重症肺炎支原体肺炎患儿血清肝细胞生长因子、前清蛋白水平变化及其临床意义

Changes and clinical significance of serum hepatocyte growth factor and prealbumin levels in children with severe mycoplasma pneumoniae pneumonia

目的探讨重症肺炎支原体肺炎(SMPP)患儿血清肝细胞生长因子(HGF)、前清蛋白(PAB)水平与病情危重程度和预后的关系。方法选取102例SMPP患儿,根据简化小儿危重病例评分法将其分为非危重组(n=35)、危重组(n=31)、极危重组(n=36),根据治疗28 d后的预后将其分为预后不良组(n=26)和预后良好组(n=76)。收集所有患儿的临床资料和实验室指标。比较不同病情危重程度SMPP患儿血清HGF、PAB水平,使用多因素logistic回归分析法分析SMPP患儿预后不良的影响因素,使用受试者操作特征(ROC)曲线评价血清HGF、PAB水平对SMPP患儿预后不良的预测价值。结果非危重组、危重组、极危重组血清HGF水平依次升高,血清PAB水平依次降低(均P<0.05)。多因素logistic回归分析结果显示,血清HGF水平升高为SMPP患儿预后不良的独立危险因素,血清PAB水平升高为独立保护因素(均P<0.05)。ROC曲线显示,血清HGF、PAB水平联合预测SMPP患儿预后不良的曲线下面积大于二指标单独预测(均P<0.05)。结论血清HGF、PAB水平与SMPP患儿病情危重程度和预后相关,可能成为SMPP患儿预后的预测指标。

Objective To investigate the relationship between the levels of serum hepatocyte growth factor(HGF)and prealbumin(PAB)and the severity of illness and prognosis in children with severe mycoplasma pneumoniae pneumonia(SMPP).Methods A total of 102 children with SMPP were selected and divided into non-critical group(n=35),critical group(n=31),and extremely critical group(n=36)according to the simplified Pediatric Critical Illness Score.According to the prognosis after 28 days of treatment,the children were divided into poor prognosis group(n=26)and good prognosis group(n=76).The clinical data and laboratory parameters of all children were collected.The levels of serum HGF and PAB in SMPP children with different severity of illness were compared.Multivariate logistic regression analysis was used to analyze the influencing factors of poor prognosis in SMPP children,and receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum HGF and PAB levels for poor prognosis in SMPP children.Results The serum HGF level increased and the serum PAB level decreased successively in the non-critical group,the critical group and the extremely critical group(all P<0.05).The results of multivariate logistic regression analysis showed that the elevated serum HGF level was an independent risk factor and the elevated serum PAB level was an independent protective factor for poor prognosis in SMPP children(all P<0.05).The ROC curve showed that the area under the curve of the combined serum HGF and PAB levels was greater than that of the two indicators alone in predicting poor prognosis in SMPP children(all P<0.05).Conclusion Serum HGF and PAB levels are related to the severity of illness and prognosis in SMPP children,and they can be used as predictive indicators of prognosis in SMPP children.