血清APOC1、LDH及炎性感染指标在难治性支原体肺炎患儿中的表达水平及其与肺通气功能、预后效果的相关性分析

Expression Levels of Serum APOC1,LDH and Inflammatory Infection Indicators in Children with Refractory Mycoplasma Pneumonia and Their Correlation with Pulmonary Ventilation Function and Prognostic Effect

目的:分析血清载脂蛋白C1(APOC1)、乳酸脱氢酶(LDH)及炎性感染指标在难治性支原体肺炎患儿中的表达水平及其与肺通气功能、预后效果的相关性。方法:选择我院自2019年1月至2022年12月接诊的130例难治性支原体肺炎患儿作为观察组,另选同期在我院体检且结果正常的儿童作为对照组。检测两组入选者血清APOC1、LDH及炎性感染指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)]表达水平、肺通气功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、呼气峰流速(PEF)];观察组患儿均严格按照《儿童社区获得性肺炎诊疗规范(2019年版)》接受治疗,通过ROC曲线下面积(AUC)评价血清APOC1、LDH及炎性感染指标对难治性支原体肺炎患儿预后不良的预测效能。结果:观察组血清APOC1、LDH、CRP、IL-6表达水平均高于对照组(P<0.05);在观察组患儿中,重症组血清APOC1、LDH、CRP、IL-6表达水平均高于轻症组(P<0.05);经Pearson相关性分析,难治性支原体肺炎患儿血清APOC1、LDH、CRP、IL-6表达水平均与FVC、FEV1、PEF呈负相关(P<0.05);经多因素Logistic回归分析,难治性支原体肺炎患儿血清APOC1、LDH、CRP、IL-6均是其预后不良的独立预测因素(P<0.05);经ROC曲线分析,难治性支原体肺炎患儿血清APOC1、LDH、CRP联合IL-6预测其预后不良的AUC为0.930。结论:血清APOC1、LDH及炎性感染指标在难治性支原体肺炎患儿中的表达水平明显升高,与其肺通气功能密切相关,其中APOC1、LDH、CRP联合IL-6预测预后不良的效能较好,值得进一步研究应用。

Objective:To analyze the expression levels of serum apolipoprotein C1(APOC1),lactate dehydrogenase(LDH)and inflammatory infection indicators in children with refractory mycoplasma pneumonia and their correlation with pulmonary ventilation function and prognostic effect.Methods:A total of 130 children with refractory mycoplasma pneumonia admitted to our hospital from January 2019 to December 2022 were selected as the observation group,and children with normal physical examination results in our hospital during the same period were selected as the control group.Serum APOC1,LDH,expression levels of inflammatory infection indicators[C-reactive protein(CRP),interleukin-6(IL-6)],pulmonary ventilation function indicators[forced vital capacity(FVC),forced expiratory volume at the first second(FEV1),peak expiratory flow rate(PEF)]of the two groups were detected.Children in the observation group were all treated strictly according to the Diagnosis and Treatment Guidelines for Children with Community Acquired Pneumonia(2019 Edition).Area under ROC curve(AUC)was used to evaluate the predictive efficacy of serum APOC1,LDH and inflammatory infection indicators on the poor prognosis of children with refractory mycoplasma pneumonia.Results:APOC1,LDH,CRP and IL-6 expression levels of the observation group were higher than those of the control group(P<0.05).Among the children in observation group,serum APOC1,LDH,CRP and IL-6 expression levels in severe group were higher than those in mild group(P<0.05).According to Pearson correlation analysis,serum APOC1,LDH,CRP and IL-6 expression levels of children with refractory mycoplasma pneumonia were negatively correlated with FVC,FEV1 and PEF(P<0.05).According to multiple Logistic regression analysis,serum APOC1,LDH,CRP and IL-6 were independent predictors of poor prognosis of refractory mycoplasma pneumonia(P<0.05).According to ROC curve analysis,the AUC of serum APOC1,LDH and CRP combined with IL-6 for predicting poor prognosis of children with refractory mycoplasma pneumonia was 0.930.Conclusion:Serum APOC1,LDH and inflammatory infection indicators increased significantly in children with refractory mycoplasma pneumonia,which was closely related to pulmonary ventilation function.Among them,APOC1,LDH and CRP combined with IL-6 showed good efficacy in predicting poor prognosis,which is worthy of further study and application.