Zhang Wen-Hua, Zhou Min-Ping, Zou Yu-Yun, Chen Jia-Wei, Wang Ting, Huang Li, Yan Yong-Dong, Ji Wei, Zhu Can-Hong, Chen Zheng-Rong
Department of Blood Transfusion, Children's Hospital of Soochow University, Suzhou, China.
Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China.
Transl Pediatr. 2023 Mar 31;12(3):396-404. doi: 10.21037/tp-23-86. Epub 2023 Mar 27.
Refractory mycoplasma pneumoniae pneumonia (RMPP) is a serious mycoplasma pneumoniae infection and is difficult to diagnose early. The levels of serum soluble B7-dendritic cell (sB7-DC) in children with mycoplasma pneumoniae pneumonia (MPP) were assessed to explore the clinical significance of sB7-DC levels in RMPP.
A total of 65 patients with mycoplasma pneumoniae pneumonia (MPP) were enrolled in this study between January 2017 and December 2018. The patients were divided into the general mycoplasma pneumoniae pneumonia (GMPP) (n=30) and RMPP groups (n=35); the data of 20 normal children served as a control group (n=20). An enzyme-linked immunoassay kit was used to detect the expression of soluble B7-dendritic cell (sB7-DC) and other inflammatory factors. Binary logistic regression was performed to identify the independent predictors of RMPP. Receiver operating characteristic (ROC) curves were drawn to evaluate the value of each independent risk factor in the early diagnosis of RMPP.
The results showed that compared to the GMPP group, children in the RMPP group had a significantly longer hospital stay and had a significantly longer fever duration (P<0.05). The values of interferon-gamma (IFN-γ), interleukin 17 (IL-17), and sB7-DC in the RMPP group were significantly higher than those in the normal control and GMPP groups (all P<0.05). The results of the correlation analysis showed that sB7-DC was positively correlated with IFN-γ and IL-17 and these indicators could be used in combination to evaluate the severity of the disease. The binary logistic regression analysis identified IL-17 and sB7-DC as independent risk factors for RMPP (P<0.05). The ROC curve analysis showed that the cut-off values of IL-17 and sB7-DC were 309.6 pg/L and 1,109.7 pg/mL, respectively. The areas under the curve (AUCs) of IL-17 and sB7-DC were 0.741 and 0.794, respectively. The sensitivity of IL-17 to RMPP prediction was 83.3%, and the specificity was 62.9%. The sensitivity and specificity of sB7-DC to RMPP were 86.7% and 62.9%, indicating that sB7-DC had the highest predictive power for RMPP.
The level of serum sB7-DC may play an important role in the early diagnosis of RMPP. Our research results provide a theoretical basis for the early diagnosis of RMPP.
难治性支原体肺炎（RMPP）是一种严重的支原体肺炎感染，早期难以诊断。评估支原体肺炎（MPP）患儿血清可溶性B7树突状细胞（sB7-DC）水平，以探讨sB7-DC水平在RMPP中的临床意义。
2017年1月至2018年12月共纳入65例支原体肺炎（MPP）患者。将患者分为普通支原体肺炎（GMPP）组（n = 30）和RMPP组（n = 35）；20例正常儿童的数据作为对照组（n = 20）。采用酶联免疫吸附测定试剂盒检测可溶性B7树突状细胞（sB7-DC）及其他炎症因子的表达。进行二元逻辑回归分析以确定RMPP的独立预测因素。绘制受试者工作特征（ROC）曲线以评估各独立危险因素在RMPP早期诊断中的价值。
结果显示，与GMPP组相比，RMPP组患儿住院时间明显延长，发热持续时间明显延长（P < 0.05）。RMPP组中干扰素-γ（IFN-γ）、白细胞介素17（IL-17）和sB7-DC的值明显高于正常对照组和GMPP组（均P < 0.05）。相关性分析结果显示，sB7-DC与IFN-γ和IL-17呈正相关，这些指标可联合用于评估疾病严重程度。二元逻辑回归分析确定IL-17和sB7-DC为RMPP的独立危险因素（P < 0.05）。ROC曲线分析显示，IL-17和sB7-DC的截断值分别为309.6 pg/L和1109.7 pg/mL。IL-17和sB7-DC的曲线下面积（AUC）分别为0.741和0.794。IL-17对RMPP预测的敏感性为83.3%，特异性为62.9%。sB7-DC对RMPP的敏感性和特异性分别为86.7%和62.9%，表明sB7-DC对RMPP的预测能力最高。
血清sB7-DC水平可能在RMPP的早期诊断中起重要作用。我们的研究结果为RMPP的早期诊断提供了理论依据。
