肺部超声评分、CT联合血清CXCL8、sB7-H3对儿童重症肺炎支原体肺炎的诊断价值  

Diagnostic value of lung ultrasound score,CT combined with serum CXCL8 and sB7-H3 for severe Mycoplasma pneumoniae pneumonia in children

作　　者：王腾飞 刘淑英 王萍 王业珠 刘庆华[2] 李执正 王叶颖 WANG Tengfei;LIU Shuying;WANG Ping;WANG Yezhu;LIU Qinghua;LI Zhizheng;WANG Yeying(Department of Ultrasound,Maternal and Child Health Hospital of Zhangqiu District,Jinan,Shandong 250200,China;Department of Ultrasound,Children's Hospital Affiliated to Shandong University,Jinan,Shandong 250200,China)

机构地区：[1]济南市章丘区妇幼保健院超声科,山东济南250200 [2]山东大学附属儿童医院超声科,山东济南250200

出　　处：《国际检验医学杂志》2025年第7期856-860,共5页International Journal of Laboratory Medicine

摘　　要：目的 探讨肺部超声(LUS)评分、计算机断层扫描(CT)联合血清CXC趋化因子配体8(CXCL8)、可溶性共刺激分子B7-H3(sB7-H3)对儿童重症肺炎支原体肺炎(MPP)的诊断价值。方法 选取2022年4月至2024年4月在济南市章丘区妇幼保健院就诊的210例MPP患儿作为研究对象,根据病情严重程度分为重症MPP组和非重症MPP组,采用酶联免疫吸附试验检测血清CXCL8、sB7-H3水平;行肺部超声(LUS)评分和CT诊断;采用一致性Kappa检验比较LUS评分、CT及血清CXCL8、sB7-H3单独及联合诊断重症MPP与临床检查结果的一致性;采用受试者工作特征曲线分析LUS评分、CT及血清CXCL8、sB7-H3诊断重症MPP的价值。结果 重症MPP组与非重症MPP组身高、年龄、发热天数、体重、住院天数、性别等一般资料比较,差异均无统计学意义(P>0.05);与非重症MPP组比较,重症MPP组血清CXCL8、sB7-H3水平及LUS评分均升高(P<0.05);LUS评分、血清CXCL8、sB7-H3诊断重症MPP的曲线下面积(AUC)为0.865、0.785、0.750;CT诊断结果显示假阳性35例,假阴性22例,与临床检查结果比较,Kappa为0.459(P<0.05);LUS评分、CT联合血清CXCL8、sB7-H3诊断结果显示假阳性3例,假阴性15例,与临床检查结果比较,Kappa为0.828(P<0.05);LUS评分、CT联合血清CXCL8、sB7-H3诊断较4项检测单独诊断的特异度和准确度均增加(P<0.05),四者联合诊断较CXCL8、sB7-H3两项指标单独诊断的灵敏度增加(P<0.05),漏诊率降低(P<0.05)。结论 MPP患儿血清CXCL8、sB7-H3水平及LUS评分均升高,LUS评分、CT联合血清CXCL8、sB7-H3诊断重症MPP的特异度和准确度均增加。Objective To explore the diagnostic value of lung ultrasound(LUS) score,computed tomography(CT) combined with serum CXC chemokine ligand 8(CXCL8) and soluble co stimulatory molecule B7-H3(sB7-H3) for severe Mycoplasma pneumoniae pneumonia(MPP) in children.Methods From April 2022 to April 2024,a total of 210 children with MPP who visited Maternal and Child Health Hospital of Zhangqiu District were included as research subjects,and they were separated into severe MPP group and non severe MPP group according to the severity of the disease.Enzyme-linked immunosorbent assay was applied to detect serum levels of CXCL8 and sB7-H3.LUS score and CT diagnosis were conducted.The value of LUS score,CT and serum CXCL8,sB7-H3 in the diagnosis of severe MPP was analyzed using the receiver operating characteristic curve.Results There were no statistically significant differences in height,age,fever days,weight,hospital stay,and gender between the severe MPP group and the non severe MPP group(P>0.05).Compared with the non severe MPP group,the serum levels of CXCL8,sB7-H3,and LUS score were all increased in the severe MPP group(P<0.05).The area under the curve(AUC) of LUS score,serum CXCL8,and sB7-H3 for diagnosing severe MPP was 0.865,0.785,and 0.750,respectively.The CT diagnosis results showed 35 false positives and 22 false negatives,with Kappa value of 0.459 compared to clinical examination results(P<0.05).The diagnostic results of LUS score,CT combined with serum CXCL8 and sB7-H3 showed 3 false positives and 15 false negatives,with Kappa vale of 0.828 compared to clinical examination results(P<0.05).The diagnosis of LUS score,CT combined with serum CXCL8,and sB7-H3 had higher specificity and accuracy than those of single detection of the four(P<0.05),and the sensitivity of the combined diagnosis of the four was increased(P<0.05) and the missed diagnosis rate was reduced compared to the single detection of CXCL8 and sB7-H3(P<0.05).Conclusion The serum levels of CXCL8,sB7-H3,and LUS score in children with MPP increase.The speci

关 键 词：肺炎支原体肺炎 CXC趋化因子配体8 可溶性共刺激分子B7-H3 肺部超声评分 诊断 

分 类 号：R563.1[医药卫生—呼吸系统]