摘要
目的探究血清25羟维生素D[25(OH) D]及甲壳质酶蛋白40(YKL-40)水平检测在儿童难治性支原体肺炎早期诊断中的临床意义。方法选取2016年4月~2018年1月笔者医院收治的肺炎支原体肺炎(MPP)患儿107例为研究对象,其中普通支原体肺炎(OMPP)组67例,难治性支原体肺炎(RMPP)组40例,选取同期肺炎健康体检儿童55例作为对照组。采集各受试者静脉血,酶联免疫吸附(ELISA)法检测各患儿血清25(OH) D及YKL-40蛋白水平,并绘制ROC曲线分析二者在RMPP早期诊断中的预测价值。结果 MPP患儿血清25(OH) D水平明显低于对照组,YKL-40蛋白水平明显高于对照组,差异有统计学意义(P <0. 05)。血清25(OH) D、YKL-40水平诊断RMPP的ROC曲线下面积(AUC)分别为0. 732、0. 679。血清25(OH) D水平与MPP患儿肺部啰音、呼吸音低、胸腔积液、肺部坏死性炎症等发生率有关(P <0. 05);血清YKL-40水平与MPP患儿肺外并发症、肺部啰音、呼吸音低、胸腔积液、肺部坏死性炎症发生率有关(P <0. 05)。RMPP组肺炎患儿血清25(OH) D水平明显低于OMPP组(P <0. 05)、YKL-40蛋白水平显著高于OMPP组(P <0. 05)。血清25(OH) D、YKL-40对MPP患者诊断的AUC分别为0. 751、0. 797。结论 RMPP患儿血清25(OH) D水平显著降低,YKL-40显著升高,检测血清25(OH) D、YKL-40水平对RMPP早期诊断,具有一定临床应用价值。
Objective To explore the clinical significance of serum 25-hydroxy vitamin D [25( OH) D] and chitinase protein 40( YKL-40) levels detections in the early diagnosis of refractory mycoplasma pneumonia in children. Methods Totally 107 children with mycoplasma pneumoniae pneumonia( MPP) in our hospital from April 2016 to January 2018 were selected as the subjects,including 67 cases of common mycoplasma pneumonia( OMPP) and 40 cases of refractory mycoplasma pneumonia( RMPP),and 55 children with pneumonia in the same period were selected as the control group. Venous blood was collected from the subjects,enzyme linked immunosorbent assay( ELISA) was used to detect serum 25( OH) D and YKL-40 protein levels,the ROC curve was drawn to analyze the predictive values of the them in the early diagnosis of RMPP. Results The serum 25( OH) D level of children in the MPP group was significantly lower than that in the control group,the level of YKL-40 protein was significantly higher than that in the control group,the differences were statistically significant( P < 0. 05). The areas under the ROC curve( AUC) of serum 25( OH) D and YKL-40 levels in the diagnosis of RMPP was 0. 732 and 0. 679 respectively. The level of serum 25( OH) D was related to the incidence rates of lung rales,low respiratory sounds,pleural effusion and necrotizing inflammation in children with MPP( P < 0. 05). The level of serum YKL-40 was related to the incidence rates of extrapulmonary complications,pulmonary rales,low respiratory sounds,pleural effusion and necrotizing inflammation in children with MPP( P < 0. 05). The level of serum 25( OH) D of children in RMPP group was significantly lower than that in OMPP group( P < 0. 05),and YKL-40 protein level was significantly higher than that in OMPP group( P < 0. 05). The AUCs of serum 25( OH) D and YKL-40 levels in the diagnosis of MPP were 0. 751 and 0. 797 respectively. Conclusion The level of serum 25( OH) D decreased significantly in children with RMPP,YKL-40 increased significantly,the detections of serum 25( OH) D and YKL-40 levels have certain clinical values in early diagnosis of RMPP.
引文
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