YKL-40、IL-8在儿童肺炎支原体肺炎中的水平变化及意义

Expression Changes and Significance of YKL-40 and IL-8 in Children with Mycoplasma Pneumoniae Pneumonia

目的探讨人软骨糖蛋白39(YKL-40)和白细胞介素8(IL-8)在肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)中的水平变化及临床意义。方法采用前瞻性对照研究,选取MPP患儿80例,根据病情分为普通肺炎支原体肺炎(general mycoplasma pneumoniae pneumonia,GMPP)组42例和重症肺炎支原体肺炎(severe mycoplasma pneumoniae pneumonia,SMPP)组38例,对照组为纤维支气管镜异物取出术患儿15例。采用酶联免疫吸附实验(ELISA法检测)检测肺泡灌洗液(bronchoalveolar lavage fluid,BALF)及血清中YKL-40和IL-8的水平,各组间差异比较,分析YKL-40和IL-8的相关性,利用ROC曲线比较二者对SMPP的诊断价值。结果SMPP组YKL-40、IL-8水平显著高于GMPP组及对照组(P<0.05),GMPP组显著高于对照组(P<0.05),MPP组BALF及血清中YKL-40与IL-8的相关系数r分别为0.440和0.804(P<0.05),YKL-40在BALF及血清中诊断SMPP的ROC曲线下面积分别为0.967(95%CI:0.935~0.998)和0.695(95%CI:0.557~0.813),IL-8在BALF及血清中诊断SMPP的ROC曲线下面积分别为0.972(95%CI:0.944~0.999)和0.848(95%CI:0.764~0.933)。结论YKL-40与IL-8参与了MPP的免疫反应过程,表达水平可作为疾病严重程度的评价指标,BALF中二者水平对诊断急性期SMPP的价值更大。

Objective To Investigate the changes and clinical significance of human cartilage glycoprotein 39(YKL-40)and interleukin-8(IL-8)in children with Mycoplasma pneumoniae pneumonia(MPP).Methods This study was a prospective controlled study.80 cases of MPP were selected.According to the condition,they were divided into general mycoplasma pneumoniae pneumonia group(42 cases)and severe mycoplasma pneumoniae pneumonia group(38 cases),and 15 cases of children with fiber broncoscopy foreign object removal were selected as control group.Enzyme linked immunosorbent assay(ELISA)was used to detect the levels of YKL-40 and IL-8 in bronchoalveolar lavage fluid(BALF)and serum.The differences between the groups was compared,and the correlation between YKL-40 and IL-8 level in acute phase of MPP children was analyzed,and ROC curve was used to compare the diagnostic value of YKL-40 and IL-8 in BALF and serum for SMPP.Results The levels of YKL-40 and IL-8 in SMPP group were significantly higher than those in GMPP group and control group(P<0.05).GMPP group was significantly higher than the control group(P<0.05).The correlation r of YKL-40 and IL-8 in acute BALF and serum of MPP group was 0.440 and 0.804 respectively(P<0.05).The area under the ROC curve of YKL-40 for diagnosis of SMPP in BALF and serum are 0.967(95%CI:0.935-0.998),0.695(95%CI:0.557-0.813)respectively.The area under the ROC curve of IL-8 for diagnosis of SMPP in BALF and serum were 0.972(95%CI:0.944-0.999),0.848(95%CI:0.764-0.933)respectively.Conclusion YKL-40 and IL-8 are involved in the immune response of MPP,and the expression level can be used as an indicator of disease severity,and BALF is more valuable in the diagnosis of acute SMPP.