Objective To investigate the relationship between serum MP-IgM antibody titer and Th1/Th2 immune response balance in patients with Mycoplasma pneumoniae (MP) pneumonia. Methods A total of 214 patients with MP pneumonia admitted to People's Hospital of Yuechi County from January 2020 to March 2022 were selected as subjects. According to the serum MP-IgM antibody titer,patients were divided into 3 groups:low titer group (92 cases),medium titer group (75 cases) and high titer group (47 cases),and according to the prognosis,they were divided into 2 groups:improvement group (125 cases) and deterioration group (89 cases). Univariate analysis of clinical data differences between patients in different serum MP-IgM antibody titers groups and different prognosis groups;generalized additive model (GAM) analysis to analyze the correlation between indicators;multi-factor logistic regression analysis to identify independent risk factors for bad prognosis. Restrictive cubic spline combined with logistic regression was employed to analyze the dose-response relationship between Th1/Th2 ratio and the risk of disease deterioration. Results There were statistically significant differences (P<0.05) in the proportion of fever,fever clearance time,WBC,CRP,IFN-γ,IL-5,and IFN-γ/IL-5 among the three groups with different serum MP-IgM antibody titers. Among them,the fever clearance time,WBC level,CRP level,IFN-γ level,and IL-5 level gradually increased with the increase of the titer level,while the IFN-γ/IL-5 ratio gradually decreased with the increase of the titer level. There was no statistical significance in the difference of fever proportion between the low titer group and the medium titer group (P>0.05),but the number of patients with fever in the high titer group was significantly higher than that in the other 2 groups. IFN-γ and IL-5 were positively correlated with serum MP-IgM titers,and Th1/Th2 immune balance index IFN-γ/IL-5 was negatively correlated with serum MP-IgM titers. Univariate and multivariate analysis showed that IFN-γ>5.25 pg/mL,IL-5>4.05 pg/mL and increased serum MP-IgM titer were the main risk factors for disease progression. The IFN-γ/IL-5 was the protective factor (P<0.05). The continuous change of Th1/Th2 ratio demonstrated a non-linear dose-response relationship with the risk of disease deterioration (P<0.01). Th1/Th2 level showed a roughly negative correlation with the risk of disease deterioration,and when Th1/Th2 ratio was greater than 1.20,the risk of disease deterioration significantly decreased with the increase of Th1/Th2 level. Conclusion Serum MP-IgM antibody titer is negatively correlated with IFN-γ/IL-5. The balance index of Th1/Th2 immune response,and the detection of serum MP-IgM antibody titer and Th1/Th2 cytokine index is helpful for early diagnosis of MP pneumonia.
维普
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