儿童肺炎支原体肺炎肺泡灌洗液中的氧化应激。

Oxidative stress in the alveolar lavage fluid of children with Mycoplasma pneumoniae pneumonia.

机构信息

Children's Intensive Care Unit, the First Affiliated Hospital of Xinxiang Medical College, Xinxiang, China.

出版信息

Pediatr Pulmonol. 2024 Nov;59(11):2772-2782. doi: 10.1002/ppul.27120. Epub 2024 Jun 21.

DOI:10.1002/ppul.27120

PMID:39031860

Abstract

OBJECTIVE

To investigate the correlation between oxidative stress in the bronchoalveolar lavage fluid (BALF) of children with Mycoplasma pneumoniae pneumonia (MPP) and the clinical characteristics of severe MPP (SMPP) and refractory MPP (RMPP).

METHODS

Clinical and BALF-related data were collected from 83 patients with MPP, of which 29 had SMPP and 54 had general MPP (GMPP); 37 patients were in the RMPP group and 46 in the non-RMPP group. The levels of malondialdehyde (MDA) and advanced oxidation protein products (AOPP) as well as the activity levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) in BALF were detected. Logistic regression analyses were performed on MDA, AOPP, SOD, GSH-PX, gender, heat peak, neutrophil percentage, C-reactive protein, lactate dehydrogenase, d-dimer, lung consolidation, sputum embolus, and pleural effusion.

RESULTS

The levels of MDA and AOPP in the BALF of the MPP group were significantly higher than those in the control group (p < .05), whereas SOD and GSH-PX levels were lower than those in the control group (p < .05). The BALF AOPP levels in the RMPP group were higher than those in the non-RMPP group, and the SOD and GSH-PX levels in the BALF were lower than those in the non-RMPP group; the difference was statistically significant (p < .05). The levels of MDA and AOPP in the BALF of children in the SMPP group were higher than those in the GMPP group, and the levels of SOD and GSH-PX were lower than those in the GMPP group, with statistically significant differences (p < .05). The C-index of the logistic regression model was 0.960 (95% confidence interval 0.958-0.963), which indicates that the model has good predictive ability.

CONCLUSION

Advanced oxidation protein products may be a marker for predicting the conditions of SMPP and RMPP, and the prediction model can assess the risk of progression in children to RMPP, which is conducive to clinical diagnosis and treatment.

摘要

目的

探讨肺炎支原体肺炎（MPP）患儿支气管肺泡灌洗液（BALF）中氧化应激与重症 MPP（SMPP）和难治性 MPP（RMPP）临床特征的相关性。

方法

收集 83 例 MPP 患儿的临床和 BALF 相关资料，其中 SMPP 29 例，一般 MPP（GMPP）54 例；RMPP 组 37 例，非 RMPP 组 46 例。检测 BALF 中丙二醛（MDA）、晚期氧化蛋白产物（AOPP）以及超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-PX）的活性水平。对 MDA、AOPP、SOD、GSH-PX、性别、热峰、中性粒细胞百分比、C 反应蛋白、乳酸脱氢酶、D-二聚体、肺实变、痰栓、胸腔积液进行 Logistic 回归分析。

结果

MPP 组 BALF 中 MDA 和 AOPP 水平明显高于对照组（p<0.05），SOD 和 GSH-PX 水平低于对照组（p<0.05）。RMPP 组 BALF 中 AOPP 水平高于非 RMPP 组，SOD 和 GSH-PX 水平低于非 RMPP 组，差异有统计学意义（p<0.05）。SMPP 组患儿 BALF 中 MDA 和 AOPP 水平高于 GMPP 组，SOD 和 GSH-PX 水平低于 GMPP 组，差异有统计学意义（p<0.05）。Logistic 回归模型的 C 指数为 0.960（95%置信区间 0.958-0.963），表明该模型具有良好的预测能力。