关键词:

白细胞介素-6, 肿瘤坏死因子-α, 乳酸脱氢酶, 难治性支原体肺炎, 儿童, 预测价值

Abstract:

Objective　To explore the value of serum levels of interleukin-6 (IL-6), tumor necrosis factor-α, (TNF-α), and lactate dehydrogenase (LDH) in the prediction of children with refractory Mycoplasma pneumonia (RMPP). Methods　Sixty children with RMPP treated at Tongchuan Maternal and Child Health Hospital from October 2023 to October 2024 were selected as an observation group, and sixty children with common mycoplasma pneumonia (MPP) during the same period were selected as a control group. In the observation group, there were 35 boys and 25 girls; they were (8.32±1.60) years old. In the control group, there were 32 boys and 28 girls; they were (8.21±1.54) years old. The serum levels of IL-6, TNF-α, and LDH were compared between the two groups. The serum levels of IL-6, TNF-α, and LDH were compared between the children with different prognoses in the observation group. The risk factors associated with the prognosis of the children with RMPP were analyzed. The predictive value of serum levels of IL-6, TNF-α and LDH for the prognosis of the children with RMPP was analyzed. The statistical methods employed included t test, χ² test, multivariate logistic regression analysis, and receiver operating characteristic curve (ROC) analysis. Results　The serum levels of IL-6, TNF-α, and LDH in the observation group were higher than those in the control group [(28.18±4.28) ng/L vs. (22.85±2.23) ng/L, (38.52±4.32) ng/L vs. (30.20±2.96) ng/L, (377.70±38.63) U/L vs. (257.67±16.49) U/L], with statistical differences (all P<0.05). Among the children in the observation group, 17 cases were classified into the poor prognosis group, while the rest 43 cases the good prognosis group; the serum levels of IL-6, TNF-α, and LDH in the poor prognosis group were higher than the those in good prognosis group [(32.42±3.25) ng/L vs. (26.51±3.39) ng/L, (43.15±3.71) ng/L vs. (36.69±2.99) ng/L, and (377.23±26.15) U/L vs. (322.08±30.88) U/L], with statistical differences (all P<0.05). The multivariate logistic regression analysis showed that the serum levels of IL-6, TNF-α, and LDH were risk factors for the prognosis of the children RMPP (all P<0.05). The area under the receiver operating characteristic curve (AUC) of the combined detection of serum IL-6, TNF-α, and LDH for predicting the prognosis of the children with RMPP was 0.992 (95%CI 0.977-0.997), with a sensitivity of 97.20% and a specificity of 93.00%. Conclusion　The combination of IL-6, TNF-α, and LDH in the prediction of the prognosis of children with RMPP has high sensitivity and specificity, indicating good predictive value.

Key words:

Interleukin-6, Tumor necrosis factor-α, Lactate dehydrogenase prognosis, Refractory mycoplasma pneumonia, Child, Predictive value