Han Qian, Jiang Tingting, Wang Tianyi, Wang Dongmeng, Tang He, Chu Yongtao, Bi Jing
Baoding Key Laboratory for Precision Diagnosis and Treatment of Infectious Diseases in Children, Baoding Hospital of Beijing Children's Hospital, Capital Medical University Baoding 071000, Hebei, China.
Hebei Key Laboratory of Infectious Diseases Pathogenesis and Precise Diagnosis and Treatment, Baoding Hospital of Beijing Children's Hospital, Capital Medical University Baoding 071000, Hebei, China.
Am J Transl Res. 2024 Aug 15;16(8):3964-3977. doi: 10.62347/OUPW3987. eCollection 2024.
To investigate the clinical relevance of cytokine levels in assessment of the severity of mycoplasma pneumoniae pneumonia (MPP) in children.
A retrospective study was conducted on 150 pediatric cases of MPP admitted to a local hospital in China from November 1, 2022 to October 31, 2023. These MPP cases were divided into mild (n=100) and severe (n=50) groups according to the severity of the disease. Cytokine levels, including Interferon-γ (IFN-γ), Tumor Necrosis Factor-α (TNF-α), C-reactive protein (CRP), Interleukin-6 (IL-6), Interleukin-2 (IL-2), and D-Dimer (D-D), were compared between the two groups. The diagnostic efficacy of each cytokine in assessing the severity of MPP was analyzed through Receiver Operating Characteristic (ROC) curves, and correlation between cytokine levels and disease severity was assessed using Pearson's correlation coefficient.
The IL-2 level was significantly lower, while TNF-α, IL-6, and IFN-γ levels were significantly higher in the severe group compared to the mild group (all P<0.05). TNF-α, IFN-γ, IL-2, IL-6, CRP, and D-D were identified as factors influencing the severity of MPP (all P<0.05). The ROC curve analysis showed that the areas under the curve (AUCs) of TNF-α, IL-2, IL-6, IFN-γ, CRP, and D-D were 0.864, 0.692, 0.874, 0.949, 0.814, and 0.691, respectively (all P<0.001), indicating their diagnostic value in assessing the severity of MPP. There exists a positive correlation between IL-2 and the percentage of normal lung density on Computed Tomography (CT) scan (P<0.05), while TNF-α, IL-6, IFN-γ, CRP, and D-D showed negative correlations with the percentage of normal lung density (P<0.05).
Cytokines such as TNF-α, IL-2, IL-6, IFN-γ, CRP, and D-D are aberrantly expressed in children with MPP and are associated with the severity of the disease. These cytokines have high diagnostic value and can serve as reference indicators for clinical, especially prognostic assessment of the severity of (pediatric) MPP.
探讨细胞因子水平在评估儿童支原体肺炎（MPP）严重程度中的临床相关性。
对2022年11月1日至2023年10月31日在中国当地一家医院收治的150例儿童MPP病例进行回顾性研究。这些MPP病例根据疾病严重程度分为轻症组（n = 100）和重症组（n = 50）。比较两组之间的细胞因子水平，包括干扰素-γ（IFN-γ）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、白细胞介素-6（IL-6）、白细胞介素-2（IL-2）和D-二聚体（D-D）。通过受试者工作特征（ROC）曲线分析每种细胞因子在评估MPP严重程度中的诊断效能，并使用Pearson相关系数评估细胞因子水平与疾病严重程度之间的相关性。
与轻症组相比，重症组的IL-2水平显著降低，而TNF-α、IL-6和IFN-γ水平显著升高（均P < 0.05）。TNF-α、IFN-γ、IL-2、IL-6、CRP和D-D被确定为影响MPP严重程度的因素（均P < 0.05）。ROC曲线分析显示，TNF-α、IL-2、IL-6、IFN-γ、CRP和D-D的曲线下面积（AUC）分别为0.864、0.692、0.874、0.949、0.814和0.691（均P < 0.001），表明它们在评估MPP严重程度方面的诊断价值。IL-2与计算机断层扫描（CT）扫描中正常肺密度百分比呈正相关（P < 0.05），而TNF-α、IL-6、IFN-γ、CRP和D-D与正常肺密度百分比呈负相关（P < 0.05）。
TNF-α、IL-2、IL-6、IFN-γ、CRP和D-D等细胞因子在MPP患儿中异常表达，并与疾病严重程度相关。这些细胞因子具有较高的诊断价值，可作为临床尤其是（儿童）MPP严重程度预后评估的参考指标。
