Predictive value of serum sFlt-1 and sCD163 levels for the prognosis of patients with severe mycoplasma pneumonia

doi:10.19871/j.cnki.xfcrbzz.2024.04.008

Abstract

Abstract: Objective To investigate the expression levels of serum soluble vascular endothelial growth factor receptor 1 (sFlt-1) and soluble hemoglobin scavenger receptor (sCD163) levels in patients with severe mycoplasma pneumonia (MPP), and to analyze their value in predicting the prognosis of MPP. Method A total of 249 MPP patients (MPP group) who visited our hospital from October 2021 to October 2023 were collected as the study subjects, according to the severity of MPP patients' condition, they were separated into a mild illness group of 145 cases and a severe illness group of 104 cases, according to the prognosis, severe patients were grouped into a poor prognosis group of 30 cases and a good prognosis group of 74 cases. Clinical data related to the study subjects were collected, enzyme linked immunosorbent assay (ELISA) was applied to detect serum levels of sFlt-1 and sCD163. Multivariate Logistic regression was applied to analyze the factors affecting the prognosis of severe MPP patients. Receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum sFlt-1 and sCD163 for poor prognosis in severe MPP patients. Result The serum levels of sFlt-1 and sCD163 in the MPP group were obviously higher than those in the control group (P<0.05). The serum levels of sFlt-1 and sCD163 in the severe group were obviously higher than those in the mild group (P<0.05). The serum levels of sFlt-1, sCD163, and CRP in the poor prognosis group were obviously higher than those in the good prognosis group (P<0.05). The results of multivariate Logistic regression analysis showed that sFlt-1 and sCD163 were risk factors for poor prognosis in severe MPP patients (P<0.05). ROC curve results showed that the AUC of serum sFlt-1 and sCD163 levels alone and in combination in predicting poor prognosis in severe MPP patients was 0.846, 0.854, and 0.923, respectively, and the combination of the two was better than the single prediction (Z=2.656, 2.519, P<0.05). Conclusion Elevated serum sFlt-1 and sCD163 are closely related to poor prognosis in patients with severe MPP, and have certain predictive value for poor prognosis.

Key words: Soluble vascular endothelial growth factor receptor 1, Soluble hemoglobin scavenger receptor, Severe mycoplasma pneumonia, Prognosis

CLC Number:

R446.11+2

Lu Xingzhong, Cao Dandan, Li Minghua, Chen Liying. Predictive value of serum sFlt-1 and sCD163 levels for the prognosis of patients with severe mycoplasma pneumonia[J]. Electronic Journal of Emerging Infectious Diseases, 2024, 9(4): 39-43.

References

[1] 杨勇刚, 刘莉, 李媛, 等. 肺炎支原体抗原联合肺炎支原体免疫球蛋白M抗体诊断肺炎支原体肺炎的价值[J]. 国际免疫学杂志, 2023, 46(3): 283-287.
[2] 曹囡囡, 黄莉, 焦琼杰, 等. 基于NLRP3/IL-1β、IL-18通路探讨CARDS Tx在儿童重症肺炎支原体肺炎中的作用[J]. 医学研究杂志, 2023, 52(1): 61-65.
[3] 高尚. 子痫前期sFlt-1相关治疗的研究进展[J]. 实用妇产科杂志, 2021, 37(2): 105-108.
[4] NEGRO A, FAMA A, PENNA D, et al.SFLT-1 levels in COVID-19 patients: Association with outcome and thrombosis[J]. Am J Hematol, 2021, 96(2): 41-43.
[5] 李睿, 宣立航, 胥国文, 等. sCD163及相关因子在稳定期哮喘炎症表型中的表达及临床意义[J]. 国际呼吸杂志, 2020, 40(11): 816-821.
[6] ZINGAROPOLI M A, NIJHAWAN P, CARRARO A, et al.Increased sCD163 and sCD14 plasmatic levels and depletion of peripheral blood pro-inflammatory monocytes, myeloid and plasmacytoid dendritic cells in patients with severe COVID-19 pneumonia[J]. Front Immunol, 2021, 12(1): 1-8.
[7] 中华医学会儿科学分会呼吸学组,《中华实用儿科临床杂志》编辑委员会. 儿童肺炎支原体肺炎诊治专家共识(2015年版)[J]. 中华实用儿科临床杂志, 2015, 30(17): 1304-1308.
[8] 国家卫生健康委员会合理用药专家委员会儿童用药专业组. 中国儿童肺炎支原体感染实验室诊断规范和临床实践专家共识(2019年)[J]. 中华儿科杂志, 2020, 58(5): 366-373.
[9] 王淑敏, 李雪军, 张奕星, 等. 肺炎支原体感染与小儿皮肤黏膜淋巴结综合征发生冠状动脉损伤相关性的Meta分析[J]. 中国全科医学, 2023, 26(20): 2532-2539.
[10] 郭建明,左一宇,赵爱宝. 血清过氧化物酶体增殖物激活受体和基质金属蛋白酶9水平与支原体肺炎患儿肠道菌群的相关性及其诊断价值[J/CD]. 新发传染病电子杂志, 2023, 8(4): 20-24.
[11] 彭力, 钟礼立, 黄寒, 等. 不同严重程度肺炎支原体肺炎患儿肺部NLRP3信号通路的变化及其临床价值[J]. 中国现代医学杂志, 2023, 33(18): 72-76.
[12] 董磊, 曹凤侠, 郁智慧. MPP患儿血浆sB7-H3水平与疾病严重程度及临床和影像学特征的关系[J]. 东南大学学报(医学版), 2023, 42(3): 369-376.
[13] MENDOZA M, GARCIA‐RUIZ I, MAIZ N, et al. Pre‐eclampsia‐like syndrome induced by severe COVID‐19: a prospective observational study[J]. BJOG, 2020, 127(11): 1374-1380.
[14] TORRES‐TORRES J, ESPINO‐Y‐SOSA S, POON L C, et al. Increased levels of soluble fms‐like tyrosine kinase‐1 are associated with adverse outcome in pregnant women with COVID‐19[J]. Ultrasound Obstet Gynecol, 2022, 59(2): 202-208.
[15] 周潮艾, 冯小伟, 王灵, 等. 肺炎患儿血清sFlt-1、PlGF表达水平与病情严重程度的关系[J]. 临床肺科杂志, 2022,27(10):1472-1475.
[16] ESPINO-Y-SOSA S, MARTINEZ-PORTILLA R J, TORRES-TORRES J, et al. Novel ratio soluble fms-like tyrosine kinase-1/angiotensin-II (sFlt-1/ANG-II) in pregnant women is associated with critical illness in COVID-19[J]. Viruses, 2021, 13(10): 1-13.
[17] RITTIG N, SVART M, JESSEN N, et al.Macrophage activation marker sCD163 correlates with accelerated lipolysis following LPS exposure: a human-randomised clinical trial[J].Endocr Connect, 2018, 7(1): 107-114.
[18] VOLFOVITCH Y, TSUR A M, GUREVITCH M, et al.The intercorrelations between blood levels of ferritin, sCD163, and IL-18 in COVID-19 patients and their association to prognosis[J]. Immunol Res, 2022, 70(6): 817-828.
[19] WANG R J, MOORE J, MOISI D, et al.HIV infection is associated with elevated biomarkers of immune activation in Ugandan adults with pneumonia[J]. PLoS One, 2019, 14(5): 1-13.