Autotaxin对儿童难治性肺炎支原体肺炎的预测价值及其与炎性细胞因子的相关性

Value of autotaxin in predicting refractory Mycoplasma pneumoniae pneumonia in children and its correlation with inflammatory cytokines

目的探讨血清和支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)自分泌运动因子(autotaxin)水平对儿童难治性肺炎支原体肺炎(refractory Mycoplasma pneumoniae pneumonia,RMPP)的预测价值及其与白细胞介素-6(interleukin-6,IL-6)、白细胞介素-8(interleukin-8,IL-8)及C-反应蛋白(C-reactive protein,CRP)的相关性。方法回顾性选取2019年1月至2021年12月收治的MPP患儿238例为研究对象,根据疾病严重程度分为RMPP组(82例)和普通肺炎支原体肺炎(general Mycoplasma pneumoniae pneumonia,GMPP)组(156例)。比较各组血清和BALF中autotaxin、IL-6、IL-8及CRP水平,分析血清和BALF中autotaxin水平对儿童RMPP的预测价值,以及RMPP患儿autotaxin水平与IL-6、IL-8及CRP水平的相关性。结果RMPP组血清和BALF中autotaxin、IL-6、IL-8及CRP水平均高于GMPP组(P<0.05)。RMPP患儿急性期血清和BALF中autotaxin、IL-6、IL-8及CRP水平均高于恢复期(P<0.05)。受试者工作特征曲线显示,血清和BALF中autotaxin水平对儿童RMPP均具有较好的预测价值(P<0.05),曲线下面积分别为0.874(95%CI:0.816~0.935)、0.862(95%CI:0.802~0.924)。相关分析显示,RMPP患儿血清和BALF中autotaxin水平与IL-6、IL-8及CRP水平均呈正相关(P<0.001)。结论RMPP患儿血清和BALF中autotaxin水平明显升高,且与病情恢复程度和炎性细胞因子相关,可作为儿童RMPP的预测指标。

Objective To study the value of autotaxin(an autocrine motility factor)level in serum and bronchoalveolar lavage fluid(BALF)in predicting refractory Mycoplasma pneumoniae pneumonia(RMPP)in children and its correlation with interleukin-6(IL-6),interleukin-8(IL-8),and C-reactive protein(CRP).Methods A retrospective analysis was performed on 238 children with Mycoplasma pneumoniae pneumonia who were admitted from January 2019 to December 2021.According to disease severity,they were divided into two groups:RMPP(n=82)and general Mycoplasma pneumoniae pneumonia(GMPP;n=156).The two groups were compared in terms of the levels of autotaxin,IL-6,IL-8,and CRP in serum and BALF to study the value of autotaxin level in serum and BALF in predicting RMPP in children,as well as the correlation of autotaxin level with IL-6,IL-8,and CRP in children with RMPP.Results Compared with the GMPP group,the RMPP group had significantly higher levels of autotaxin,IL-6,IL-8,and CRP in serum and BALF(P<0.05).For the children with RMPP,the levels of autotaxin,IL-6,IL-8,and CRP in serum and BALF in the acute stage were significantly higher than those in the convalescent stage(P<0.05).The receiver operating characteristic(ROC)curve showed that the level of autotaxin in serum and BALF had a good value in predicting RMPP in children,with an area under the curve of 0.874(95%CI:0.816-0.935)and 0.862(95%CI:0.802-0.924),respectively.The correlation analysis showed that the level of autotaxin in serum and BALF was positively correlated with IL-6,IL-8,and CRP levels(P<0.001).Conclusions The level of autotaxin in serum and BALF increases and is correlated with the degree of disease recovery and inflammatory cytokines in children with RMPP.Autotaxin can be used as a predictive indicator for RMPP in children.