儿童重症肺炎支原体肺炎血清sTREM-1、MMP-9水平及临床意义

doi:10.3877/cma.j.issn.1674-6902.2021.03.007

目的

探讨儿童重症肺炎支原体肺炎血清可溶性髓系细胞触发受体-1(sTREM-1)、基质金属蛋白酶-9(MMP-9)水平及临床意义。

方法

选择2018年3月至2020年5月本院收治的76例肺炎支原体肺炎患儿，依据病情严重程度分为重症肺炎组48例、中度肺炎组28例。对比两组患儿血清sTREM-1、MMP-9水平；统计重症肺炎支原体肺炎患儿预后情况，分死亡组7例和存活组41例；分析血清sTREM-1、MMP-9水平对儿童重症肺炎支原体肺炎预后的预测价值。

结果

重症肺炎组患儿血清sTREM-1、MMP-9水平均高于中度肺炎组(P<0.05)；重症肺炎支原体肺炎患儿死亡的发生率为14.58%(48/7)。死亡组重症肺炎支原体肺炎患儿血清sTREM-1、MMP-9水平分别为(105.27±25.86)ng/L、(346.25±53.46)ng/ml均高于存活组(74.20±16.52)ng/L、(296.45±22.35)ng/ml(P<0.05)。血清sTREM-1、MMP-9预测儿童重症肺炎支原体肺炎预后的最佳截断点分别为89.65 ng/L、310.57 ng/ml。血清sTREM-1、MMP-9两者联合的特异度为97.56%，高于血清sTREM-1、MMP-9水平单独进行评估的特异度，且血清sTREM-1、MMP-9两者联合预测儿童重症肺炎支原体肺炎预后的曲线下面积为0.738，高于血清sTREM-1、MMP-9水平单独预测的AUC(P<0.05)。

结论

血清sTREM-1、MMP-9水平预测重症肺炎支原体肺炎患儿预后的评估较高，两者联合适用于对重症肺炎支原体肺炎患儿预后有意义。

关键词: 重症肺炎, 支原体肺炎, 可溶性髓系细胞触发受体-1, 基质金属蛋白酶-9

Objective

To investigate the levels of soluble myeloid cell triggering receptor-1 (sRM-1) and matrix metalloproteinase-9 (MMP-9) in serum of children with severe mycoplasma pneumoniae pneumonia and their clinical significance.

Methods

76 children with Mycoplasma pneumoniae pneumonia admitted to our hospital from March 2018 to May 2020 were selected and divided into severe pneumonia group 48 cases and moderate pneumonia group 28 cases according to the severity of their illness. Serum sTREM-1 and MMP-9 levels were compared between the two groups. The prognosis of children with severe mycoplasma pneumoniae pneumonia was analyzed and divided into death group 7 cases and survival group 41 cases. Receiver operating characteristic curve (ROC) was prepared to analyze the predictive value of serum sRM-1 and MMP-9 levels on the prognosis of children with severe Mycoplasma pneumoniae pneumonia.

Results

Serum sTREM-1 and MMP-9 levels in severe pneumonia group were higher than those in moderate pneumonia group (P<0.05). The incidence of prognostic death in children with severe mycoplasma pneumoniae pneumonia was 14.58% (7/48). Serum sRM-1 and MMP-9 levels in the death group were (105.27±25.86) ng/L and (346.25±53.46) ng/ml, respectively, higher than those in the survival group (74.20±16.52) ng/L and (296.45±22.35) ng/ml (P<0.05). ROC analysis showed that the best cutoff points of serum sRM-1 and MMP-9 for predicting the prognosis and death of children with severe Mycoplasma pneumoniae pneumonia were 89.65 ng/L and 310.57 ng/ml, respectively. The combined specificity of serum sRM-1 and MMP-9 was 97.56%, higher than that of serum sRM-1 and MMP-9 alone, and the area under the curve of the combined prediction of serum sRM-1 and MMP-9 for the prognosis of children with severe mycoplasma pneumoniae pneumonia was 0.738. Higher than the AUC predicted by serum sMOM-1 and MMP-9 levels alone (P<0.05).

Conclusion

Serum sMOM-1 and MMP-9 levels are highly effective in predicting the prognosis and death of children with severe mycoplasma pneumoniae pneumonia, and they are suitable for predicting the prognosis of children with severe mycoplasma pneumoniae pneumonia together.

Key words: Severe pneumonia, Mycoplasma pneumonia, Soluble myeloid cell trigger receptor-1, Matrix metalloproteinase-9

表1 两组患儿血清sTREM-1、MMP-9水平(±s)

组　别	例数	sTREM-1(ng/L)	MMP-9(ng/ml)
重症肺炎组	48	78.73±18.32^ab	303.71±46.42^ab
轻/中度肺炎组	28	51.32±15.47^a	128.63±25.18^a
t值		283.729	353.028
P值		<0.01	<0.01

表1 两组患儿血清sTREM-1、MMP-9水平(±s)

组　别	例数	sTREM-1(ng/L)	MMP-9(ng/ml)
重症肺炎组	48	78.73±18.32^ab	303.71±46.42^ab
轻/中度肺炎组	28	51.32±15.47^a	128.63±25.18^a
t值		283.729	353.028
P值		<0.01	<0.01

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Serum sTREM-1 and MMP-9 levels in children with severe mycoplasma pneumoniae pneumonia and the clinical significance

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Serum sTREM-1 and MMP-9 levels in children with severe mycoplasma pneumoniae pneumonia and the clinical significance