血清CCSP、sPLA2、CRP水平在肺炎支原体肺炎患儿中的变化及临床价值

Changes and Clinical Value of Serum Levels of CCSP,sPLA2 and CRP in Children with Mycoplasma Pneumoniae Pneumonia

目的分析肺炎支原体肺炎(MPP)患儿血清Clara细胞分泌蛋白(CCSP)、分泌型磷脂酶A2(sPLA2)、C反应蛋白(CRP)水平变化,并探讨其对预后的评估价值。方法回顾性选取105例MPP患儿为研究组,另选取同期健康儿童35例作为对照组。比较两组临床指标及血清CCSP、sPLA2、CRP水平。依据病情严重程度将研究组患儿分为轻症64例、重症41例,比较其血清CCSP、sPLA2、CRP水平及临床肺部感染评分(CPIS)。分析血清CCSP、sPLA2、CRP与临床指标、CPIS评分相关性。研究组予以常规治疗10 d,依据预后情况分为预后不良25例、预后良好80例,比较其治疗前、治疗3 d后血清CCSP、sPLA2、CRP水平。分析治疗3 d后血清CCSP、sPLA2、CRP对治疗10 d预后的评估价值。结果研究组白细胞计数、中性粒细胞计数、红细胞沉降率高于对照组,淋巴细胞计数低于对照组(P<0.05);研究组血清CCSP水平低于对照组,血清sPLA2、CRP水平高于对照组(P<0.05);重症者血清CCSP水平低于轻症者,血清sPLA2、CRP水平及CPIS评分高于轻症者(P<0.05);血清CCSP与白细胞计数、中性粒细胞计数、红细胞沉降率、CPIS评分、病情程度呈负相关,血清sPLA2、CRP与之相反(P<0.05);预后不良者治疗3 d后血清CCSP水平低于预后良好者,血清sPLA2、CRP水平高于预后良好者(P<0.05);血清CCSP、sPLA2、CRP联合评估预后的AUC大于单项指标评估(P<0.05)。结论MPP患儿血清CCSP水平降低,血清sPLA2、CRP水平升高,且与病情程度密切相关,联合检测其水平对MPP患儿预后具有一定评估价值。

Objective To analyze the changes in serum levels of clara cell secretory protein(CCSP),secretory phospholipase A2(sPLA2),and C-reactive protein(CRP)in children with Mycoplasma pneumoniae pneumonia(MPP),and explore their prognostic value.Methods A total of 105 children with MPP were selected as the study group,and 35 healthy children in the same period were selected as the control group.The clinical indexes and the serum levels of CCSP,sPLA2 and CRP were compared between the two groups.According to the severity of the disease,the study group was divided into 64 cases of mild disease and 41 cases of severe disease.The serum levels of CCSP,sPLA2,CRP and clinical pulmonary infection score(CPIS)were compared.The correlation of serum of CCSP,sPLA2 and CRP with clinical indicators and CPIS score was analyzed.The study group was given conventional treatment for 10 days,and was divided into 25 cases with poor prognosis and 80 cases with good prognosis according to the prognosis.The serum levels of CCSP,sPLA2 and CRP were compared before treatment and after 3 days of treatment.The evaluation value of serum CCSP,sPLA2 and CRP on the prognosis of 10 days after treatment was analyzed.Results The white blood cell count,neutrophil count and erythrocyte sedimentation rate in the study group were higher than those in the control group,while the lymphocyte count was lower than that in the control group(P<0.05);the serum level of CCSP in the study group was lower than that in the control group,and the serum levels of sPLA2 and CRP in the study group were higher than those in the control group(P<0.05);the serum level of CCSP in severe patients was lower than that in mild patients,and the serum levels of sPLA2,CRP and CPIS score in severe patients were higher than those in mild patients(P<0.05);serum of CCSP was negatively correlated with white blood cell count,neutrophil count,erythrocyte sedimentation rate,CPIS score and disease severity,while serum of sPLA2 and CRP were on the contrary(P<0.05);after 3 days of treatment,the serum level of CCSP patients with poor prognosis was lower than that of patients with good prognosis,and the serum levels of sPLA2 and CRP were higher than those of patients with good prognosis(P<0.05);the AUC of combined evaluation of CCSP,sPLA2 and CRP was greater than that of single index evaluation(P<0.05).Conclusion The serum level of CCSP in children with MPP is decreased,and the serum levels of sPLA2 and CRP are increased,which are closely related to the severity of the disease.Combined detection of their levels has a certain value in evaluating the prognosis of children with MPP.