白介素-22在肺炎支原体肺炎患儿支气管肺泡灌洗液中的表达及意义

Expression and Significance of Interleukin-22 in Bronchoalveolar Lavage Fluid of Children with Mycoplasma Pneumoniae Pneumonia

目的探讨肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)患儿支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)中白介素-22(interleukin-22,IL-22)的水平及意义。方法选取124例MPP患儿为研究组,另选同期20例行支气管异物取出术的患儿为对照组。根据病情严重程度及影像学表现将MPP患儿分成不同亚组:轻症MPP组和重症MPP组、MPP组肺不张组和非肺不张组、肺实变组和非肺实变组、胸腔积液组和无胸腔积液组。采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测所有患儿BALF中IL-22的水平;并采用受试者工作特征(receiver operating characteristics,ROC)曲线分析IL-22对重症MPP的预测价值。结果MPP患儿IL-22水平明显高于对照组(P<0.05);重症MPP患儿IL-22水平明显高于轻症MPP患儿(P<0.05)。影像学表现为肺不张、胸腔积液的患儿IL-22水平均较无相关表现者明显升高(均P<0.05),而肺实变患儿和非肺实变患儿IL-22水平比较差异无统计学意义(P>0.05)。IL-22对重症MPP的诊断效能较好[AUC(95%CI)=0.788(95%CI:0.705~0.856)],最佳界限值为42.2 pg·mL-1,敏感性为65.91%,特异性为88.75%。结论MPP患儿BALF中IL-22水平升高,与肺不张、胸腔积液等影像学表现及病情严重程度明显相关,且对重症MPP具有一定的诊断价值。

Objective To investigate the expression and significance of interleukin-22(IL-22)in bronchoalveolar lavage fluid(BALF)of children with mycoplasma pneumoniae pneumonia(MPP).Methods One hundred and twenty-four children with MPP were selected as the study group,and 20 children undergoing removal of bronchial foreign bodies as the control group.According to the severity of the disease and imaging manifestations,MPP children were divided into mild MPP group,severe MPP group,atelectasis group,non-atelectasis group,consolidation group,non-consolidation group,pleural effusion group,and non-pleural effusion group.The expression of IL-22 in BALF was detected by ELISA,and the predictive value of IL-22 for severe MPP was analyzed by ROC curve.Results The level of IL-22 in MPP group was higher than that in control group(P<0.05),and that in severe MPP group was significantly higher than that in mild MPP group(P<0.05).Furthermore,IL-22 expression in atelectasis group and pleural effusion group were higher than that in non-atelectasis group and non-pleural effusion group,respectively(P<0.05).However,there was no significant difference between consolidation group and non-consolidation group(P>0.05).IL-22 showed a good diagnostic efficiency for severe MPP(AUC(95%CI=0.788(95%CI:0.705-0.856)).The optimum threshold value,sensitivity and specificity were 42.2 pg·mL-1,65.91%and 88.75%,respectively.Conclusion The increased expression of IL-22 in BALF of MPP children is obviously related to the severity of the disease and the imaging findings such as atelectasis and pleural effusion,suggesting a diagnostic value of IL-22 in severe MPP.