TNF-αlevels.Pulmonary function tests were performed using a pediatric spirometer.The severity of pneumonia was evaluated using the Clinical Pulmonary Infection Score(CPIS).Pearson correlation analysis was used to examine the relationship between cytokine levels and pulmonary function parameters as well as CPIS scores.Multivariate logistic regression analysis was used to explore the factors affecting the development of PE in MPP patients,and receiver operating characteristic(ROC)curve analysis was conducted to assess the diagnostic value of the cytokines for MPP complicated by PE.Results Compared to the control group,serum levels of IL-10,IL-1β,IFN-γ,and TNF-αwere significantly elevated in both the PE and non-PE groups(t=14.280/29.595,24.898/21.110,15.317/9.328,34.357/37.029,P<0.05).In the PE group,the levels of IL-10,IL-1β,IFN-γ,and TNF-αwere significantly higher than in the non-PE group(t=5.379,20.821,7.907,10.972,P<0.05).Compared to the non-PE group,children in the PE group had lower values for tidal volume(VT),peak expiratory flow at 75%tidal volume(TEF25/PTEF%),respiratory rate(Ti/Te),and peak expiratory flow time ratio(TPTEF/TE),along with higher CPIS scores,and these differences were statistically significant(P<0.05).The levels of IL-10,IL-1β,IFN-γ,and TNF-αwere negatively correlated with pulmonary function parameters and CPIS scores in the PE group(P<0.001).Multivariate logistic regression analysis revealed tha

关 键 词：肺炎支原体肺炎 胸腔积液 儿童 炎性因子 肺功能 临床诊疗 

分 类 号：R725.6[医药卫生—儿科] R561[医药卫生—临床医学]