摘要
目的 探讨血清CXC趋化因子配体10(CXCL10)联合高分辨CT影像学特征对小儿重症支原体肺炎的预测价值.方法 选2021年4月至2024年4月在青岛市胶州中心医院接受治疗的重症支原体肺炎患者126例,根据患者治疗1个月内是否继发呼吸衰竭、闭塞性支气管炎、肺纤维化、血管内弥漫性凝血、死亡等不良预后分为预后不良组和预后良好组,比较两组的血清CXCL10水平及高分辨CT影像学特征,分析血清CXCL10水平及高分辨CT影像学特征对重症支原体肺炎患者预后的影响,评价血清CXCL10联合高分辨CT影像学特征对重症支原体肺炎患者不良预后的预测价值.结果 126例重症支原体肺炎患者中预后不良28例,发生率22.22％.预后不良组肺部叩诊浊音、C反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)、血清CXCL10高于预后良好组(P＜0.05).预后不良组中大叶性肺炎、肺实变、肺不张、胸腔积液的占比高于预后良好组(P＜0.05).血清CXCL10(OR=3.823,95％CI:1.526～9.575)、大叶性肺炎(OR=3.640,95％CI:1.447～9.154)、肺实变(OR=4.023,95％CI:1.641～9.865)、肺不张(OR=3.658,95％CI:1.511～8.856)、胸腔积液(OR=3.688,95％CI:1.468～9.264)是重症支原体肺炎患者预后不良的危险因素(P＜0.05).血清CXCL10联合高分辨CT影像学特征预测重症支原体肺炎患者不良预后的敏感度为0.85,特异度为0.62,曲线下面积为0.867.结论 血清CXCL10联合高分辨CT影像学特征可用于评估重症支原体肺炎患者的不良预后,预测效能良好.
Abstract
Objective To explore the predictive value of serum CXC chemokine ligand 10(CXCL10)combined with high-resolution CT imaging features for severe mycoplasma pneumonia in children.Methods 126 patients with severe Mycoplasma pneumoniae pneumonia who received treatment in hospitals from April 2021 to April 2024 were selected.According to whether the patients had secondary respiratory failure,obstructive bronchitis,pulmonary fibrosis,dissemi-nated intravascular coagulation,death and other adverse prognoses within one month of treatment,they were divided in-to poor prognosis group and good prognosis group.The serum CXCL10 levels and high-resolution CT imaging charac-teristics of the two groups were compared,and the impact of serum CXCL10 levels and high-resolution CT imaging characteristics on the prognosis of severe Mycoplasma pneumoniae pneumonia patients was analyzed.The predictive value of serum CXCL10 combined with high-resolution CT imaging characteristics on the adverse prognosis of severe Mycoplasma pneumoniae pneumonia patients was evaluated.Results Among 126 patients with severe mycoplasma pneumonia,28 had poor prognosis,with an incidence rate of 22.22％.The lung percussion dullness,C-reactive protein(CRP),procalcitonin(PCT),white blood cell count(WBC),and serum CXCL10 in the poor prognosis group were high-er than those in the good prognosis group(P＜0.05).The proportion of lobar pneumonia,pulmonary consolidation,ate-lectasis,and pleural effusion in the poor prognosis group was higher than that in the good prognosis group(P＜0.05).Serum CXCL10(OR=3.823,95％CI:1.526-9.575),lobar pneumonia(OR=3.640,95％CI:1.447-9.154),pulmonary consolidation(OR=4.023,95％CI:1.641-9.865),atelectasis(OR=3.658,95％CI:1.511-8.856),and pleural effusion(OR=3.688,95％CI:1.468-9.264)are risk factors for poor prognosis in patients with severe Mycoplasma pneumoni-ae pneumonia(P＜0.05).The sensitivity,specificity,and area under the curve of serum CXCL10 combined with high-resolution CT imaging features for predicting poor prognosis in patients with severe mycoplasma pneumonia were 0.85,0.62 and 0.867,respectively.Conclusion The combination of serum CXCL10 and high-resolution CT imaging features can be used to evaluate the poor prognosis of patients with severe mycoplasma pneumonia,with good predictive power.
维普
万方数据