摘要
目的探讨肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)患儿血清肝素结合蛋白(heparinbinding protein,HBP)、基质金属蛋白酶2(matrix metalloproteinase 2,MMP-2)和可溶性尿激酶型纤溶酶原激活物受体(soluble urokinase-type plasminogen activator receptor,suPAR)的表达水平变化及其对预后的预测价值。方法选取2023年4月至2024年5月在武汉市第三医院确诊的86例MPP患儿作为研究组,并纳入同期90例在我院健康体检儿童作为对照组。根据预后评估结果,将MPP患儿分为预后不良组(42例)和预后良好组(44例)。采用ELISA法检测血清HBP、MMP-2及suPAR水平;通过多因素Logistic回归分析明确MPP患儿预后不良的危险因素;绘制受试者工作特征曲线,评估各指标对MPP患儿预后不良的诊断效能。结果与对照组比较,研究组血清HBP、MMP-2及suPAR水平均显著升高(P<0.05);与预后良好组相比,预后不良组血清HBP、MMP-2、suPAR及CRP水平均较高(P<0.05)。多因素分析显示,血清HBP、MMP-2及suPAR水平升高是MPP患儿不良预后的独立危险因素(均P<0.05)。ROC分析表明,血清HBP、MMP-2、suPAR联合诊断MPP患者预后不良的曲线下面积(area under curve,AUC)为0.985,其效能显著优于单独指标检测(z=1.971,2.545,2.356;均P<0.05)。结论MPP患儿血清HBP、MMP-2及suPAR水平升高,且与其不良预后密切相关,3者联合检测对MPP患儿预后不良具有较高预测价值。
Objective To investigate the changes in the expression levels of heparin binding protein(HBP),matrix metalloproteinase-2(MMP-2),and soluble urokinase type plasminogen activator receptor(suPAR)in the serum of children with Mycoplasma pneumoniae pneumonia(MPP)and their predictive value for prognosis.Methods A total of 86 children with MPP diagnosed in our hospital from April 2023 to May 2024(study group)were selected as the study subjects,and 90 children of the same age who passed the health examination test in our hospital during the same period were selected as the control group.Serum samples were collected from all patients,and the patients were assigned into a poor prognosis group of 42 and a good prognosis group of 44 according to the evaluation results of the pediatric patients.ELISA method was applied to detect the levels of serum HBP,MMP-2,and suPAR.Multivariate logistic regression analysis was applied to identify risk factors for poor prognosis in MPP patients.ROC curves were plotted to analyze the diagnostic value of serum levels of HBP,MMP-2 and suPAR in the poor prognosis of MPP patients.Results Compared with the control group,the levels of serum HBP,MMP-2,and suPAR in the study group were greatly higher;compared with the good prognosis group,the poor prognosis group had higher levels of serum HBP,MMP-2,and suPAR expression(P<0.05).Compared with the good prognosis group,the serum CRP level in the poor prognosis group was significantly increased(P<0.05).Multivariate analysis showed that elevated serum levels of HBP,MMP-2,and suPAR were independent risk factors for poor prognosis in children with MPP(P<0.05).ROC curve analysis indicated that the area under the curve(AUC)of the combined detection of serum HBP,MMP-2,and suPAR for diagnosing poor prognosis in MPP patients was 0.985,and its diagnostic efficacy was significantly superior to that of single index detection(z=1.971,2.545,2.356,P<0.05).Conclusion Elevated serum HBP,MMP-2,and suPAR levels in children with MPP are closely related to poor prognosis.Combined of the three tests showed high predictive value for adverse outcomes in children with MPP.
作者
张颖
王丽艳
张伶
Zhang Ying;Wang Liyan;Zhang Ling(Department of Pediatrics,Wuhan Third Hospital,Wuhan 430000,China)
出处
《传染病信息》
2025年第5期472-477,共6页
Infectious Disease Information
基金
湖北省卫生健康委科研项目(WJ2021M011)。
