不同严重程度肺炎支原体感染患儿血清HO-1和NQO-1表达及意义

The expression and significance of serum HO-1 and NQO-1 in children with different severity of mycoplasma pneumoniae infection

目的探讨不同严重程度肺炎支原体(MP)感染患儿血红素加氧酶-1(HO-1)及醌氧化还原酶(NQO-1)表达及临床意义。方法选取2022年1月至6月在济宁医学院附属医院治疗的MP感染患儿140例作为观察组,同时选取体检健康儿童100例作为对照组,比较对照组和观察组间及不同严重程度MP感染患儿间的血清白细胞介素-2(IL-2)、IL-6、IL-10、IL-1β、肿瘤坏死因子α(TNF-α)、γ-干扰素(IFN-γ)、HO-1水平,NQO-1蛋白相对表达量,用力肺活量(FVC)、第一秒最大呼气量(FEV1)、最大呼气流速峰值(PEF)、用力呼气50%流速与最大呼气中段流速(MEF25-70)、用力呼气50%流速(MEF50)和用力呼气25%流速(MEF25)。采用Pearson相关法分析HO-1、NQO-1表达与炎症因子、肺功能指标的相关性。采用受试者工作特征(ROC)曲线分析HO-1、NQO-1表达预测重症MP的价值。结果观察组血清IL-2、IL-6、IL-10、IL-1β、TNF-α、IFN-γ和HO-1水平明显高于对照组(均P<0.05),而NQO-1蛋白相对表达量明显低于对照组(P<0.05)。观察组FVC、FEV1、PEF、MEF25-70、MEF50和MEF25明显低于对照组(均P<0.05)。观察组重症患儿血清IL-2、IL-6、IL-10、IL-1β、TNF-α、IFN-γ和HO-1水平明显高于轻症患儿(均P<0.05),而NQO-1蛋白相对表达量、FVC、FEV1、PEF、MEF25-70、MEF50和MEF25明显低于轻症患儿(均P<0.05)。MP感染患儿HO-1与IL-6、IL-1β、IFN-γ呈正相关,NQO-1蛋白相对表达量与IL-6、IL-1β、IFN-γ呈负相关(均P<0.05);HO-1与MEF50、MEF25呈负相关,NQO-1蛋白相对表达量与MEF50呈正相关(均P<0.05)。HO-1、NQO-1蛋白相对表达量预测重症MP的ROC曲线下面积分别为0.871和0.934(均P<0.05)。结论 MP感染患儿血清HO-1、NQO-1表达与细胞因子及肺功能指标存在相关性,在预测重症方面有一定应用价值。

Objective To explore the expression and clinical significance of heme oxygenase-1(HO-1)and quinone oxidoreductase(NQO-1)in children with different severity levels of mycoplasma pneumoniae(MP)infection.Methods A total of 140 children with MP infection who were treated at the Affiliated Hospital of Jining Medical University from January to June 2022 were selected as the observation group,while 100 healthy children who underwent physical examination were selected as the control group.The serum levels of interleukin-2(IL-2),IL-6,IL-10,IL-1β,tumor necrosis factorα(TNF-α),interferonγ(IFN-γ),HO-1,and relative expression of NQO-1 protein were compared between the control group and the observation group,as well as between children with different degrees of MP infection,Forced vital capacity(FVC),maximum expiratory volume in the first second(FEV1),peak expiratory flow rate(PEF),50%forced expiratory flow rate and maximum mid expiratory flow rate(MEF25-70),50%forced expiratory flow rate(MEF50),and 25%forced expiratory flow rate(MEF25).Pearson correlation method was used to analyze the correlation between the expression of HO-1 and NQO-1 with inflammatory factors and lung function indicators.The receiver operating characteristic(ROC)curve was used to analyze the value of HO-1 and NQO-1 expression in predicting severe MP.Results The serum levels of IL-2,IL-6,IL-10,IL-1β,TNF-α,IFN-γ,and HO-1 in the observation group were significantly higher than those in the control group(all P<0.05),while the relative expression level of NQO-1 protein was significantly lower than that in the control group(P<0.05).The FVC,FEV1,PEF,MEF25-70,MEF50,and MEF25 in the observation group were significantly lower than those in the control group(all P<0.05).The serum levels of IL-2,IL-6,IL-10,IL-1β,TNF-α,IFN-γ,and HO-1 in the observation group of severe children were significantly higher than those in mild children(all P<0.05),while the relative expression of NQO-1 protein,FVC,FEV1,PEF,MEF25-70,MEF50,and MEF25 were significantly lower than those in mild children(all P<0.05).HO-1 in children with MP infection is positively correlated with IL-6,IL-1β,and IFN-γ,while the relative expression level of NQO-1 protein is negatively correlated with IL-6,IL-1β,and IFN-γ(all P<0.05);HO-1 was negatively correlated with MEF50 and MEF25,while the relative expression level of NQO-1 protein was positively correlated with MEF50(all P<0.05).The area under the ROC curve for predicting the relative expression levels of HO-1 and NQO-1 proteins in severe MP was 0.871 and 0.934,respectively(all P<0.05).Conclusions The expression of serum HO-1 and NQO-1 in children with MP infection is correlated with cytokines and lung function indicators,and has certain application value in predicting severe illness.