血清GM-CSF、sCD163水平与难治性肺炎支原体肺炎患儿病情及预后的关系  

Relationship between Serum GM-CSF and sCD163 Levels and the Condition and Prognosis of Children with Refractory Mycoplasma Pneumoniae Pneumonia

作　　者：陈雷 龚倩 程海燕[2] 沈怀云 CHEN Lei;GONG Qian;CHENG Haiyan;SHEN Huaiyun(Department of Pediatrics,The First People's Hospital of Mengcheng County,Bozhou,Anhui 233500,China;Department of Pediatrics,Huangshan City People's Hospital,Huangshan,Anhui 245000,China;Department of Pediatrics,The First Affiliated Hospital of Bengbu Medical University,Bengbu,Anhui 233000,China)

机构地区：[1]蒙城县第一人民医院儿科,安徽亳州233500 [2]黄山市人民医院儿科,安徽黄山245000 [3]蚌埠医科大学第一附属医院儿科,安徽蚌埠233000

出　　处：《转化医学杂志》2025年第3期5-10,共6页Translational Medicine Journal

基　　金：安徽省临床医学研究转化专项项目(202304295107020050)。

摘　　要：目的探讨血清粒细胞-巨噬细胞集落刺激因子(GM-CSF)、可溶性分化簇163(sCD163)水平与难治性肺炎支原体肺炎(RMPP)患儿病情及预后的关系。方法选取2021年1月至2024年4月蒙城县第一人民医院收治的RMPP患儿152例(RMPP组)、一般支原体肺炎(GMPP)患儿60例(GMPP组)和同期体检健康儿童60例(对照组)为研究对象。将RMPP组患儿根据病情严重程度分为重症RMPP组(81例)和轻症RMPP组(71例),根据28 d预后将其分为不良预后组(55例)和良好预后组(97例)。采用酶联免疫吸附法检测患儿血清GM-CSF、sCD163水平。以RMPP患儿预后为因变量,多因素非条件Logistic回归确定其影响因素,绘制受试者工作特征曲线分析血清GM-CSF、sCD163水平对其的预测效能。结果RMPP组血清GM-CSF、sCD163水平分别为(12.96±4.17)ng/m L、(188.88±28.23)pg/m L,显著高于GMPP组[(9.40±2.29)ng/m L、(148.49±24.00)pg/m L]和对照组[(4.58±1.17)ng/m L、(99.18±20.30)pg/m L](P均<0.01)。重症RMPP组血清GM-CSF、sCD163水平分别为(11.37±3.97)ng/m L、(178.19±25.88)pg/m L,显著低于轻症RMPP组[(14.77±3.64)ng/m L、(201.07±25.91)pg/m L](P均<0.01)。不良预后组血清GM-CSF、sCD163水平分别为(15.55±3.61)ng/m L、(207.13±23.66)pg/m L,显著高于良好预后组[(11.49±3.74)ng/m L、(178.53±25.29)pg/m L](P均<0.01)。RMPP患儿不良预后的独立危险因素为热程长(OR=1.515,95%CI:1.120~2.049)、重症RMPP(OR=5.615,95%CI:1.992~15.829)、GM-CSF高(OR=1.284,95%CI:1.114~1.480)和s CD163高(OR=1.046,95%CI:1.023~1.069)(P均<0.05)。血清GM-CSF、sCD163水平联合预测RMPP患儿不良预后的曲线下面积为0.861(95%CI:0.796~0.912),大于血清GM-CSF[0.784(95%CI:0.710~0.846)]、sCD163[0.785(95%CI:0.711~0.847)]水平的单独预测能力(P均<0.05)。结论RMPP患儿血清GM-CSF、sCD163水平升高,与病情严重程度加重和不良预后相关;血清GM-CSF、sCD163水平联合对RMPP患儿不良预后的预测效能较高。Objective To investigate the relationship between the levels of serum granulocyte-macrophage colony-stimulating factor(GM-CSF)and soluble cluster of differentiation 163(sCD163)and the disease severity and prognosis in children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods A total of 152 children with RMPP(RMPP group),60 children with general Mycoplasma pneumoniae pneumonia(GMPP group),and 60 healthy children who underwent physical examination during the same period(control group)were enrolled from January 2021 to April 2024 at The First People's Hospital of Mengcheng County.The RMPP patients were further classified into severe RMPP group(n=81)and mild RMPP group(n=71)based on disease severity,and into poor prognosis group(n=55)and good prognosis group(n=97)based on 28-day prognosis.Enzyme-linked immunosorbent assay was used to measure the serum levels of GM-CSF and sCD163.The prognosis of RMPP children was taken as the dependent variable,and multivariate unconditional Logistic regression analysis was conducted to determine its influencing factors.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive efficacy of serum GM-CSF and sCD163 levels.Results The serum levels of GM-CSF and sCD163 in the RMPP group[(12.96±4.17)ng/mL,(188.88±28.23)pg/mL]were significantly higher than those in the GMPP group[(9.40±2.29)ng/mL,(148.49±24.00)pg/mL]and the control group[(4.58±1.17)ng/mL,(99.18±20.30)pg/mL](both P<0.01).The serum levels of GM-CSF and sCD163 in the severe RMPP group[(11.37±3.97)ng/mL,(178.19±25.88)pg/mL)]were significantly below those in the mild RMPP group[(14.77±3.64)ng/mL,(201.07±25.91)pg/mL](both P<0.01).The serum levels of GM-CSF and sCD163 in the poor prognosis group[(15.55±3.61)ng/mL,(207.13±23.66)pg/mL]were significantly higher than those in the good prognosis group[(11.49±3.74)ng/mL,(178.53±25.29)pg/mL](both P<0.01).Independent risk factors for poor prognosis in RMPP children included prolonged fever(OR=1.515,95%CI:1.120-2.049),severe RMPP(OR=5.61

关 键 词：儿童 难治性肺炎支原体肺炎 粒细胞-巨噬细胞集落刺激因子 可溶性分化簇163 病情 预后 

分 类 号：R375+.2[医药卫生—病原生物学]