黏蛋白MUC5AC在肺炎支原体肺炎患儿气道中的表达及临床意义

Expression and clinical significance of MUC5AC in airway of children with mycoplasma pneumoniae pneumonia

目的探讨黏蛋白5AC(MUC5AC)在儿童肺炎支原体肺炎(MPP)患者呼吸道中的表达,为MPP黏液栓早期诊断及治疗提供临床帮助。方法纳入2022年4-10月住院进行肺泡灌洗的MPP患儿共94例,根据首次纤维支气管镜下是否观察到黏液栓,将MPP组分为黏液栓组41例及非黏液栓组53例。收集两组相关临床资料及实验室检查数据。结果与非黏液栓组比较,黏液栓组的热程和住院时间均较长,C反应蛋白(CRP)、乳酸脱氢酶(LDH)、降钙素原(PCT)、D二聚体、灌洗液肺炎支原体DNA(MP-DNA)拷贝数值、白细胞介素17(IL-17)、MUC5AC水平均升高,差异有统计学意义(P<0.05)。MUC5AC与IL-17、LDH均呈正相关(分别r=0.54,P=0.002;r=0.39,P=0.019),以MUC5AC水平绘制受试者工作特征曲线,其曲线下面积为0.811,预测MPP黏液栓形成的灵敏度为86.2%,特异度为71.4%。结论MPP黏液栓形成患儿MUC5AC表达水平增高;MUC5AC对MPP黏液栓的形成具有一定的预测价值。

Objective To investigate the expression of mucin 5AC(MUC5AC)in airway of children with mycoplasma pneumoniae pneumonia(MPP),and to provide clinical value for early diagnosis and treatment of MPP mucus plug.Methods A total of 94 children with MPP who were hospitalized for alveolar lavage from April 2022 to October 2022 were included in the MPP group.According to whether mucus plug was observed under the first fiberoptic bronchoscope,the MPP group was divided into mucus plug group(n=41)and non-mucus plug group(n=53).Relevant clinical data and laboratory examination data were collected.Results Compared with non mucus plug group,the mucus plug group had a longer heat duration and hospital stay,and the levels of CRP,LDH,PCT,D-dimer,MP-DNA copy value of lavage fluid,IL-17,MUC5AC were all increased,with statistically significant differences(P<0.05).MUC5AC was positively correlated with LDH and IL-17 levels(r=0.54,P=0.002;r=0.39,P=0.019).The ROC curve plotted based on the level of MUC5AC had an area under the ROC curve of 0.811,a sensitivity of 86.2% and a specificity of 71.4% for predicting formation of mucus plug in MPP.Conclusions There was an increase in the level of MUC5AC in children with mucus plug group in MPP,and the level of MUC5AC had a certain value for predicting mucus plug formation.