Changes and clinical significance of serum IL-17A,RANTES and GM-CSF in children with RMPP
Objective To explore the changes and clinical significance of serum interleukin-17A(IL-17A),regulated upon activation normal T cell expressed and secreted(RANTES)and granulocyte-macro-phage colony-stimulating factor(GM-CSF)in children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods A total of 162 children with RMPP and 120 children with general Mycoplasma pneumoni-ae pneumonia(GMPP)were enrolled as study group and control group between at Xingtai General Hospital of North China Medical and Health Group from December 2019 to December 2021.General data from both groups were collected.The levels of serum IL-17A,RANTES and GM-CSF were detected and compared between the two groups.Their diagnostic value for children with RMPP was analyzed using receiver operating characteristic(ROC)curves.The influencing factors of RMPP were analyzed using univariate and multivariate logistic model analysis.Results The proportions of atelectasis,lung consolidation and pleural effusion,FEV1,FVC,CRP and D-D in the study group were higher than those in the control group(P<0.05),and levels of serum IL-17A,RANTES and GM-CSF were also higher than those in the control group(P<0.05).Pearson correlation analysis showed that FEV1 and FVC were negatively correlated with serum IL-17A,RANTES and GM-CSF in RMMP children(P<0.05).Furthermore,serum IL-17A was positively correlated with RANTES and GM-CSF,and RAN-TES was also positively correlated with GM-CSF(P<0.05).ROC curve analysis showed that the AUC of serum IL-17A combined with RANTES and GM-CSF in the diagnosis of RMPP was 0.906,significantly higher than that of any single indicator(0.785,0.752,0.765).Logistic model analysis showed that atelectasis(OR=2.052),lung consolidation(OR=2.591,P=0.002),pleural effusion(OR=2.309,P=0.001),serum IL-17A≥10.77 pg/mL(OR=1.984,P<0.001),RANTES≥32.95 μg/L(OR=1.833)and GM-CSF≥10.58 μg/L(OR=1.902)were in-dependent risk factors for RMPP.Conclusion The levels of serum IL-17A,RANTES and GM-CSF are in-creased in children with RMPP.The combined detection of these three markers has shown to have higher diagnos-tic accuracy,which can aid in the early diagnosis and intervention of RMPP.
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