高通量测序联合乳酸脱氢酶预测儿童重症肺炎支原体肺炎的意义  

Significance of high-throughput sequencing combined with lactate dehydrogenase in predicting severe Mycoplasma pneumonia pneumonia in children

作　　者：王文正 赖秀蓝 李桂秋 龚慧 劳健醒 魏影 WANG Wenzheng;LAI Xiulan;LI Guiqiu;GONG Hui;LAO Jianxing;WEI Ying(Clinical Medical College,Jiamusi University,Jiamusi,Heilongjiang 154003,China;Department of Pediatrics,Huazhong University of Science and Technology Union Hospital,Shenzheng,Guangdong 518052,China;Department of Laboratory Medicine Center,Huazhong University of Science and Technology Union Hospital,Shenzheng,Guangdong 518052,China;Heilongjiang Provincial Hospital,Harbin,Heilongjiang 150030,China)

机构地区：[1]佳木斯大学临床医学院,黑龙江佳木斯154003 [2]华中科技大学协和深圳医院儿科,广东深圳518052 [3]华中科技大学协和深圳医院检验医学中心,广东深圳518052 [4]黑龙江省医院,黑龙江哈尔滨150030

出　　处：《国际检验医学杂志》2025年第6期709-713,共5页International Journal of Laboratory Medicine

基　　金：深圳市南山区重点项目(NS2022018);2024年深圳市南山区技术研发和创意设计项目(NS2024002);华中科技大学协和深圳医院院级课题(YN2022017)。

摘　　要：目的探讨血清乳酸脱氢酶(LDH)水平联合高通量测序对重症肺炎支原体肺炎(SMPP)患儿的预测价值。方法回顾性分析2023年10月至2024年3月在华中科技大学协和深圳医院就诊的99例肺炎支原体肺炎(MPP)患儿的临床资料。根据病情严重程度,将患儿分为轻症组(33例)和重症组(66例)。采用Spearman相关进行相关性分析,Logistic回归分析SMPP的影响因素,受试者工作特征(ROC)曲线评估LDH预测SMPP的价值。结果重症组LDH水平高于轻症组(P<0.05),高通量测序结果显示,重症组中检出的毒力阳性和耐药基因A2063G位点突变占比高于轻症组(P<0.05)。多因素Logistic回归分析结果显示,LDH水平和耐药基因A2063G位点突变均与SMPP有关(P<0.05)。ROC曲线分析表明,LDH联合高通量测序检测耐药基因A2063G位点突变预测SMPP有较高价值,曲线下面积为0.724。结论血清LDH联合高通量测序检测耐药基因A2063G位点突变可作为预测SMPP的有效指标。Objective To investigate the predictive value of serum lactate dehydrogenase(LDH)level combined with high-throughput sequencing in children with severe Mycoplasma pneumoniae pneumonia(SMPP).Methods The clinical data of 99 children with Mycoplasma pneumoniae pneumonia(MPP)admitted to Huazhong University of Science and Technology Union Hospital from October 2023 to March 2024 were retrospectively analyzed.According to the severity of the disease,the children were divided into mild group(33 cases)and severe group(66 cases).Spearman correlation analysis was used for correlation analysis,Logistic regression was used to analyze the influencing factors of SMPP,and the receiver operating characteristic(ROC)curve was used to evaluate the value of LDH in predicting SMPP.Results The level of LDH in the severe group was higher than that in the mild group(P<0.05).The results of high-throughput sequencing showed that the proportions of virulence positive and drug resistance gene A2063G mutation in the severe group were higher than those in the mild group(P<0.05).Multivariate Logistic regression analysis showed that LDH level and drug resistance gene A2063G mutation were related to the SMPP(P<0.05).ROC curve analysis showed that LDH combined with high-throughput sequencing detection of drug resistance gene A2063G mutation had a high value in predicting SMPP,and the area under the curve was 0.724.Conclusion Serum LDH combined with high-throughput sequencing detection of drug resistance gene A2063G mutation can be used as an effective indicator to predict SMPP.

关 键 词：重症肺炎支原体肺炎 高通量测序 乳酸脱氢酶 耐药基因 

分 类 号：R725.6[医药卫生—儿科]