Predictive value of serum nuclear receptor 4A1 level for refractory Mycoplasma pneumoniae pneumonia in children
Objective To investigate predictive value of serum nuclear receptor 4A1(NR4A1)for refractory Mycoplasma pneumoniae pneumonia(RMPP)in children.Methods 200 children with Mycoplasma pneumoniae pneumonia(MPP)who admitted to The First Affiliated Hospital of Hebei North University from April 2022 to April 2023 were selected as the study subjects,and they were divided into general Mycoplasma pneumoniae pneumonia(GMPP)group(n=132)and RMPP group(n=68)according to disease condition of the child.The differences in serum NR4A1 level and clinical data of the children were compared between the two groups.Pearson correlation analysis was used to analyze correlations of serum NR4A1 with serum C-reactive protein(CRP),interleukin-6(IL-6)and interleukin-8(IL-8).Receiver operating characteristic(ROC)curve was used to analyze predictive value of serum NR4A1 for RMPP in children.Results Compared with GMPP group,length of hospital stay,high fever rate,incidences of pleural effusion,lung consolidation,pulmonary atelectasis and neutrophil percentage(NEUT％)of the children in RMPP group were higher than those in GMPP group,while the serum albumin level was lower,and the differences were statistically significant(t/Z/2 values ranged from 6.386 to 41.599,all P＜0.05).The serum NR4A1 level of the children in RMPP group was lower than that in GMPP group,while the serum levels of CRP,IL-6 and IL-8 were higher than those in GMPP group,and the differences were statistically significant(t values ranged from 10.279 to 16.889,all P＜0.05).The serum NR4A1 level of the children in acute RMPP stage was lower than that in recovery RMPP stage,while the serum levels of CRP,IL-6 and IL-8 were higher than those in recovery stage,and the differences were statistical significant(t value ranged from 6.367-16.889,all P＜0.05).Pearson correlation analysis showed that the serum NR4A1 was negatively correlated with CRP,IL-6 and IL-8(r=-0.335,-0.507 and-0.291 respectively,all P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of serum NR4A1 for predicting RMPP was 0.870(95％CI:0.821-0.919),the best cut-off value was 0.89,and the sensitivity and the specificity were 74.21％and 92.60％,respectively.Conclusion The expression of NR4A1 in serum is low in children with RMPP,and is related to recovery degree of the disease and expression of inflammatory factors,therefore,it has a good predictive value for RMPP in children.
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