摘要
目的:探讨肺炎支原体肺炎(MPP)患儿血清总胆红素(TBIL)、肺表面活性物质相关蛋白D(SP-D)、辅助性T细胞17(Th17)/调节性T细胞(Treg)水平变化及预测价值.方法:选取2022年4月-2023年12月本院收治的103例MPP患儿为研究组,其中急性期56例、恢复期47例;同时选取同期本院体检的健康儿童63例作为对照组.根据病情转归分为预后良好、预后不良.比较两组实验室指标[白细胞介素-17(IL-17)、白细胞介素-35(IL-35)、C反应蛋白(CRP)、降钙素原(PCT)]、入院时血清TBIL、SP-D、Th17/Treg水平,分析治疗3 d各血清指标对病情转归的预测价值,Logistic回归方程分析影响MPP患儿病情转归的危险因素.结果:与对照组比较,研究组 TBIL、SP-D、Th17/Treg、IL-17、CRP、PCT 水平升高,IL-35 水平降低,FEV1、FVC、PEF 降低(P＜0.05);与预后良好患儿比较,预后不良患儿血清TBIL、SP-D、Th17/Treg水平升高(P＜0.05);TBIL、Th17/Treg 与 IL-17、CRP 呈正相关,SP-D 与 PCT 呈正相关,且与 IL-35 呈负相关(P＜0.05);TBIL、SP-D、Th17/Treg是影响MPP患儿预后不良的危险因素(P＜0.05);三项联合检测时AUC均高于单项检测(P＜0.05).结论:MPP患儿血清TBIL、SP-D、Th17/Treg水平升高,对MPP患儿病情转归具有一定预测价值.
Abstract
Objective:To investigate the changes and predictive value of serum total bilirubin(TBIL),lung surfactant-associated protein D(SP-D),and helper T-cell 17(Th17)/regulatory T-cell(Treg)levels in children with Mycoplasma pneumoniae pneumoniae(MPP).Methods:A total of 103 children with MPP who were admitted to our hospital from April 2022to December 2023 were selected as the research group,including 56 cases in the acute stage and 47 cases in the recovery stage;At the same time,63 healthy children who underwent physical examination in our hospital during the same period were selected as the control group.According to the outcome of the disease,it is divided into good prognosis and poor prognosis.The laboratory indexes[interleukin-17(IL-17),interleukin-35(IL-35),C-reactive protein(CRP),procalcitonin(PCT)],serum TBIL,The levels of SP-D and Th17/Treg were analyzed,and the predictive value of each serum index on the disease outcome after 3 days of treatment was analyzed.Logistic regression equation was used to analyze the risk factors affecting the disease outcome of children with MPP.Results:Compared with the control group,the levels of TBIL,SP-D,Th17/Treg,IL-17,CRP,and PCT in the study group were increased,the levels of IL-35 were decreased,and the levels ofFEV1,FVC,and PEF were decreased(P＜0.05);Compared with children with good prognosis,the serum levels of TBIL,SP-D and Th17/Treg in children with poor prognosis increased(P＜0.05);TBIL and Th17/Treg were positively correlated with IL-17 and CRP,SP-D was positively correlated with PCT,and negatively correlated with IL-35(P＜0.05);TBIL,SP-D and Th17/Treg were risk factors for poor prognosis in children with MPP(P＜0.05);The AUC of the three combined tests were higher than those of the single test(P＜0.05).Conclusion:The serum levels of TBIL,SP-D and Th17/Treg are increased in children with MPP,which has a certain predictive value for the prognosis of children with MPP.
维普
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