儿童重症肺炎支原体肺炎血清CCL8、CCL22水平及临床意义  

Serum levels and clinical significance of CCL8 and CCL22 in children with severe Mycoplasma pneumoniae pneumonia

作　　者：张军 唐斌 屈林林 ZHANG Jun;TANG Bin;QU Linlin(Department of Pediatrics,the First People′s Hospital of Suqian City,Suqian,Jiangsu 223800,China)

机构地区：[1]宿迁市第一人民医院儿科,江苏宿迁223800

出　　处：《国际检验医学杂志》2025年第6期698-703,共6页International Journal of Laboratory Medicine

基　　金：江苏省卫生健康委科研项目(M2020045)。

摘　　要：目的探讨重症肺炎支原体肺炎(SMPP)患儿血清CC趋化因子配体(CCL)8、CCL22水平及临床意义。方法选取2021年1月至2023年6月该院收治的103例SMPP患儿为SMPP组,根据简化小儿危重病例评分分为非危重组(37例)、危重组(40例)、极危重组(26例),根据入院治疗28 d预后情况分为预后不良组(22例)和预后良好组(81例)。选取同期60例轻症肺炎支原体肺炎(MMPP)患儿为MMPP组和60例体检健康儿童为对照组。采用酶联免疫吸附试验检测血清CCL8、CCL22、C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平。采用Pearson或Spearman相关分析CCL8、CCL22水平与CRP、PCT、TNF-α、IL-6及病情严重程度的关系,采用多因素Logistic回归分析SMPP患儿预后不良的影响因素,受试者工作特征(ROC)曲线评估CCL8、CCL22对SMPP患儿预后不良的预测价值。结果与对照组比较,SMPP组和MMPP组CCL8、CCL22、CRP、PCT、TNF-α、IL-6水平升高(P<0.05),且SMPP组上述指标水平升高较MMPP组明显(P<0.05)。与非危重组比较,极危重组和危重组CCL8、CCL22、CRP、PCT、TNF-α、IL-6水平升高(P<0.05),且极危重组上述指标水平升高较危重组明显(P<0.05)。SMPP组CCL8、CCL22水平与病情严重程度、CRP、PCT、TNF-α、IL-6均呈正相关(P<0.05)。与预后良好组比较,预后不良组CCL8、CCL22、CRP、PCT、TNF-α、IL-6水平升高(P<0.05)。血清CRP、PCT、TNF-α、IL-6、CCL8、CCL22水平升高是SMPP患儿预后不良的独立危险因素(P<0.05)。血清CCL8、CCL22及二者联合检测预测预后不良的曲线下面积分别为0.807、0.801、0.907,二者联合检测的预测价值大于各指标单独预测(Z=1.811、1.864,P=0.029、0.025)。结论血清CCL8、CCL22在SMPP患儿中水平升高,并与病情严重程度及预后密切相关,早期联合检测可作为预测SMPP患儿预后不良的标志物。Objective To investigate the serum levels of CC chemokine ligand(CCL)8 and CCL22 in children with severe Mycoplasma pneumoniae pneumonia(SMPP)and their clinical significance.Methods A total of 103 children with SMPP admitted to the hospital from January 2021 to June 2023 were selected as the SMPP group.According to the simplified pediatric critical illness score,they were divided into non-critical group(37 cases),critical group(40 cases),and extremely critical group(26 cases).According to the prognosis of 28 d after admission,the patients were divided into poor prognosis group(22 cases)and good prognosis group(81 cases).At the same time,a total of 60 children with mild Mycoplasma pneumoniae pneumonia(MMPP)were enrolled as the MMPP group,and 60 healthy children who underwent physical were enrolled as the control group.Enzyme-linked immunosorbent assay was used to detect serum levels of CCL8,CCL22,C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6).Pearson or Spearman correlation analysis was used to analyze the relationship between CCL8,CCL22 levels and CRP,PCT,TNF-α,IL-6 and the disease severity.Multivariate Logistic regression was used to analyze the influencing factors for the poor prognosis of children with SMPP.The receiver operating characteristic(ROC)curve was used to evaluate the value of CCL8 and CCL22 in predicting the poor prognosis of children with SMPP.Results Comp ared with the control group,the levels of CCL8,CCL22,CRP,PCT,TNF-αand IL-6 were significantly increased in the SMPP group and MMPP group(P<0.05),and the levels of the above indexes in the SMPP group were significantly higher than those in the MMPP group(P<0.05).Compared with the non-critical group,the levels of CCL8,CCL22,CRP,PCT,TNF-αand IL-6 in the extremely critical group and the critical group were increased(P<0.05),and the levels of the above indexes in the extremely critical group were increased more significantly than those in the critical group(P<0.05).The levels of CCL8 and CCL22 i

关 键 词：重症肺炎支原体肺炎 CC趋化因子配体8 CC趋化因子配体22 预后 

分 类 号：R725.6[医药卫生—儿科]