肺炎支原体Ig-DNA、高密度脂蛋白、自然杀伤细胞及血小板水平对儿童重症肺炎支原体肺炎的诊断预测价值
Predictive value of Ig Mycoplasma pneumoniae-DNA, high-density lipoprotein, natural killer cell, and platelet levels for diagnosing severe M. pneumoniae pneumonia in children.
作者信息
Kai-Jing Zhang, Xin-Feng Zhao, Xiaojuan Lv, Xiao-Hui Huang
机构信息
Department Hematology of Hangzhou Children's Hospital, Zhejiang University of Traditional Chinese Medicine, Hangzhou, China.
Laboratory Department of Hangzhou Children's Hospital, Zhejiang University of Traditional Chinese Medicine, Hangzhou, China.
出版信息
Indian J Med Microbiol. 2025 Jan-Feb;53:100770. doi: 10.1016/j.ijmmb.2024.100770. Epub 2024 Dec 7.
OBJECTIVE
The present study aimed to assess the predictive value of Ig Mycoplasma pneumoniae (MP)-DNA, high-density lipoprotein (HDL), natural killer (NK) cell, and platelet (PLT) levels for the diagnosis of severe MP pneumonia (SMPP) in children with MP pneumonia (MPP).
METHODS
Children with MPP admitted to our hospital from August 2022 to February 2024 were selected and assigned to the non-SMPP (NSMPP) and SMPP groups according to whether they had severe pneumonia. The following parameters were analyzed and compared between the two groups by the rank-sum test: age; Ig MP-DNA level; white blood cell, neutrophil (N), and monocyte counts; platelet (PLT), C-reactive protein (CRP), lactate dehydrogenase (LDH), triglycerides, high-density lipoprotein (HDL), low-density lipoprotein, and procalcitonin levels; and levels of T cells, CD4 T cells, CD8 T cells, B cells, and NK cells. The chi-square test was used to analyze differences in these variables between genders. One-way analysis of variance was used to select significant variables (P < 0.1) from the abovementioned ones, and the selected variables were analyzed by multivariate analysis of variance to detect independent risk factors. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) value were determined for the independent risk factors.
RESULTS
The two groups showed significant differences in the levels of Ig MP-DNA, N, PLT, CRP, LDH, HDL, CD8 T cells, and NK cells. PLT and Ig MP-DNA levels were positively correlated with the risk of SMPP development; however, HDL and NK levels showed a negative correlation. The AUC values for Ig MP-DNA + HDL, Ig MP-DNA + NK, Ig MP-DNA + PLT, NK + HDL, NK + PLT, and PLT + HDL were 0.825, 0.812, 0.813, 0.724, 0.717, and 0.701, respectively.
CONCLUSION
The combination of variables, including Ig MP-DNA + HDL, Ig MP-DNA + NK, and Ig MP-DNA + PLT, can predict whether MPP children would develop SMPP.
目的
本研究旨在评估肺炎支原体（MP）-DNA、高密度脂蛋白（HDL）、自然杀伤（NK）细胞及血小板（PLT）水平对儿童支原体肺炎（MPP）发展为重症MP肺炎（SMPP）的预测价值。
方法
选取2022年8月至2024年2月我院收治的MPP患儿，根据是否发生重症肺炎分为非SMPP（NSMPP）组和SMPP组。采用秩和检验分析比较两组患儿的以下参数：年龄；MP-DNA水平；白细胞、中性粒细胞（N）及单核细胞计数；血小板（PLT）、C反应蛋白（CRP）、乳酸脱氢酶（LDH）、甘油三酯、高密度脂蛋白（HDL）、低密度脂蛋白及降钙素原水平；T细胞、CD4 T细胞、CD8 T细胞、B细胞及NK细胞水平。采用卡方检验分析上述变量在不同性别间的差异。采用单因素方差分析从上述变量中筛选出有统计学意义的变量（P < 0.1），并对筛选出的变量进行多因素方差分析以检测独立危险因素。绘制独立危险因素的受试者工作特征（ROC）曲线并计算ROC曲线下面积（AUC）值。
结果
两组患儿在MP-DNA、N、PLT、CRP、LDH、HDL、CD8 T细胞及NK细胞水平上存在显著差异。PLT及MP-DNA水平与SMPP发生风险呈正相关；然而，HDL及NK水平呈负相关。MP-DNA + HDL、MP-DNA + NK、MP-DNA + PLT、NK + HDL、NK + PLT及PLT + HDL的AUC值分别为0.825、0.812、0.813、0.724、0.717及0.701。
结论
MP-DNA + HDL、MP-DNA + NK及MP-DNA + PLT等变量组合可预测MPP患儿是否会发展为SMPP。
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