| 李 革,余怡如,陈 放,魏 俊,黄永建.NLR、25-（OH）D3、IL-6、PCT与重症肺炎支原体肺炎患儿免疫功能和预后不良的关系研究[J].,2023,(3):461-465 |
| NLR、25-（OH）D3、IL-6、PCT与重症肺炎支原体肺炎患儿免疫功能和预后不良的关系研究 |
| Relationship Study between NLR, 25-(OH)D3, IL-6, PCT and Immune Function and Poor Prognosis in Children with Severe Mycoplasma Pneumoniae Pneumonia |
| 投稿时间：2022-05-07 修订日期：2022-05-31 |
| DOI：10.13241/j.cnki.pmb.2023.03.012 |
| 中文关键词: 重症肺炎支原体肺炎 NLR 25-（OH）D3 IL-6 PCT 免疫功能 预后 |
| 英文关键词: Severe mycoplasma pneumoniae pneumonia NLR 25-(OH)D3 IL-6 PCT Immune function Prognosis |
| 基金项目:湖北省自然科学基金项目（2015CFB659） |
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| 中文摘要: |
| 摘要 目的：探讨中性粒细胞与淋巴细胞比值（NLR）、25-羟维生素D3 [25-（OH）D3]、白细胞介素-6（IL-6）、降钙素原（PCT）与重症肺炎支原体肺炎（MMP）患儿免疫功能和预后不良的关系。方法：选取2019年2月至2021年12月我院收治的106例重症MMP患儿作为重症组，同期收治的101例轻症MMP患儿（轻症组）作为对照。检测外周血中性粒细胞计数、淋巴细胞计数、T淋巴细胞亚群以及血清25-（OH）D3、IL-6、PCT水平，计算NLR。分析NLR、25-（OH）D3、IL-6、PCT与T淋巴细胞亚群的相关性。重症MMP患儿治疗后随访半年，根据重症MMP患儿的预后情况分为预后良好组（75例）和预后不良组（31例），多因素Logistic回归分析影响重症MMP患儿预后的因素。结果：重症组NLR、IL-6、PCT水平，CD8+高于轻症组（P＜0.05），25-（OH）D3水平、CD3+、CD4+、CD4+/CD8+低于轻症组（P＜0.05）。NLR、IL-6、PCT水平与CD3+、CD4+、CD4+/CD8+呈负相关（P＜0.05），与CD8+呈正相关（P＜0.05）；25-（OH）D3与CD3+、CD4+、CD4+/CD8+呈正相关（P＜0.05），与CD8+呈负相关（P＜0.05）。多因素Logistic回归分析显示：肺大片实变影、NLR（较高）、IL-6（较高）、PCT（较高）是重症MPP患儿预后不良的危险因素（P＜0.05），25-（OH）D3（较高）是保护因素（P＜0.05）。结论：重症MMP患儿NLR、IL-6、PCT水平升高，25-（OH）D3水平降低，且与细胞免疫功能低下以及预后不良有关，检测NLR、IL-6、PCT、25-（OH）D3有助于评估重症MMP患儿的预后。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between neutrophil to lymphocyte ratio (NLR), 25-hydroxyvitamin D3 [25-(OH)D3], interleukin-6 (IL-6), procalcitonin (PCT) and immune function and poor prognosis in children with severe mycoplasma pneumoniae pneumonia (MMP). Methods: 106 children with severe MMP who were admitted to our hospital from February 2019 to December 2021 were selected as the severe group, and 101 children with mild MMP (mild group) who were admitted in the same period were selected as the control. Peripheral blood neutrophil count, lymphocyte count, T lymphocyte subsets, serum 25-(OH)D3, IL-6, PCT levels were detected, and NLR was calculated. The correlation between NLR, 25-(OH)D3, IL-6, PCT and T lymphocyte subsets was analyzed. Children with severe MMP were followed up for half a year after treatment, according to the prognosis of children with severe MMP, they were divided into good prognosis group (75 cases) and poor prognosis group (31 cases). Multivariate Logistic regression analysis was used to analyze the factors affecting the prognosis of children with severe MMP. Results: The NLR, IL-6, PCT levels and CD8+ in the severe group were higher than those in the mild group (P<0.05), while the 25-(OH)D3 level, CD3+, CD4+ and CD4+/CD8+ were lower than those in the mild group (P<0.05). The NLR, IL-6 and PCT levels were negatively correlated with CD3+, CD4+ and CD4+/CD8+ (P<0.05), and positively correlated with CD8+ (P<0.05). 25-(OH)D3 was positively correlated with CD3+, CD4+, CD4+/CD8+ (P<0.05), and negatively correlated with CD8+ (P<0.05). Multivariate Logistic regression analysis showed that massive consolidation of lung, NLR (higher), IL-6 (higher) and PCT (higher) were risk factors for poor prognosis in children with severe MPP (P<0.05), and 25-(OH)D3 (higher) was a protective factor (P<0.05). Conclusion: The NLR, IL-6, and PCT levels are increased, and the 25-(OH)D3 level is decreased in children with severe MMP, which are related to cellular immune dysfunction and poor prognosis. The detection of NLR, IL-6, PCT, and 25-(OH)D3 is helpful to evaluate the prognosis of children with severe MMP. |
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