肺炎支原体抗体效价对MPP的诊断价值及与气道炎症反应的关系

Diagnostic value of Mycoplasma pneumoniae antibody titer in MPP and its relationship with airway inflammation

目的探究ROC曲线评价肺炎支原体(MP)抗体效价对肺炎支原体肺炎(MPP)患儿的诊断价值及其对气道炎症反应的影响。方法选取阜阳市阜南县中医院2020年1月至2022年8月疑似MP感染患儿272例作为研究对象,根据呼吸道多病原核酸检测结果确诊为MPP患儿(168例)与非MMP患儿(104例)。采用颗粒凝集法检测血清MP抗体效价,受试者工作特征(ROC)曲线评价MP抗体效价对MPP的诊断价值,对比不同MP抗体效价患儿气道炎症反应指标[嗜酸粒细胞(EOS)、白三烯B4(LTB4)、白介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)]水平,分析气道炎症反应指标与MP抗体效价相关性,并进行多元线性回归分析。结果以咽拭子检测结果为金标准,确诊168例阳性。外周血EOS、LTB4、IL-18、TNF-α、CRP水平:MP抗体效价<1:160<1:160<1:320<1:640<+1:1280,差异有统计学意义(F=80.241、97.513、90.028、87.502、80.325,P<0.05);外周血EOS、LTB4、IL-18、TNF-α、CRP水平与MP抗体效价呈正相关(r=0.735、0.578、0.494、0.399、0.424,P<0.05);多元线性回归模型控制发热时间、病情程度、X线影像特点等混杂因素后,外周血EOS、LTB4、IL-18、TNF-α、CRP仍与MP抗体效价显著相关(P<0.05)。结论MP抗体效价与MPP患儿气道炎症反应关系密切,对疑似MP感染患儿进行MP抗体效价检测可提高诊断率,便于指导临床早期治疗。

Objective To explore the ROC curve to evaluate the diagnostic value of Mycoplasma pneumoniae(MP)antibody titer in children with Mycoplasma pneumoniae pneumonia(MPP)and its influence on airway inflammation.Methods From January 2020 to August 2022 in Funan County Hospital of Traditional Chinese Medicine,a total of 272 children with suspected MP infection were selected as the research object.According to the results of multiple pathogenic nucleic acid testing in the respiratory tract,children diagnosed with MPP(168 cases)and non-MMP(104 cases)The particle agglutination method was used to detect the serum MP antibody titer,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of MP antibody titer for MPP.The levels of airway inflammation indicators[eosinophils(EOS),leukotriene B4(LTB4),interleukin-18(IL-18),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)]in children with different MP antibody titers were compared.The correlation between airway inflammation response indicators and MP antibody titer was analyzed,and multiple linear regression analysis was performed.Results 168 positives were confirmed using pharyngeal swab results as the gold standard.Peripheral blood EOS,LTB4,IL-18,TNF-α,CRP levels:MP antibody titer<1∶160<1∶160<1∶320<1∶640<+1∶1280,the difference was statistically significant(F=80.241、97.513、90.028、87.502、80.325,P<0.05).The levels of EOS,LTB4,IL-18,TNF-α,CRP in peripheral blood were positively correlated with MP antibody titers(r=0.735、0.578、0.494、0.399、0.424,P<0.05).After controlling confounding factors such as fever time,disease severity,and X-ray image characteristics in the multiple linear regression model,peripheral blood EOS,LTB4,IL-18,TNF-α,and CRP levels were still significantly correlated with MP antibody titers(P<0.05).Conclusion The MP antibody titer is closely related to the airway inflammation in children with MPP.Detection of MP antibody titer in children with suspected MP infection can improve the diagnostic rate and facilitate early clinical treatment.