血清生成素样蛋白4、碱酯酶水平在肺炎支原体肺炎患儿诊断和病情评估中的应用价值  

Application value of serum ANGPTL4 and cholinesterase levels in diagnosis and severity assessment of Mycoplasma pneumoniae pneumonia in children

作　　者：周玲 叶海燕 刘依枫 石群 谭冬琼 王佟缘 闫军 ZHOU Ling;YE Haiyan;LIU Yifeng;SHI Qun;TAN Dongqiong;WANG Tongyuan;YAN Jun(Department of Pediatrics,Chongqing Jiulongpo District People's Hospital,400050,China)

机构地区：[1]重庆市九龙坡区人民医院儿科,400050

出　　处：《传染病信息》2025年第2期181-185,共5页Infectious Disease Information

摘　　要：目的探究血管生成素样蛋白4(angiopoietin-like protein4,ANGPTL4)、血清胆碱酯酶(serum cholinesterase,sCHE)水平与肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)患儿诊断、病情评估的关系。方法选取2023年1月至2024年1月于重庆市九龙坡区人民医院就诊的80例MPP患儿(MPP组),将MPP组进一步分为轻症组(44例)与重症组(36例),另选取80名同期于本院儿科进行体检的健康儿童(健康组),比较各组临床资料和相关检测指标。用Logistic回归分析分析MPP患儿发生重症的影响因素。用受试者工作特征(receiver operating characteristic curve,ROC)曲线分析血清ANGPTL4、sCHE水平诊断MPP患儿发生重症的效能。结果MPP组与健康组相比,患儿体内白细胞计数、C反应蛋白、肿瘤坏死因子α、血清ANGPTL4水平均显著升高(P均<0.05),SCHE水平显著降低(P<0.05);重症组与轻症组相比,血清ANGPTL4水平显著升高、sCHE水平显著降低(P<0.05)。MPP组患儿血清ANGPTL4与sCHE水平呈负相关(r=-0.490)。Logistic回归分析结果显示,ANGPTL4水平升高、sCHE水平下降是MPP患儿发生重症的危险因素。ROC曲线分析结果显示,MPP患儿血清ANGPTL4水平诊断MPP患儿发生重症的曲线下面积(area under curve,AUC)为0.778,敏感度为63.75%,特异度为91.25%;血清sCHE水平诊断MPP患儿发生重症的AUC为0.878,敏感度为85.00%,特异度为87.50%;血清ANGPTL4、sCHE2者联合诊断MPP患儿发生重症的AUC为0.920,敏感度92.5%,特异度为82.50%。结论血清ANGPTL4、sCHE可用于MPP诊断与病情评估,且ANGPTL4、sCHE联合诊断效能优于各自单独诊断。Objective To investigate the relationship between the levels of angiopoietin like protein 4(ANGPTL4),serum cholinesterase(sCHE),and the diagnosis and assessment of Mycoplasma pneumoniae pneumonia(MPP)in children.Methods A total of 80 children with MPP(MPP group)who received medical treatment at Jiulongpo District People's Hospital in Chongqing from January 2023 to January 2024 were selected.The MPP group was further divided into mild and severe groups,and 80 healthy children who underwent physical examinations in the pediatric department of our hospital during the same period were selected(healthy group).The clinical data and relevant testing indicators of each group were compared.Use Logistic regression analysis to analyze the influencing factors of severe MPP in children.Use receiver operating characteristic curve(ROC)to analyze the diagnostic efficacy of serum ANGPTL4 and sCHE levels for the occurrence of misdiagnosis in MPP children.Results Compared with the healthy group,the white blood cell count,C-reactive protein,tumor necrosis factor alpha,and serum ANGPTL4 levels in the MPP group were significantly increased(P<0.05),while sCHE levels were significantly decreased(P<0.05);Compared with the mild group,the severe group showed a significant increase in serum ANGPTL4 and a significant decrease in sCHE levels(P<0.05).The serum ANGPTL4 and sCHE levels in MPP group children were negatively correlated(r=-0.490).The results of logistic regression analysis showed that elevated ANGPTL4 levels and decreased sCHE levels were risk factors for severe MPP in children.The ROC curve analysis results showed that the area under curve(AUC)for diagnosing severe MPP in children with MPP based on serum ANGPTL4 levels was O.778,with a sensitivity of 63.75%and specificity of 91.25%;The AUC,sensitivity,and specificity of serum sCHE levels in diagnosing severe MPP in children were 0.878,85.00%,and 87.50%,respectively;The AUC,sensitivity,and specificity of the combined diagnosis of serum ANGPTL4 and sCHE for severe MPP in children we

关 键 词：肺炎支原体肺炎 血管生成素样蛋白4 胆碱酯酶 诊断 病情评估 

分 类 号：R512.5[医药卫生—内科学]