支气管肺泡灌洗液中几丁质酶样蛋白YKL-40对儿童难治性肺炎支原体肺炎的预测价值

Value of chitinase-like protein YKL-40 in bronchoalveolar lavage fluid for predicting refractory Mycoplasma pneumoniae pneumonia in children

摘要:

目的 探讨支气管肺泡灌洗液（bronchoalveolar lavage fluid，BALF）中几丁质酶样蛋白YKL-40对儿童难治性肺炎支原体肺炎（refractory Mycoplasma pneumoniae pneumonia，RMPP）的预测价值。方法 50例普通型肺炎支原体肺炎（Mycoplasma pneumoniae pneumonia，MPP）和22例RMPP患儿纳入研究。比较两组患儿的临床特征、实验室检查结果、影像学表现及BALF中YKL-40水平的差异；采用受试者工作特征曲线分析BALF YKL-40对RMPP的预测价值。结果 RMPP组发热、气促、肺实变及胸腔积液的发生率明显高于普通型MPP组（P < 0.05），血清C-反应蛋白和乳酸脱氢酶水平明显高于普通型MPP组（P < 0.05）。RMPP组BALFYKL-40水平明显高于普通型MPP组（P < 0.05）。以BALF YKL-40水平绘制受试者工作特征曲线，其曲线下面积为0.750，预测RMPP的灵敏度为72.7%，特异度为64.0%。结论 RMPP患儿BALF YKL-40表达水平增高；BALF YKL-40对RMPP具有一定的预测价值。

Abstract:

Objective To evaluate the value of chitinase-like protein YKL-40 in bronchoalveolar lavage fluid (BALF) for predicting refractory Mycoplasma pneumoniae pneumonia (RMPP) in children. Methods A total of 50 children with common Mycoplasma pneumoniae pneumonia (MPP) and 22 children with RMPP were enrolled. The two groups were compared in terms of clinical features, laboratory examination results, imaging findings, and YKL-40 levels in BALF. The receiver operating characteristic (ROC) curve was used to evaluate the value of YKL-40 in BALF for predicting RMPP. Results Compared with the common MPP group, the RMPP group had significantly higher incidence rates of fever, shortness of breath, lung consolidation, and pleural effusion (P < 0.05) and significantly higher serum levels of C-reactive protein and lactate dehydrogenase (P < 0.05). The RMPP group had a significantly higher level of YKL-40 in BALF than the common MPP group (P < 0.05). The ROC curve plotted based on the level of YKL-40 in BALF had an area under the ROC curve of 0.750, a sensitivity of 72.7% and a specificity of 64.0% for predicting RMPP. Conclusions There is an increase in the level of YKL-40 in BALF in children with RMPP, and the level of YKL-40 in BALF has a certain value for predicting RMPP.