摘要
目的观察可溶性生长刺激表达基因2蛋白(stimulation gene 2 protein,sST2)、心脏型脂肪酸结合蛋白(heart-fatty acid binding protein,H-FABP)及氨基末端B型利钠肽前体(amino terminal B-type natriuretic peptide precursor,NT-proBNP)对肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)患儿并发心肌损伤的预测价值。方法选取2024年1月―2025年6月河北医科大学第四医院收治的MPP患儿119例为研究对象,根据疾病发展过程中是否发生心肌损伤分为心肌损伤组29例与无心肌损伤组90例。对比分析2组临床资料。采用酶联免疫吸附法检测sST2及H-FABP;采用化学发光免疫分析法检测NT-proBNP。采用多因素Logistic回归分析、Spearman相关性分析及ROC曲线分析。结果心肌损伤组发热持续时间≥7 d和阵发性咳嗽比例、住院时间及C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)、血小板计数(platelet count,PLT)、肌酸激酶同工酶(creatine kinase-MB,CK-MB)、心肌肌钙蛋白I(cardiac troponin I,cTnI)、乳酸脱氢酶(lactate dehydrogenase,LDH)、天冬氨酸转氨酶(aspartate aminotransferase,AST)、sST2、H-FABP、NT-proBNP水平高于无心肌损伤组,差异有统计学意义(P<0.001)。Spearman相关性分析显示,sST2、H-FABP、NT-proBNP分别与CK-MB、cTnI、LDH、AST呈正相关(P<0.001)。多因素Logistic回归分析显示,sST2、H-FABP、NT-proBNP是影响心肌损伤的危险因素(P<0.001)。受试者工作特征(receiver operating characteristic,ROC)曲线分析显示,sST2、H-FABP、NT-proBNP预测MPP患儿并发心肌损伤的曲线下面积(area under the curve,AUC)分别为0.719(95%CI:0.650~0.789)、0.760(95%CI:0.683~0.817)、0.681(95%CI:0.605~0.746);3项指标联合检测的AUC为0.850(95%CI:0.783~0.892),高于以上指标单独检测(Z=3.370、2.816、3.711,均P<0.001)。结论sST2、H-FABP、NT-proBNP三者联合可用于MPP患儿心肌损伤并发风险的评估,预测价值高于单独指标。
Objective To investigate the predictive value of soluble growth stimulation gene 2 protein(sST2),heart-fatty acid binding protein(H-FABP)and amino terminal B-type natriuretic peptide precursor(NT-proBNP)on myocardial injury in children with mycoplasma pneumoniae pneumonia(MPP).Methods A total of 119 children with MPP admitted to the Fourth Hospital of Hebei Medical University between January 2024 and June 2025 were selected as the study subjects.According to occurrence of myocardial injury in the course of disease development,the patients were divided into myocardial injury group(n=29)and non-myocardial injury group(n=90).The clinical characteristics of the two groups were compared and analyzed.sST2 and H-FABP were detected by enzyme-linked immunosorbent assay and NT-proBNP was detected by electrochemiluminescence immunoassay(ECLIA).Multivariate logistic regression analysis,Spearman correlation analysis and ROC curve analysis were used.Results The proportions of fever duration≥7 d and paroxysmal cough,length of hospital stay,and levels of C-reactive protein(CRP),procalcitonin(PCT),platelet count(PLT),creatine kinase-MB(CK-MB),cardiac troponin I(cTnI),lactate dehydrogenase(LDH),aspartate aminotransferase(AST),sST2,H-FABP,and NT-probBNP in the myocardial injury group were higher or longer than those in the non-myocardial injury group,and the differences were statistically significant(P<0.001).Spearman correlation analysis showed that sST2,H-FABP and NT-proBNP were positively correlated with CK-MB,cTnI,LDH and AST,respectively(P<0.001).Multivariate logistic regression analysis showed that sST2,H-FABP,and NT-proBNP were the risk factors for myocardial injury(P<0.001).Receiver operating characteristic(ROC)curve analysis showed that the areas under the ROC curve(AUCs)of sST2,H-FABP,and NT-probBNP for predicting myocardial injury in children with MPP were 0.719(95%CI:0.650―0.789),0.760(95%CI:0.683~0.817)and 0.681(95%CI:0.605―0.746),respectively.The AUC of the combined detection of the three indicators was 0.850(95%CI:0.783―0.892),which was higher than that of the individual detection of the above indicators(Z=3.370,2.816,3.711,all P<0.001).Conclusion The combination of sST2,H-FABP and NT-proBNP can be used to evaluate the risk of myocardial injury in children with MPP,and the predictive value of sST2,H-FABP and NT-proBNP is higher than that of single indicator.
作者
张宏
李云婷
马鸣
赵日旸
刘丹
ZHANG Hong;LI Yun-ting;MA Ming;ZHAO Ri-yang;LIU Dan(Department of Clinical Laboratory,the Fourth Hospital of Hebei Medical University,Shijiazhuang050012,China;Department of Clinical Laboratory,the Second Hospital ofHebei Medical University,Shijiazhuang 050000,China)
出处
《河北医科大学学报》
2026年第2期137-141,共5页
Journal of Hebei Medical University
关键词
肺炎
支原体
心肌损伤
预测价值
pneumonia,mycoplasma
myocardial injury
predictive value
