摘要
目的探讨肺炎支原体抗体(mycoplasma pneumoniae immunoglobulin M,MP-IgM)、人软骨糖蛋白39(human cartilage glycoprotein 39,YKL-40)、载脂蛋白C1(apolipoprotein C-I,APOC1)和白细胞介素-6(interleukin 6,IL-6)在儿童支原体肺炎治疗及预后中的意义。方法选取2017年1月至2017年12月本院确诊的80例儿童支原体肺炎患儿为观察组给予对症治疗,选取同期健康体检儿童40例为对照组。分别检测两组儿童外周静脉血中MP-IgM、YKL-40、APOC1和IL-6表达水平。结果与对照组相比,观察组患儿血清YKL-40、APOC1和IL-6表达水平显著升高,血清MP-IgM呈明显阳性;观察组血清YKL-40、APOC1和IL-6表达水平治疗后显著降低,血清MP-IgM阳性(P <0.05)。儿童支原体肺炎血清YKL-40、APOC1和IL-6水平,MP-IgM阳性率与疾病严重程度存在显著的正相关关系,P<0.05。经ROC分析可知,MP-IgM、YKL-40、APOC1和IL-6这4项生物学标志物并联试验灵敏度为92.00%,串联试验特异性为100.00%,显著大于各单项生物学标志物检测(P<0.05)。与对照组相比,观察组患儿FEV_1/FVC(%)及FEV_1%预计值显著降低(P<0.05)。与治疗前相比,观察组患儿治疗后FEV_1/FVC(%)及FEV_1%预计值显著升高(P<0.05)。儿童肺炎支原体患儿YKL-40、APOC1和IL-6水平,MP-IgM阳性率与患儿肺功能存在显著的负相关关系,P<0.05。结论儿童支原体肺炎患儿血清MP-IgM、YKL-40、APOC1和IL-6表达水平异常升高;监测患儿血清MP-IgM、YKL-40、APOC1和IL-6水平变化对于辅助诊断和评价儿童支原体肺炎的病情程度和治疗具有一定的临床意义,值得推广研究。
Objective To investigate the clinical values of Mycoplasma pneumoniae Immunoglobulin M(MP-IgM),Human cartilage glycoprotein 39(YKL-40),apolipoprotein CI(APOC1) and interleukin-6.(Interleukin 6,IL-6) in the treatment and prognosis of children with mycoplasmal pneumonia.Methods Eighty children with mycoplasmal pneumonia diagnosed in our hospital from January,2017 to December,2017 were enrolled in the observation group.40 patients for physical examination were selected as the control group.The expression levels of MP-IgM,YKL-40,APOC1 and IL-6 in peripheral blood of two groups of children were detected.Results Compared with the control group,the expression levels of YKL-40,APOC1 and IL-6 in the serum of the observation group were significantly increased,and the serum MP-IgM was significantly positive.The levels of these three markers significantly decreased after the treatment,serum MP-IgM was remaining positive(P <0.05).There was a significant positive correlation between the positive rate of YKL-40,APOC1 and IL-6 and the severity of MP-IgM in children with mycoplasmal pneumonia(P <0.05).According to the ROC analysis,the sensitivity of the parallel bioassay of MP-IgM,YKL-40,APOC1 and IL-6 was 92.00%,and the tandem test specificity was 100.00%,which were significantly greater than each single biomarker detection(P <0.05).Compared with the control group,the FEV 1/FVC(%) and FEV 1% predicted values were significantly lower in the observation group(P <0.05).The FEV 1/FVC(%) and FEV 1% predicted values were significantly higher in the observation group than in the pre-treatment group(P <0.05).There were significant negative correlations between YKL-40,APOC1 and IL-6 levels and MP-IgM positive rate in children with Mycoplasma pneumoniae(P <0.05).Conclusion The expressions of MP-IgM,YKL-40,APOC1 and IL-6 are abnormally elevated in children with mycoplasmal pneumonia.These markers can be monitored to facilitate the diagnosis and treatment of mycoplasmal pneumonia in children and is worthy of promotion.
作者
李智琼
孙承谋
朱玲娜
孔昌盛
LI Zhi-qiong;SUN Cheng-mou;ZHU Ling-na;KONG Chang-sheng(Department of Clinical Laboratory,Yiling Hospital,Yichang 443100,China)
出处
《标记免疫分析与临床》
CAS
2019年第4期576-579,619,共5页
Labeled Immunoassays and Clinical Medicine
