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| 外周血SAA、CRP/PA、VEGF与肺炎支原体肺炎患儿病情程度、肺功能及预后的关系 |
| The relationship between peripheral blood SAA, CRP/PA, VEGF and the severity, pulmonary function, and prognosis of children with Mycoplasma pneumoniae pneumonia |
| 投稿时间：2025-04-28 修订日期：2025-04-28 |
| DOI： |
| 中文关键词: 淀粉样蛋白A C反应蛋白/前白蛋白 血管内皮生长因子 肺炎支原体肺炎 病情程度 肺功能 预后 |
| 英文关键词: Amyloid protein A C-reactive protein/prealbumin Vascular endothelial growth factor Mycoplasma pneumoniae pneumonia Severity Pulmonary function Prognosis |
| 基金项目:赣州市科技计划项目（20222ZDX8597） |
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| 中文摘要: |
| 目的：探讨外周血淀粉样蛋白A（SAA）、C反应蛋白（CRP）/前白蛋白（PA）、血管内皮生长因子（VEGF）与肺炎支原体肺炎（MPP）患儿病情程度、肺功能及预后的关系。方法：选择会昌县妇幼保健院2023年2月至2024年8月期间收治的106例MPP患儿作为研究对象（MPP组），根据28d的预后情况分为预后良好组（n=77）、预后不良组（n=29），根据病情程度分为轻度组（n=61）、重度组（n=45）。另取同期体检健康儿童90名为对照组。比较对照组和MPP组的外周血SAA、CRP/PA、VEGF和肺功能指标，比较轻度组和重度组的外周血SAA、CRP/PA、VEGF水平，采用Pearson和Spearman相关性分析外周血SAA、CRP/PA、VEGF与MPP患儿肺功能指标、病情程度的相关性。比较预后不良组和预后良好组的外周血SAA、CRP/PA、VEGF水平。受试者工作特征（ROC）曲线分析外周血SAA、CRP/PA、VEGF单独及联合检测对MPP患儿28d预后的评估价值。结果：MPP组的外周血SAA、CRP/PA、VEGF高于对照组，第1秒用力呼气容积（FEV1 ）、呼气流量峰值（PEF）、用力肺活量 （FVC）低于对照组（P<0.05）。重度组的外周血SAA、CRP/PA、VEGF高于轻度组（P<0.05）。外周血SAA、CRP/PA、VEGF与FEV1、PEF、FVC呈负相关，而与病情程度呈正相关（P<0.05）。预后不良组的外周血SAA、CRP/PA、VEGF水平高于预后良好组（P<0.05）。外周血SAA、CRP/PA、VEGF单独检测评估MPP患儿的28d预后的曲线下面积（AUC）分别为0.514、0.562、0.585；外周血SAA、CRP/PA、VEGF联合检测评估MPP患儿的28d预后的AUC为0.725，显著高于单独检测。结论：外周血SAA、CRP/PA、VEGF水平异常升高参与着MPP病情进展、肺功能损害及不良预后。联合检测外周血SAA、CRP/PA、VEGF水平可有效评估MPP患儿的短期预后。 |
| 英文摘要: |
| Objective: To investigate the relationship between peripheral blood amyloid protein A (SAA), C-reactive protein (CRP)/prealbumin (PA), vascular endothelial growth factor (VEGF) and the severity, pulmonary function, and prognosis of children with Mycoplasma pneumoniae pneumonia (MPP). Method: 106 children with MPP who were admitted to Huichang Maternal and Child Health Hospital from February 2023 to August 2024 were selected as the study subjects (MPP group), they were divided into good prognosis group (n=77) and poor prognosis group (n=29) according to the 28 day prognosis, they were divided into mild group (n=61) and severe group (n=45) according to the disease severity. Another 90 healthy children who underwent physical examinations during the same period were selected as the control group. The peripheral blood SAA, CRP/PA, VEGF, and pulmonary function indicators between the control group and MPP group were compared, and the peripheral blood SAA, CRP/PA, and VEGF levels between the mild group and severe group were compared, Pearson and Spearman correlation analysis was used to investigate the correlation between peripheral blood SAA, CRP/PA, VEGF and pulmonary function indicators and disease severity in children with MPP. The levels of peripheral blood SAA, CRP/PA, and VEGF between poor prognosis group and good prognosis group were compared. Receiver operating characteristic (ROC) curve was used to analyze the value of peripheral blood SAA, CRP/PA, VEGF detection alone and in combination for evaluating the 28 day prognosis in children with MPP. Result: The peripheral blood SAA, CRP/PA, and VEGF levels in the MPP group were higher than those in the control group, while the forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), and forced vital capacity (FVC) were lower than those in the control group (P<0.05). Peripheral blood SAA, CRP/PA, and VEGF levels in the severe group were higher than those in the mild group (P<0.05). Peripheral blood SAA, CRP/PA, VEGF were negatively correlated with FEV1, PEF, FVC, but positively correlated with the severity of the disease(P<0.05). Peripheral blood SAA, CRP/PA, and VEGF in the poor prognosis group were higher than those in the good prognosis group (P<0.05). The area under the curve (AUC) values of peripheral blood SAA, CRP/PA, and VEGF for evaluating the 28 day prognosis of MPP patients were 0.514, 0.562, and 0.585, respectively, the AUC of 28 day prognosis evaluation in children with MPP by combined detection of peripheral blood SAA, CRP/PA, and VEGF was 0.725, significantly higher than that of individual detection. Conclusion: Abnormal elevation of peripheral blood SAA, CRP/PA, and VEGF levels is involved in the progression of MPP, the injury of pulmonary function, and poor prognosis. combined detection of peripheral blood SAA, CRP/PA, and VEGF levels can effectively evaluate the short-term prognosis of MPP patients. |
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