| 卢红霞,黄晗,郭燕军,等.儿童难治性支原体肺炎白细胞介素 -8、白细胞介素 -17、 CD4-CD8比值与病情及预后的相关性研究[J].安徽医药,2021,25(12):2411-2415. |
| 儿童难治性支原体肺炎白细胞介素 -8、白细胞介素 -17、 CD4-CD8比值与病情及预后的相关性研究 |
| Correlation between interleukin-8, interleukin-17, CD4+/CD8+ levels and the condition and prognosis of children with refractory mycoplasma pneumoniae pneumonia |
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| DOI：10.3969/j.issn.1009-6469.2021.12.019 |
| 中文关键词: 肺炎，支原体 CD4淋巴细胞计数 CD8阳性 T淋巴细胞 CD4-CD8比值 白细胞介素 -8 白细胞介素 -17 病情 预后 儿童 |
| 英文关键词: Pneumonia, mycoplasma CD4 lymphocyte count Interleukin-17 Condition Prognosis Children |
| 基金项目:2018年度河南省医学科技攻关计划(联合共建项目)(2018020665) |
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| 中文摘要: |
| 目的研究白细胞介素 -8(IL-8)、白细胞介素 -17(IL-17)、 CD4-CD8比值( CD4+/CD8+)水平与儿童难治性支原体肺炎(RMPP)病情及预后的相关性。方法回顾性选取 2017年 1月至 2019年 7月在郑州大学附属儿童医院呼吸内科住院治疗的 180例肺炎支原体肺炎( MPP)病儿中 37例 RMPP纳入 RMPP组，其余 143例普通 MMP纳入轻型肺炎支原体肺炎( MMPP)组。比较两组病儿急性期 IL-8、IL-17、CD4+/CD8+水平及其他实验室指标， logistic回归分析获得 RMPP相关影响因素，绘制受试者工作特征( ROC)曲线分析 logistic回归模型对 RMPP的预测价值；依据支气管镜下表现评价预后，比较不同预后病人急性期血 IL-8、IL-17、CD4+/CD8+水平。结果 RMPP组病儿 IL-8［( 85.69±37.48)ng/L比( 39.44±17.17)ng/L］、 IL-17［( 2.27±0.61)ng/L比(1.64±0.95)ng/L］、白细胞计数( WBC)、中性粒细胞计数( Neu)、血小板计数( PLT)、 C反应蛋白( CRP)、红细胞沉降率( ESR)、乳酸脱氢酶( LDH)、纤维蛋白原( Fib)、 D-二聚体显著高于 MMPP组， RMPP组病儿 CD4+/CD8+(0.92±0.22)显著低于 MMPP组 CD4+/CD8+(1.49±0.37)病儿( P<0.05)； logistic回归分析显示 IL-8、CRP、D-二聚体是 RMPP的独立危险因素， CD4+/CD8+是保护因素； logistic回归模型预测 RMPP的曲线下面积( AUC)为 0.992，临界值 >0.136，灵敏度、特异度分别为 100.00%、96.50%；IL-8、 CD4+/CD8+、CRP、D-二聚体的 AUC分别为 0.847、0.901、0.768、0.828，临界值分别为 >70.71 ng/L、≤1.26 ng/L、>37.95 mg/L、>1.62 mg/L；恢复期 RMPP组中 29例接受支气管镜检查， 13例恢复期预后不良的 RMPP病儿 IL-8显著高于 16例预后良好病儿， CD4+/CD8+显著低于预后良好病儿( P<0.001)但 IL-17比较差异无统计学意义( P>0.05)。结论 IL-8、CD4+/CD8+可作为预测 RMPP病情、预后的灵敏指标，但 IL-17与 RMPP病，情及预后的关系仍有待探究。 |
| 英文摘要: |
| Objective To study the correlation between interleukin-8 (IL-8), interleukin-17 (IL-17), CD4+/CD8+ and the condition and prognosis of children with refractory mycoplasma pneumoniae pneumonia (RMPP).Methods One hundred and eighty childrenwith mycoplasma pneumoniae pneumonia (MPP) who were hospitalized in the Department of Respiratory Medicine, Affiliated Chil.dren′s Hospital of Zhengzhou University from January 2017 and July 2019 were retrospectively selected, including 37 cases with RM.PP (RMPP group) and 143 cases with common MMP [mild MPP (MMPP) group]. IL-8, IL-17 and CD4+/CD8+ levels and other laborato.ry indexes in acute phase were compared between the two groups. Logistic regression analysis was performed to obtain relevant influ.encing factors of RMPP, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of logistic re.gression model for RMPP. The prognosis was evaluated according to the performance under bronchoscope, and the blood IL-8, IL-17 and CD4+/CD8+ levels in patients with different prognosis in acute phase were compared. Results IL-8 [(85.69±37.48) ng/L vs. (39.44±17.17) ng/L], IL-17 (2.27±0.61) ng/L vs. (1.64±0.95)ng/L, white blood cell count (WBC), neutrophil count (Neu), platelet count (PLT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH), fibrinogen (Fib) and D-dimer in RMPP group were significantly higher than those in MMPP group, while CD4+/CD8+ (0.92±0.22) in RMPP group was significantly low.er than (1.49±0.37) of the MMPP group (P<0.05). Logistic regression analysis showed that IL-8, CRP and D-dimer were independentrisk factors of RMPP, and CD4+/CD8+ was a protective factor. Logistic regression model predicted that the Area under the Curve(AUC) of RMPP was 0.992, critical value was > 0.136, the sensitivity and specificity were 100.00% and 96.50%, respectively. TheAUC values of IL-8, CD4+/CD8+, CRP and D-dimer were 0.847, 0.901, 0.768 and 0.828, respectively. The critical values were > 70.71ng/L, ≤ 1.26 ng/L, > 37.95 mg/L and > 1.62 mg/L, respectively. 29 children in the RMPP group underwent bronchoscopy during the re.covery period. IL-8 in 13 children with poor prognosis was significantly higher than that in 16 children with good prognosis, whileCD4+/CD8+ was significantly lower than that of children with good prognosis (P<0.001). However, there was no statistically significant difference in IL-17 (P>0.05).Conclusions IL-8 and CD4+/CD8+ can be used as sensitive indexes to predict the condition and progno. sis of RMPP. The relationship between IL-17 and the condition and prognosis of RMPP needs further study. |
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