血清粒细胞集落刺激因子、乳酸脱氢酶3、半胱氨酰白三烯对重症肺炎支原体肺炎患儿临床转归的预测价值

doi:10.19871/j.cnki.xfcrbzz.2025.04.011

摘要/Abstract

摘要： 目的探讨粒细胞集落刺激因子（granulocyte colony-stimulating factor,G-CSF）、乳酸脱氢酶3（lactate dehydrogenase 3,LDH3）、半胱氨酰白三烯（cysteinyl leukotrienes,CysLTs）在重症肺炎支原体肺炎患儿血清中的水平,分析其预测患儿临床转归的价值。方法选取2022年7月至2024年7月绵阳市中医医院收治的重症肺炎支原体肺炎患儿（重症组,n=98）、同期收治的轻症肺炎支原体肺炎患儿（轻症组,n=114）和同期体检健康的儿童（对照组,n=100）。分析比较三组一般资料、血清G-CSF、LDH3、CysLTs及第1秒用力呼气量（forced expiratory volume in 1 second,FEV₁）、用力肺活量（forced vital capacity,FVC）指标,Pearson法分析重症肺炎支原体肺炎患儿血清G-CSF、LDH3、CysLTs与肺功能指标的相关性。根据治疗效果,将重症肺炎支原体肺炎患儿分为治疗有效组（n=67）和治疗无效组（n=31）,Logistic回归分析影响重症肺炎支原体肺炎患儿转归结局的因素,受试者操作特征曲线（receiver operating characteristic curve,ROC曲线）曲线分析重症肺炎支原体肺炎患儿血清G-CSF、LDH3、CysLTs水平对治疗效果的预测价值。结果轻症组和对照组淋巴细胞计数、FEV₁、FEV₁/FVC水平较重症组高（P<0.05）;血清G-CSF、LDH3、CysLTs水平较重症组低（P<0.05）。重症组患儿血清G-CSF、LDH3、CysLTs两两之间均呈正相关（P<0.05）,且3个指标均与FEV₁、FEV₁/FVC呈负相关（P<0.05）。治疗有效组淋巴细胞计数、FEV₁、FEV₁/FVC显著高于治疗无效组（P<0.05）,血清G-CSF、LDH3、CysLTs水平显著低于治疗无效组（P<0.05）。G-CSF、LDH3、CysLTs水平较高是患儿治疗无效的危险因素（P<0.05）,FEV₁/FVC较高是患儿治疗无效的保护因素（P<0.05）。G-CSF、LDH3、CysLTs三者联合预测治疗效果的曲线下面积（area under curve,AUC）为0.869,优于单项检测（Z_G-CSF-联合=2.791、P=0.005,Z_LDH3-联合=2.087、P=0.037,Z_{CysLTs-联合}=2.963、P=0.003）。结论重症肺炎支原体肺炎患儿血清G-CSF、LDH3、CysLTs水平升高,与患儿疾病转归有关,3个指标联合检测可能在预测重症肺炎支原体肺炎患儿临床转归上具有一定价值。

关键词: 重症肺炎支原体肺炎, 粒细胞集落刺激因子, 乳酸脱氢酶3, 半胱氨酰白三烯, 转归, 预测价值, 儿童

Abstract: Objective To explore the levels of serum granulocyte colony-stimulating factor (G-CSF), lactate dehydrogenase 3 (LDH3), and cysteinyl leukotrienes (CysLTs) in children with severe Mycoplasma pneumoniae pneumonia, and to analyze their value in predicting clinical outcomes. Method From July 2022 to July 2024, 98 children with severe Mycoplasma pneumoniae pneumonia admitted to our hospital were regarded as the study subjects (severe group), simultaneously, 114 children with mild Mycoplasma pneumoniae pneumonia admitted to our hospital were included as the mild group, and 100 healthy children who underwent physical check-ups were selected as the control group. The general information, serum levels of G-CSF, LDH3, CysLTs, as well as indicators of forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC) were analyzed and compared among the three groups. Pearson correlation analysis was used to assess the correlation between serum G-CSF, LDH3, CysLTs and lung function indicators in children with severe Mycoplasma pneumoniae pneumonia. Based on the treatment effect, children with severe Mycoplasma pneumoniae pneumonia were assigned into the effective treatment group (n=67) and the ineffective treatment group (n=31). Logistic regression analysis was applied to analyze the factors affecting the outcome of children with severe Mycoplasma pneumoniae pneumonia. The receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum G-CSF, LDH3, and CysLTs ffor treatment efficacy in children with severe Mycoplasma pneumoniae pneumonia. Results The lymphocyte count, FEV₁, and FEV₁/FVC levels in the severe group were obviously lower than those in the mild group and the control group (P<0.05). The levels of serum G-CSF, LDH3, and CysLTs in the severe group were obviously higher than those in the control group and mild group (P<0.05). In children with severe Mycoplasma pneumoniae pneumonia, serum G-CSF, LDH3, and CysLTs were positively correlated with each other (P<0.05), and all three were negatively correlated with FEV₁ and FEV₁/FVC (P<0.05). The lymphocyte count, FEV₁, and FEV₁/FVC in the effective treatment group were obviously higher than those in the ineffective treatment group (P<0.05), while the levels of serum G-CSF, LDH3, and CysLTs were obviously lower than those in the ineffective treatment group (P<0.05). Higher levels of G-CSF, LDH3, and CysLTs were risk factors for ineffective treatment in children (P<0.05), while FEV₁/FVC was a protective factor (P<0.05). The AUC of the combination of G-CSF, LDH3, and CysLTs for predicting treatment efficacy was 0.869, which was better than single indicator detection (Z_{G-CSF-combination}=2.791, P=0.005, Z_{LDH3- combination}=2.087, P=0.037, Z_{CysLTs-combination}=2.963, P=0.003). Conclusion The serum levels of G-CSF, LDH3, and CysLTs in children with severe Mycoplasma pneumoniae pneumonia are elevated, and they are related to the disease outcome. Combined measurement of the three may have value in predicting the clinical outcome of children with severe Mycoplasma pneumoniae pneumonia.

Key words: Severe Mycoplasma pneumoniae pneumonia, Granulocyte colony-stimulating factor, Lactate dehydrogenase 3, Cysteinyl leukotrienes, Outcome, Predictive value, Children

中图分类号:

R563.1

宋丹, 何秋红, 刘建设. 血清粒细胞集落刺激因子、乳酸脱氢酶3、半胱氨酰白三烯对重症肺炎支原体肺炎患儿临床转归的预测价值[J]. 新发传染病电子杂志, 2025, 10(4): 65-70.

Song Dan, He Qiuhong, Liu Jianshe. The predictive value of serum G-CSF, LDH3, and CysLTs for clinical outcomes in children with severe Mycoplasma pneumoniae pneumonia[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(4): 65-70.

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