摘要
目的探讨肺炎支原体肺炎(MPP)患儿血清白细胞介素-18(IL-18)、白细胞介素-33(IL-33)水平与呼出气一氧化氮(FeNO)、C-反应蛋白(CRP)水平的关系及其临床应用价值。方法选择2022年1月至2023年12月邛崃市中医医院166例肺炎患儿作为感染组,根据感染病原菌分为MPP组48例与非MPP组118例,选择同期100名健康儿童作为对照组。比较三组、MPP组不同病情患儿IL-18、IL-33、FeNO、CRP水平。采用Pearson线性相关分析IL-18、IL-33水平与FeNO、CRP水平的关系,采用ROC曲线分析上述指标对MPP病情严重性的诊断价值。结果MPP组IL-18、IL-33、FeNO、IgM均高于非MPP组与对照组,差异有统计学意义(P<0.05)。WBC、CRP、PCT水平比较:非MPP组>MPP组>对照组,IL-18、IL-33、FeNO、IgM水平比较:MPP组>非MPP组>对照组,差异均有统计学意义(P<0.05)。IL-18、IL-33、FeNO、CRP水平比较:重度组>中度组>轻度组,差异有统计学意义(P<0.05)。Pearson相关分析显示:IL-18与IL-33、FeNO、CRP呈正相关关系(P<0.05);IL-33与FeNO、CRP呈正相关关系(P<0.05);FeNO与CRP呈正相关关系(P<0.05)。ROC曲线分析显示:IL-18、IL-33、FeNO、CRP单独诊断MPP病情的ROC-AUC分别为0.729(0.621~0.821)、0.750(0.651~0.850)、0.739(0.641~0.844)、0.752(0.654~0.857);联合IL-18、IL-33、FeNO、CRP诊断MPP病情的ROC-AUC为0.919(0.850~0.987),灵敏度为94.3%,特异度为89.5%。结论MPP患者血清IL-18、IL-33、FeNO及CRP水平与病情严重程度呈正相关,联合检测四项指标可通过协同作用显著提升诊断效能,联合诊断的结果可为MPP临床评估和诊断提供参考依据。
Objective To investigate the relationship between serum interleukin⁃18(IL⁃18)and in⁃terleukin⁃33(IL⁃33)levels and exhaled nitric oxide(FeNO)and C⁃reactive protein(CRP)levels in patients with mycoplasma pneumoniae pneumonia(MPP)and its differential diagnostic value.Methods From January 2022 to December 2023,166 patients diagnosed with pneumonia were selected as the research subjects for the infection group.They were divided into the MPP group(48 cases)and the non⁃MPP group(118 cases)based on the pathogenic bacteria causing the infection.Meanwhile,100 healthy children were selected as the control group.Detailed information for all subjects was recorded.The levels of IL⁃18 and IL⁃33 were measured using ELISA,FeNO was measured using an electrochemical method,and CRP was detected using an immunofluores⁃cence dry quantitative method.Clinical differences among the three groups were compared.Pearson linear corre⁃lation was used to analyze the relationship between IL⁃18 and IL⁃33,FeNO and CRP,and ROC curve was used to analyze the differential diagnostic value of these indicators for MPP.Results The levels of IL⁃18,IL⁃33,FeNO,and IgM in the MPP group were higher than those in the non⁃MPP group and control group(P<0.05).Comparison of WBC,CRP,PCT levels:the non⁃MPP group>the MPP group>the control group.IL⁃1,IL⁃33,FeNO,and IgM levels:MPP group>non⁃MPP group>control group,the difference was statistically signifi⁃cant(P<0.05).IL⁃18,IL⁃33,FeNO,and CRP levels:severe group>moderate group>mild group,the differ⁃ence was statistically significant(P<0.05).Pearson correlation analysis showed that IL⁃18 was positively corre⁃lated with IL⁃33,FeNO,and CRP(P<0.05).IL⁃33 was positively correlated with FeNO and CRP(P<0.05).There is a positive correlation between FeNO and CRP(P<0.05).Diagnostic value analysis showed that the ROC⁃AUC of IL⁃18,IL⁃33,FeNO,and CRP alone in diagnosing MPP were 0.729(0.621~0.821),0.750(0.651~0.850),0.739(0.641~0.844)and 0.739,respectively The ROC⁃AUC of combined diagnosis of MPP was 0.919(0.850~0.987),with a sensitivity of 94.3%,and a specificity of 89.5%.Conclusion The levels of serum IL⁃18,IL⁃33,FeNO,and CRP in MPP patients are positively correlated with the severity of the disease.The combined detection of these four indicators can significantly improve diagnostic efficacy through synergistic effects.The re⁃sults of joint diagnosis can be used as potential biomarkers for the clinical evaluation and diagnosis of MPP.
作者
刘娟
汪杨
赵蓉
LIU Juan;WANG Yang;ZHAO Rong(Department of Pediatrics,Qionglai Traditional Chinese Medicine Hospital,Qionglai,Sichuan,China,611530)
出处
《分子诊断与治疗杂志》
2025年第8期1392-1395,共4页
Journal of Molecular Diagnostics and Therapy
基金
四川省邛崃市科技惠民技术研发项目(qlsjkjhm20210029)。
