肺炎支原体感染复发喘息患儿血清EDN、IL-13、TGF-β1水平及危险因素分析

doi:10.11958/20241823

天津医药 ›› 2025, Vol. 53 ›› Issue (2): 151-155.doi: 10.11958/20241823

肺炎支原体感染复发喘息患儿血清EDN、IL-13、TGF-β1水平及危险因素分析

刘文洁¹(), 武帆²^,^△(), 赵娜娜¹, 申营², 齐海燕³

1 山东第二医科大学附属医院（临床医学院），山东第二医科大学（邮编261031）
2 山东第二医科大学附属医院儿科（邮编261031）
3 山东第二医科大学附属医院检验科（邮编261031）

收稿日期:2024-11-13 修回日期:2024-12-19 出版日期:2025-02-15 发布日期:2025-02-26
通讯作者: ^△ E-mail：316857828@qq.com
作者简介:刘文洁（1996），女，硕士在读，主要从事儿童呼吸系统疾病方面研究。E-mail：juanawater@163.com
基金资助:
山东省儿童青少年生长发育与健康管理重点课题(JKZX2023138);潍坊市卫生健康科研项目(WFWSJK-2023-039)

Analysis of serum levels of EDN, IL-13, TGF-β1 and risk factors in children with recurrent wheezing of mycoplasma pneumoniae infection

LIU Wenjie¹(), WU Fan²^,^△(), ZHAO Nana¹, SHEN Ying², QI Haiyan³

1 Affiliated Hospital of Shandong Second Medical University, School of Clinical Medicine, Shandong Second Medical University, Weifang 261031, China
2 Department of Pediatrics, Affiliated Hospital of Shandong Second Medical University
3 Department of Laboratory, Affiliated Hospital of Shandong Second Medical University

Received:2024-11-13 Revised:2024-12-19 Published:2025-02-15 Online:2025-02-26
Contact: ^△ E-mail：316857828@qq.com

刘文洁, 武帆, 赵娜娜, 申营, 齐海燕. 肺炎支原体感染复发喘息患儿血清EDN、IL-13、TGF-β1水平及危险因素分析[J]. 天津医药, 2025, 53(2): 151-155.

LIU Wenjie, WU Fan, ZHAO Nana, SHEN Ying, QI Haiyan. Analysis of serum levels of EDN, IL-13, TGF-β1 and risk factors in children with recurrent wheezing of mycoplasma pneumoniae infection[J]. Tianjin Medical Journal, 2025, 53(2): 151-155.

摘要/Abstract

摘要：

目的探讨肺炎支原体（MP）感染复发喘息患儿血清嗜酸性粒细胞来源神经毒素（EDN）、白细胞介素（IL）-13、转化生长因子（TGF）-β1水平并分析MP感染复发喘息的危险因素。方法 80例MP感染的患儿根据既往有无MP感染伴喘息病史分为MP感染复发喘息组（复发喘息组）45例和MP感染无喘息组（无喘息组）35例，选取同期支气管哮喘急性发作的患儿35例为哮喘组。采用酶联免疫吸附试验测定EDN、IL-13、TGF-β1水平。多因素Logistic回归分析影响MP感染复发喘息的危险因素，受试者工作特征（ROC）曲线评估EDN、IL-13、TGF-β1对MP感染复发喘息的预测价值。结果与无喘息组比较，复发喘息组、哮喘组EDN、IL-13、TGF-β1水平均较高（P<0.05），哮喘组与复发喘息组比较差异无统计学意义。单因素分析显示，复发喘息组的出生体质量低于无喘息组，特应性体质、一二级亲属过敏史、烟雾接触、住院时间≥7 d比例高于无喘息组（P<0.05）。多因素Logistic回归分析显示，EDN、IL-13、TGF-β1水平升高及特应性体质、烟雾接触是MP感染复发喘息的危险因素（P<0.05）。ROC曲线结果显示，EDN、IL-13、TGF-β1及三者联合预测MP感染复发喘息的曲线下面积（AUC）分别为0.688、0.662、0.689和0.765，联合预测效能最高。结论 MP感染复发喘息患儿血清EDN、IL-13、TGF-β1水平升高，三者可预测MP感染后患儿复发喘息，为临床干预提供指导。

关键词: 肺炎支原体, 嗜酸细胞源神经毒素, 转化生长因子β1, 白细胞介素13, 儿童, 喘息

Abstract:

Objective To investigate serum levels of eosinophilic neurotoxin (EDN), interleukin (IL)-13 and transforming growth factor (TGF)-β1 in children with recurrent wheezing of mycoplasma pneumoniae (MP) infection and analyze risk factors of recurrent wheezing with MP infection. Methods A total of 80 children with MP infection were divided into the MP infection recurrence wheezing group (45 cases) and the MP infection non-wheezing group (35 cases) according to the previous history of MP infection with wheezing, and 35 children with acute attacks of bronchial asthma were selected as the asthma group. The levels of EDN, IL-13 and TGF-β1 were determined by enzyme-linked immunosorbent assay. Multivariate Logistic regression analysis was performed to analyze risk factors of MP infection recurrence and wheezing. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of EDN, IL-13 and TGF-β1 on MP infection recurrence and wheezing. Results Compared with the non-asthmatic group, levels of EDN, IL-13 and TGF-β1 were higher in the recurrent asthmatic group and the asthmatic group (P<0.05). There were no significant differences in EDN, IL-13 and TGF-β1 levels between the asthma group and the recurrent asthmatic group. Univariate analysis showed that the birth weight was lower in the recurrent wheezing group than that of the non-wheezing group, and the proportion of atopic constitution, the first and second degree relatives allergy history, smoke exposure and hospital stay ≥7 d were higher than those of the non-wheezing group (P<0.05). Multivariate Logistic regression analysis showed that higher levels of EDN, IL-13, TGF-β1, atopic constitution and smoke exposure were risk factors for recurrent wheezing of MP infection (P<0.05). ROC curve results showed that the AUC of EDN, IL-13 and TGF-β1 for predicting the recurrence of MP infection and wheeting was 0.688, 0.662 and 0.689, respectively, and the AUC of the combined prediction of EDN, IL-13 and TGF-β1 was 0.765, which was the most effective than each single index. Conclusion Serum levels of EDN, IL-13 and TGF-β1 increase in children with recurrent wheezing of MP infection, and their serum levels may predict repeated wheezing in children after MP infection, providing guidance for clinical intervention.

Key words: mycoplasma pneumoniae, eosinophil-derived neurotoxin, transforming growth factor beta1, interleukin-13, child, wheezing

中图分类号:

R725.62

图/表 5

参考文献 23

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组别	n	EDN	IL-13	TGF-β1
无喘息组	35	0.47（0.32，0.69）	0.59（0.33，1.01）	28.9（14.9，44.8）
复发喘息组	45	0.89（0.48，1.47）^a	1.14（0.46，1.79）^a	44.3（28.9，48.7）^a
哮喘组	35	1.22（0.82，1.37）^a	1.37（0.65，1.63）^a	45.1（37.3，46.5）^a
H		18.786^＊	12.826^＊	13.274^＊

组别	n	EDN	IL-13	TGF-β1
无喘息组	35	0.47（0.32，0.69）	0.59（0.33，1.01）	28.9（14.9，44.8）
复发喘息组	45	0.89（0.48，1.47）^a	1.14（0.46，1.79）^a	44.3（28.9，48.7）^a
哮喘组	35	1.22（0.82，1.37）^a	1.37（0.65，1.63）^a	45.1（37.3，46.5）^a
H		18.786^＊	12.826^＊	13.274^＊

组别			n	年龄/岁		性别（男/女）			特应性体质
无喘息组			35	6（4，8）		19/16			10（28.57）
复发喘息组			45	5（3，6）		29/16			28（62.22）
χ²或Z				1.501		0.847			8.940^＊
组别		出生情况
组别		足月/早产			顺产/剖宫产			出生体质量/g
无喘息组		29/6			19/16			3 500（3 250，3 800）
复发喘息组		37/8			19/26			3 250（3 000，3 600）
χ²或Z		0.005			1.149			2.000^＊
组别	一二级亲属过敏史						烟雾接触			住院时间≥7 d
无喘息组	11（31.43）						2（5.71）			11（31.43）
复发喘息组	26（57.78）						12（26.67）			25（55.56）
χ²	5.498^＊						5.986^＊			4.630^＊

组别			n	年龄/岁		性别（男/女）			特应性体质
无喘息组			35	6（4，8）		19/16			10（28.57）
复发喘息组			45	5（3，6）		29/16			28（62.22）
χ²或Z				1.501		0.847			8.940^＊
组别		出生情况
组别		足月/早产			顺产/剖宫产			出生体质量/g
无喘息组		29/6			19/16			3 500（3 250，3 800）
复发喘息组		37/8			19/26			3 250（3 000，3 600）
χ²或Z		0.005			1.149			2.000^＊
组别	一二级亲属过敏史						烟雾接触			住院时间≥7 d
无喘息组	11（31.43）						2（5.71）			11（31.43）
复发喘息组	26（57.78）						12（26.67）			25（55.56）
χ²	5.498^＊						5.986^＊			4.630^＊

因素	β	SE	Wald χ²	P	OR（95%CI）
EDN	1.581	0.614	6.619	0.010	4.859（1.457~16.201）
IL-13	1.060	0.507	4.377	0.036	2.887（1.069~7.792）
TGF-β1	0.041	0.020	4.054	0.044	1.042（1.001~1.085）
特应性体质	1.593	0.618	6.650	0.010	4.917（1.466~16.499）
烟雾接触	2.467	0.924	7.129	0.008	11.787（1.927~72.089）
常数项	-0.260	1.096	0.056	0.813	0.771

肺炎支原体感染复发喘息患儿血清EDN、IL-13、TGF-β1水平及危险因素分析

Analysis of serum levels of EDN, IL-13, TGF-β1 and risk factors in children with recurrent wheezing of mycoplasma pneumoniae infection

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指标	截断值	敏感度/%	特异度/%	AUC（95%CI）	P
EDN	0.59 μg/L	68.9	68.6	0.688（0.570~0.806）	0.004
IL-13	1.09 μg/L	51.1	80.0	0.662（0.542~0.782）	0.013
TGF-β1	30.23 μg/L	75.6	60.0	0.689（0.572~0.806）	0.004
三者联合		64.4	85.7	0.765（0.660~0.870）	<0.001

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