摘要
目的 探究儿童难治性支原体肺炎患儿血清中趋化因子(C-C基元)配体5(CCL5)和可溶性B7-H3(sB7-H3)的表达水平,以及其诊断价值。方法 选取2019年1月至2022年1月我院98例支原体肺炎患儿作为研究对象,根据患儿病情严重程度分为普通型支原体肺炎组(n=55)和难治性支原体肺炎组(n=43)。采用酶联免疫吸附测定法(ELISA)检测血清CCL5、sB7-H3水平并比较;采用Pearson法分析血清CCL5、sB7-H3水平之间的相关性;Logistic回归分析发生儿童难治性支原体肺炎的影响因素;受试者工作特征(ROC)曲线分析血清CCL5、sB7-H3水平联合对儿童难治性支原体肺炎的诊断价值。结果 难治性支原体肺炎组和普通型支原体肺炎组患儿的年龄、性别以及体重差异无统计学意义(P>0.05),发热时间、合并高热、气促、肺不张、肺实变方面的差异有统计学意义(P<0.05);与普通型支原体肺炎相比,难治性支原体肺炎组血清CCL5、sB7-H3水平明显升高,差异有统计学意义(P<0.05);经Pearson法分析,难治性支原体肺炎患儿的血清CCL5、sB7-H3水平呈正相关(r=0.650,P<0.001);Logistics回归分析结果显示,发热时间、合并高热、气促、肺不张、肺实变、CCL5、sB7-H3是儿童难治性支原体肺炎的独立危险因素(P<0.05);血清CCL5、sB7-H3水平诊断儿童难治性支原体肺炎的曲线下面积(AUC)分别为0.953、0.903,截断值分别为3.79 ng/L、20.10ng/mL,灵敏度分别为84.69%、90.82%,特异度分别为95.56%、86.67%,且CCL5、sB7-H3联合诊断儿童难治性支原体肺炎的AUC为0.973,灵敏度为89.80%,特异度为95.56%。结论 儿童难治性支原体肺炎患儿血清CCL5、sB7-H3水平均升高,血清CCL5、sB7-H3水平联合可能较好地诊断儿童难治性支原体肺炎。
Objective To investigate the expression levels of chemokine(C-C subunit) ligand 5(CCL5) and soluble B7-H3(sB7-H3) in the serum of children with refractory mycoplasma pneumonia,and their diagnostic value.Methods From January 2019 to January 2022,98 children with Mycoplasma pneumonia in our hospital were selected as the research subjects.According to the severity of the condition,the children were grouped into the common mycoplasma pneumonia group(55 cases) and the refractory mycoplasma pneumonia group(43 cases).Enzyme linked immunosorbent assay(ELISA) was applied to detect and compare serum CCL5 and sB7-H3 levels.Pearson method was applied to analyze the correlation between serum levels of CCL5 and sB7-H3.Logistic regression was applied to analyze the influencing factors of refractory mycoplasma pneumonia in children.Receiver operating characteristic(ROC) curve was applied to analyze the diagnostic value of the combination of serum CCL5 and sB7-H3 levels in children with refractory mycoplasma pneumonia.Results There was no statistically obvious difference in age,gender and weight between the refractory mycoplasma pneumonia group and the common mycoplasma pneumonia group(P>0.05),but there were obvious differences in fever time,concomitant high fever,shortness of breath,atelectasis,and pulmonary consolidation(P<0.05).Compared with common mycoplasma pneumonia,the serum levels of CCL5 and sB7-H3 in the refractory mycoplasma pneumonia group were obviously increased(P<0.05).According to Pearson's analysis,the serum levels of CCL5 and s B7-H3 in children with refractory mycoplasma pneumonia were positively correlated( r =-0.650,P < 0.001).The results of Logistic regression analysis showed that prolonged fever time,concomitant high fever,shortness of breath,atelectasis,lung consolidation,CCL5,and s B7-H3 were independent risk factors for refractory mycoplasma pneumonia in children( P < 0.05).The area under the curve( AUC)of serum CCL5 and s B7-H3 levels for diagnosing refractory mycoplasma pneumonia in children was 0.953 and 0.903,respectively,with cutoff value of 3.79 ng/L and 20.10 ng/m L,sensitivity of 84.69% and 90.82%,and specificity of 95.56% and 86.67%,respectively,and the AUC of CCL5 combined s B7-H3 for diagnosing refractory mycoplasma pneumonia in children was 0.973,with a sensitivity of 89.80% and a specificity of 95.56%.Conclusion The serum levels of CCL5 and s B7-H3 in children with refractory mycoplasma pneumonia are all elevated,and the combination of serum CCL5 and s B7-H3 levels may be a good diagnostic tool for refractory mycoplasma pneumonia in children.
作者
刘英丽
尚云非
桂明珠
李青华
LIU Yingli;SHANG Yunfei;GUI Mingzhu;LI Qinghua(Department of Pediatrics,Shanghai Ninth People’s Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 201900,China;Department of Neurology,Luodian Hospital of Baoshan District,Shanghai 201908,China;Department of Pediatrics,Luodian Hospital of Baoshan District,Shanghai 201908,China)
出处
《临床肺科杂志》
2024年第4期492-496,共5页
Journal of Clinical Pulmonary Medicine
