血清FIB及TSP-1水平与重症肺炎支原体肺炎患儿预后相关性分析

目的 通过分析重症肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)患儿血清中人纤维蛋白原(fibrinogen,FIB)、血小板反应蛋白1(thrombospondin-1,TSP-1)表达水平与患儿预后的相关性,为早期临床识别重症MPP患儿及预后评估提供帮助。方法 回顾性分析2019年1月至2020年12月在延安市人民医院确诊并治疗的重症MPP患儿80例作为观察组,另选取同期诊疗的轻症MPP患儿80例作为对照组,采用酶联免疫吸附(enzyme-linked immunosorbent essay,ELISA)法检测2组患儿血清中FIB、TSP-1表达水平。采用Pearson法分析FIB、TSP-1水平与肺炎严重指数(PSI)的相关性;通过ROC曲线分析血清FIB、TSP-1水平对重症MPP患儿不良预后的预测价值。结果 相比于对照组,观察组患儿血小板计数(PLT)、平均血小板体积(MPV)、D-二聚体、抗凝血酶Ⅲ(ATⅢ)、白细胞计数(WBC)、中性粒细胞计数(NEU)、乳酸脱氢酶(LDH)、红细胞沉降率(ESR)、C反应蛋白(CRP)水平和PSI评分升高,差异有统计学意义(P＜0.05);观察组患儿血清中FIB、TSP-1表达水平比对照组明显升高,差异有统计学意义(P＜0.05);观察组患儿血清FIB、TSP-1表达水平与PSI评分呈正相关性(P＜0.05),且观察组患儿血清FIB、TSP-1表达水平及PSI评分比对照组MPP患儿显著升高,差异有统计学意义(P＜0.05);血清FIB、TSP-1联合预测重症MPP患儿不良预后灵敏度为88.89%,特异度为81.13%,曲线下面积为0.920。结论 FIB、TSP-1在重症MPP患儿血清中表达较轻症明显升高,与患儿病情严重程度具有一定相关性。

Correlation analysis of serum FIB,TSP-1 expression levels and prognosis of children with severe mycoplasma pneumonia

Objective To detect the expressions of human fibrinogen (FIB) and thrombospondin-1 (TSP-1) in the serum of children with severe mycoplasma pneumoniae pneumonia (MPP),and explore the correlation between them and the prognosis of children with severe MPP.Methods From January 2019 to December 2020,80 children with severe MPP who were diagnosed and treated in Yan'an People's Hospitai were selected,in addition,and 80 children with mild MPP were selected as the control group.The levels of FIB and TSP-1 in serum were detected by enzyme-linked immunosorbent assay,and Pearson method was used to analyze the correlations between FIB,TSP-1 and pneumonia severity index (PSI),and ROC curve was used to analyze the prognostic values of FIB and TSP-1 for poor prognosis in children with severe MPP.Results Compared with MPP patients in mild group,the levels of platelet count (PLT),mean platelet volume (MPV),D-dimer,antithrombin Ⅲ (AT Ⅲ),white blood cell count (WBC),neutrophil count (NEU),lactate dehydrogenase (LDH),erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),and PSI score were higher in severe MPP group,the differences were statistically significant(P＜0.05); the levels of FIB and TSP-1 in serum of MPP patients in severe group were significantly higher than those in mild group,the differences were statistically significant(P＜0.05); the expressions of FIB and TSP-1 in children with severe MPP were positively correlated with PSI score(P＜0.05); the expression levels of FIB,TSP-1 and PSI score in severe group were significantly higher than those in mild group(P＜0.05); and the sensitivity,specificity and area under the curve of FIB combined with TSP-1 in the predicting poor prognosis of children with severe MPP were 88.89%,81.13% and 0.920,respectively.Conclusion FIB and TSP-1 are highly expressed in the serum of children with severe MPP,which is related to the severity of the disease.