The value of serum indexes in early diagnosis of refractory mycoplasma pneumoniae pneumonia in children
10.3760/cma.j.cn115455-20241114-00999
- VernacularTitle:血清指标对儿童难治性肺炎支原体肺炎的早期诊断价值
- Author:
Li XU
1
;
Yan GUO
1
;
Xuehui ZHANG
1
;
Chen HU
1
Author Information
1. 济宁医学院附属医院儿科，济宁 272000
- Publication Type:Journal Article
- Keywords:
Pneumoniae, mycoplasma;
Chitinase protein 40;
Galactin-3;
Regulated upon activation normal T cell expressed and secreted
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(7):660-665
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the early diagnostic value of combined detection of serum chitinase protein 40 (YKL-40), galectin-3 (Gal-3), and regulated upon activation normal T cell expressed and secreted (RANTES) for refractory mycoplasma pneumoniae pneumonia (RMPP) in children.Methods:One hundred and twenty-six children with RMPP (RMPP group), 126 children with global mycoplasma pneumoniae pneumonia (GMPP) (GMPP group), and 126 healthy children who underwent physical check up (control group) in the Affiliated Hospital of Jining Medical College from June 2022 to June 2024 were retrospectively selected. The serum levels of YKL-40, Gal-3 and RANTES were compared. Multivariate Logistic regression was used to analyze the independent influencing factors of RMPP. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of serum YKL-40, Gal-3 and RANTES levels for RMPP.Results:Compared with the control group, the serum YKL-40, Gal-3 and RANTES levels in the RMPP and GMPP groups were obviously higher: (42.19 ± 4.94) and (37.68 ± 4.25) μg/L vs. (26.73 ± 3.31) μg/L, (12.24 ± 2.89) and (8.87 ± 2.56) ng/L vs. (3.92 ± 1.27) ng/L, (33.82 ± 3.86) and (29.28 ± 3.72) μg/L vs. (21.34 ± 2.79) μg/L, with statistical significance ( P<0.05). Compared with the GMPP group, the serum YKL-40, Gal-3 and RANTES levels in the RMPP group were obviously higher ( P<0.05). Compared with the GMPP group, there was no statistically obvious difference in age, gender, body weight, duration of fever and atelectasis in the RMPP group ( P>0.05), however, the levels of C-reactive protein (CRP), procalcitonin (PCT), and the proportions of pleural effusion and lung consolidation were obviously higher in the RMPP group: (22.45 ± 4.21) mg/L vs. (18.69 ± 3.56) mg/L, (0.18 ± 0.04) μg/L vs. (0.15 ± 0.03) μg/L, 31.75% (40/126) vs. 17.46% (22/126), 38.89% (49/126) vs. 25.40% (32/126), P<0.05. CRP, PCT, pleural effusion, pulmonary consolidation, YKL-40, Gal-3 and RANTES were all independent influencing factors of RMPP ( P<0.05). The areas under the curve (AUC) of serum YKL-40, Gal-3 and RANTES levels for diagnosing RMPP in children were 0.769, 0.833 and 0.825, respectively. The AUC of the combined diagnosis of YKL-40, Gal-3 and RANTES was 0.923, which was obviously higher than that of the single indicator diagnosis ( Z = 5.373, 3.677 and 4.191; P<0.01). The sensitivity of the three combined diagnosis was 73.81%, and the specificity was 92.86%. Conclusions:Serum YKL-40, Gal-3 and RANTES levels are obviously elevated in patients with RMPP, and all of which are influencing factors of RMPP. The combination of the three has high diagnostic value for RMPP.
