摘要
目的研究肺炎支原体肺炎(MPP)合并气道黏液栓患儿血清可溶性程序性死亡因子配体-2(sPD-L2)和透明质酸受体Layilin(LAYN)的表达及临床意义。方法选取自2018年1月至2022年1月期间收治的184例MPP患儿为MPP组,以同期择期行腹股沟斜疝60例儿童为对照组。根据支气管镜下是否合并气道黏液栓,将MPP组分为单纯MPP组(130例)和MPP合并气道黏液栓组(54例)。酶联免疫吸附实验检测血清sPD-L2、LAYN水平。多因素logistic回归分析影响MPP患儿合并气道黏液栓的危险因素。受试者工作特征(ROC)曲线分析血清sPD-L2、LAYN对MPP合并气道黏液栓的预测价值。结果MPP组血清sPD-L2、LAYN明显高于对照组,差异有统计学意义(均P<0.05)。MPP合并气道黏液栓组患儿发热时间、血清C反应蛋白、胸腔积液、肺不张、累及肺叶≥2个、sPD-L2、LAYN水平高于单纯MPP组,差异有统计学意义(均P<0.05)。MPP合并气道黏液栓患儿血清sPD-L2、LAYN与白细胞、C反应蛋白、中性粒细胞百分比呈显著正相关(均P<0.05)。发热时间、血清sPD-L2、LAYN升高是影响MPP合并气道黏液栓形成的独立危险因素。发热时间、sPD-L2、LAYN联合对MPP合并气道黏液栓预测的ROC曲线下面积为0.893,高于单一指标检测0.820、0.721及0.789,差异有统计学意义(Z=4.302、5.618、4.518,均P<0.001)。结论MPP合并气道黏液栓患儿血清sPD-L2、LAYN水平升高,发热时间、血清sPD-L2、LAYN升高是MPP合并气道黏液栓形成的独立危险因素,三项联合有助于评估MPP合并气道黏液栓。
Objective To investigate the expression and clinical significance of serum soluble programmed cell death ligand-2(sPD-L2)and hyaluronic acid receptor Layilin(LAYN)in children with Mycoplasma pneumoniae pneumonia(MPP)complicated by airway mucus plug.Methods A total of 184 children with MPP from January 2018 to January 2022 were selected as the MPP group,and 60 children undergoing elective inguinal hernia repair in the same period were selected as the control group.According to whether airway mucus plug was combined under bronchoscopy,the MPP group was divided into the simple MPP group(130 cases)and the MPP combined with mucus plug group(54 cases).Enzyme-linked immunosorbent assay was used to detect serum sPD-L2 and LAYN levels.Multivariate logistic regression analysis was used to analyze the risk factors affecting the formation of airway mucus plug in children with MPP.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum sPD-L2 and LAYN for MPP combined with airway mucus plug.Results The serum levels of sPD-L2 and LAYN in the MPP group were significantly higher than those in the control group,and the differences were statistically significant(all P<0.05).In the MPP group with airway mucus plug,the fever duration,serum C-reactive protein,pleural effusion,lung collapse,involvement of≥2 lung lobes,sPD-L2,and LAYN levels were higher than those in the simple MPP group,and the differences were statistically significant(all P<0.05).The serum levels of sPD-L2 and LAYN in children with MPP combined with airway mucus plug were significantly positively correlated with white blood cell count,C-reactive protein,and percentage of neutrophils(all P<0.05).Fever duration,elevated serum sPD-L2,and LAYN were independent risk factors for the formation of airway mucus plug in MPP.The combined ROC curve for fever duration,sPD-L2,and LAYN predicting MPP combined with airway mucus plug had an area under the curve of 0.893,higher than the single indicator detection of 0.820,0.721,and 0.789,with statistically significant differences(Z=4.302,5.618,4.518,all P<0.001).Conclusion The elevated serum levels of sPD-L2 and LAYN in children with MPP combined with airway mucus plug,along with prolonged fever duration,indicate independent risk factors for the formation of airway mucus plug.The combination of these three factors helps assess the presence of MPP combined with airway mucus plug.
作者
王可
于京虎
裴艳莹
WANG Ke;YU Jing-hu;PEI Yan-ying(Department of Pediatrics,Jiamusi Central Hospital,Jiamusi 154002,Heilongjiang,China;不详)
出处
《广东医学》
CAS
2024年第5期620-625,共6页
Guangdong Medical Journal
基金
黑龙江省医药卫生科研课题(2019352)。
