摘要
目的研究核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)炎症小体通路与儿童重症肺炎支原体肺炎发生的关系,并分析其诊断价值。方法选取2020年5月—2022年12月济南市第二妇幼保健院收治的187例肺炎支原体肺炎患儿,其中重症组86例、轻症组101例,选取同期体检的健康儿童120名为对照组,检测外周血NLRP3、接头蛋白凋亡相关斑点样蛋白(ASC)和半胱天冬酶1(caspase-1)信使核糖核酸(mRNA)水平,不同病情患儿社区获得性呼吸窘迫综合征毒素(C ARDSTx)、白细胞介素(IL)-1β、IL-18水平,分析两类指标之间的相关性及NLRP3、ASC、caspase-1 mRNA对儿童重症肺炎支原体肺炎的诊断价值。结果对照组、轻症组、重症组NLRP3、ASC和caspase-1 mRNA水平呈逐渐升高趋势(P<0.05);重症组C ARDSTx、IL-1β、IL-18水平高于轻症组(P<0.05);肺炎支原体肺炎患儿两类指标水平呈正相关关系(P<0.05);NLRP3、ASC和caspase-1 mRNA联合诊断儿童重症肺炎支原体肺炎的曲线下面积(AUC)为0.869,敏感度和特异度分别为79.07%和82.18%。结论肺炎支原体肺炎患儿NLRP3、ASC、caspase-1 mRNA水平及CARDSTx、IL-1β、IL-18水平存在明显的相关性,NLRP3、ASC、caspase-1 mRNA对儿童重症肺炎支原体肺炎的诊断价值较高。
OBJECTIVE To observe the association between nucleotide-binding oligomerization domain-like recep-tor protein 3(NLRP3)inflammasome pathway and severe Mycoplasma pneumoniae pneumonia in the children and analyze the diagnostic value.METHODS A total of 187 children with M.pneumoniae pneumonia who were treated in the Jinan Second Maternal and Child Health Hospital from May 2020 to Dec 2022 were enrolled in the study and were divided into the severe group with 86 cases and the mild group with 101 cases.Meanwhile,120 healthy children who received physical examination were chosen as the control group.The expression levels of pe-ripheral blood NLRP3,apoptosis associated speck-like protein(ASC)and caspase-1(caspase-1)messenger ribo-nucleic acid(mRNA)were detected.The levels of community-acquired respiratory distress syndrome toxin(CARDSTx),interleukin(IL)-1βand IL-18 were compared among the children with different illness condition.The association between the two types of indexes and the values of NLRP3,ASC and caspase-1 mRNA in diagno-sis of severe M.pneumoniae pneumonia were analyzed.RESULTS The levels of NLRP3,ASC and caspase-1 mR-NA of the control group,the mild group and the severe group showed upward trends(P<0.05).The levels of CARDSTx,IL-1βand IL-18 of the severe group were higher than those of the mild group(P<0.05).The two types of indexes of the children with M.pneumoniae pneumonia were positively correlated(P<0.05).The area under curve(AUC)of the joint detection of NLRP3,ASC and caspase-1 mRNA was 0.869 in diagnosis of the se-vere M.pneumoniae pneumonia,with the sensitivity 79.07%,the specificity 82.18%.CONCLUSION There is significant association between the levels of NLRP3,ASC,caspase-1 mRNA and the levels of CARDSTx,IL-1βand IL-18 of the children with M.pneumoniae pneumonia.The NLRP3,ASC and caspase-1 mRNA have high val-ues in diagnosis of the severe M.pneumoniae pneumonia.
作者
吕国锋
连丽英
吕文丽
闫敏
田涛
LYU Guo-feng;LIAN Li-ying;LYU Wen-li;YAN Min;TIAN Tao(Jinan Second Maternal and Child Health Hospital,Jinan,Shandong 271100,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2024年第2期258-262,共5页
Chinese Journal of Nosocomiology
基金
山东省医药卫生科技计划项目(2019WS021)。
关键词
肺炎支原体肺炎
儿童
重症
核苷酸结合寡聚化结构域样受体蛋白3
炎症小体通路
诊断价值
Mycoplasma pneumoniae pneumonia
Child
Severe
Nucleotide-binding oligomerization domain-like receptor protein 3
Inflammasome pathway
Diagnostic value
作者简介
吕国锋(1983-),男,本科,主治医师,研究方向:儿童呼吸疾病诊疗。
