肺炎支原体肺炎急性期感染患儿血清和肽素心肌素的检测水平及临床意义

The detection levels and clinical significance of serum Copeptin and Myocardin in children with acute stage infection of Mycoplasma pneumoniae pneumonia

目的探讨肺炎支原体肺炎(MPP)急性期感染患儿血清中和肽素(Copeptin)、心肌素(Myocardin)的表达水平及临床意义。方法选取2017年5月-2019年11月于该院确诊并治疗的MPP患儿329例,其中急性期感染患儿179例作为观察组,非急性期患儿150例作为对照组;酶联吸附试验(ELISA)法检测两组患儿血清中Copeptin、Myocardin、免疫球蛋白M(IgM)及免疫球蛋白G(IgG)的表达水平;Logistic回归分析肺炎支原体急性期感染的危险因素;受试者工作特征曲线(ROC曲线)分析MPP患儿血清中Copeptin及Myocardin表达水平对急性期感染的诊断价值。结果观察组患儿血清中IgM、IgG、Copeptin及Myocardin的表达水平均高于对照组[(1.97±0.25)g/L vs.(1.45±0.21)g/L、(12.72±1.71)g/L vs.(10.50±1.16)g/L、(15.59±4.16)ng/ml vs.(10.18±2.41)ng/ml、(122.68±39.43)ng/L vs.(86.75±17.48)ng/L,均P<0.05];Logistic回归分析显示Copeptin、Myocardin高表达是MPP急性期感染的危险因素(OR=1.361、1.458,P=0.017、0.000);MPP患儿血清中Copeptin诊断急性期感染的ROC曲线下面积为0.862,截断值为13.150 ng/ml,灵敏度为74.3%,特异度为88.7%;血清中Myocardin诊断急性期感染的ROC曲线下面积为0.800,截断值为102.953 ng/L,灵敏度为68.7%,特异度为88.0%;Copeptin、Myocardin联合诊断急性期感染的ROC曲线下面积为0.908,灵敏度为79.9%,特异度为92.7%。结论Copeptin、Myocardin在急性期MPP患儿血清中均呈高表达,是MPP急性期感染的危险因素并对MPP急性期感染有一定诊断价值。

Objective To observe the expression levels of serum Copeptin and Myocardin in children with acute stage infection of Mycoplasma pneumoniae pneumonia(MPP)and discuss its clinical significance.Methods From May 2017 to November 2019,329 children with MPP were selected,among them,179 children with acute infection were in the observation group and 150 children without acute infection were in the control group;the expression levels of Copeptin,Myocardin,IgM and IgG in serum of the two groups were detected by enzyme-linked immunosorbent assay(ELISA);the risk factors of Mycoplasma pneumoniae infection in acute stage were analyzed by Logistic regression;and the diagnostic values of the expression levels of serum Copeptin and Myocardin in MPP children to acute infection was analyzed by receiver operating characteristic curve(ROC).Results The expression levels of IgM,IgG,Copeptin and Myocardin in the serum of the observation group were higher than those of the control group[(1.97±0.25)g/L vs.(1.45±0.21)g/L,(12.72±1.71)g/Lvs.(10.50±1.16)g/L,(15.59±4.16)ng/ml vs.(10.18±2.41)ng/ml,(122.68±39.43)ng/L vs.(86.75±17.48)ng/L,all P<0.05];Logistic regression analysis showed that high expression of Copeptin and Myocardin were the risk factors of MPP acute infection(OR=1.361,1.458,P=0.017,0.000);the area under ROC curve of serum Copeptin in the diagnosis of acute infection of MPP children was 0.862,the cutoff value was 13.150 ng/ml,the sensitivity was 74.3%,and the specificity was 88.7%;the area under ROC curve of serum Myocardin in the diagnosis of acute infection of MPP children was 0.800,the cutoff value was 102.953 ng/L,the sensitivity was 68.7%,and the specificity was 88.0%;the area under ROC curve of Copeptin combined with Myocardin in the diagnosis of acute infection of MPP children was 0.908,the sensitivity was 79.9%,and the specificity was 92.7%.Conclusion Copeptin and Myocardin are highly expressed in the serum of MPP children,which are risk factors of MPP acute infection and has a certain diagnostic value for MPP acute infection.