重症支原体肺炎患儿发生塑形性支气管炎的危险因素及TSP1、FOXP3水平对塑形性支气管炎的预测分析  

Prediction analysis of risk factors and TSP1, FOXP 3 levels in children with severe Mycoplasma pneumonia

作　　者：赵惠[1] 潘余乐 古丽巴哈·买买提[1] 刘玉[1] ZHAO Hui;PAN Yule;Gulibaha Maimaiti;LIU Yu(Department of Pediatrics,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830000,China;不详)

机构地区：[1]新疆医科大学第一附属医院儿内一科,新疆乌鲁木齐830000 [2]新疆维吾尔自治区伊犁哈萨克自治州伊宁市兵团第四师医院产科,新疆伊宁835000

出　　处：《中华全科医学》2025年第5期798-801,805,共5页Chinese Journal of General Practice

基　　金：省部共建中亚高发病成因与防治国家重点实验室项目(SKL-HIDCA-2021-JH3)。

摘　　要：目的 在重症支原体肺炎患儿发病过程中,会有一定比例的患儿出现塑形性支气管炎(PB)这种严重的并发症。探究其发病机制,分析凝血酶敏感蛋白1(TSP1)、叉状头螺旋转录因子3(FOXP3)水平对塑形性支气管炎的预测价值。方法 选取2020年6月—2024年6月新疆医科大学第一附属医院儿内一科收治的320例重症支原体肺炎患儿作为研究对象,按照纤维支气管镜下是否可见塑形性支气管炎,将其分为PB组(120例)和非PB组(200例)。采用单因素及多因素分析重症支原体肺炎患儿塑形性支气管炎发生的危险因素,采用ELISA检测TSP1、FOXP3水平,采用ROC曲线评估TSP1、FOXP3对塑形性支气管炎的预测价值。结果 多因素logistic回归分析显示,发热持续时间≥8 d、存在呼吸急促、存在胸腔积液、白细胞计数≥8.10×10~9/L、中性粒细胞比例≥68.10%、淋巴细胞比例<30%、CRP≥40 mg/L、乳酸脱氢酶(LDH)≥450 U/L均为重症支原体肺炎患儿塑形性支气管炎发生的危险因素(P<0.05)。与非PB组TSP1[(54.68±9.00)ng/mL]、FOXP3(3.08±0.51)表达比较,PB组TSP1[(66.71±12.17)ng/mL]、FOXP3(3.92±0.69)表达升高(P<0.05)。ROC曲线结果显示,与TSP1、FOXP3单项诊断对比,联合诊断AUC值显著高于单项(P<0.05)。结论 发热持续时间、呼吸急促、胸腔积液、WBC、PLT、淋巴细胞比例、CRP、LDH等均为导致重症支原体肺炎患儿塑形性支气管炎发生的风险因素,TSP1、FOXP3对预测塑形性支气管炎的发生有较高的价值。Objective In the onset process of children with severe Mycoplasma pneumonia,a certain proportion of children will have plastic bronchitis(PB).The aim is to explore the pathogenesis and analyzed the predictive value of thrombine-sensitive protein 1(TSP1)and forked head spiral transcription factor 3(FOXP3)levels for plastic bronchitis.Methods A total of 320 children with severe Mycoplasma pneumonia admitted to the First Affiliated Hospital of Xinjiang Medical University from June 2020 to June 2024 were selected and divided into PB group(120 cases)and non-PB group(200 cases).Univariate and multivariate factors were used to analyze the risk factors of PB in children with severe Mycoplasma pneumonia.TSP1 and FOXP3 levels were measured by ELISA.ROC evaluated the predictive value of TSP1 and FOXP3 for plastic bronchitis.Results Multivariate logistic regression analysis showed that fever duration≥8 d,tachypnea,pleural effusion,white blood cell count≥8.10×109/L,neutrophil ratio≥68.10%,lymphocyte ratio<30%,CRP≥40 mg/L,LDH≥450 U/L were the risk factors for PB in children with severe Mycoplasma pneumonia(P<0.05).Compared with the non-PB group,the expressions of TSP1[(54.68±9.00)ng/mL]and FOXP3(3.08±0.51)were increased in PB group[(66.71±12.17)ng/mL and 3.92±0.69,P<0.05].ROC results showed that compared with the single diagnosis of TSP1 and FOXP3,the combination of the two had higher diagnostic value(P<0.05).Conclusion The duration of fever,tachypnea,pleural effusion,white blood cell count,neutrophil ratio,lymphocyte ratio,CRP and LDH are risk factors for plastic bronchitis in children with severe Mycoplasma pneumonia.TSP1 and FOXP3 have high value in predicting plastic bronchitis.

关 键 词：重症支原体肺炎 塑形性支气管炎 凝血酶敏感蛋白1 叉状头螺旋转录因子3 

分 类 号：R563.15[医药卫生—呼吸系统] R725.6[医药卫生—内科学]