肺炎支原体肺炎患儿血清LXA4和KLF5表达的临床意义

doi:10.11958/20252960

天津医药 ›› 2026, Vol. 54 ›› Issue (3): 269-274.doi: 10.11958/20252960

肺炎支原体肺炎患儿血清LXA4和KLF5表达的临床意义

张润春(), 李树华^△(), 王玉珍, 王巧文

唐山市妇幼保健院儿科（邮编063000）

收稿日期:2025-09-19 修回日期:2025-12-09 出版日期:2026-03-15 发布日期:2026-03-17
通讯作者: △E-mail：181843718@qq.com
作者简介:张润春（1981），女，副主任医师，主要从事儿科方面研究。E-mail：lusy_158666@163.com
基金资助:
河北省医学科学研究课题计划(20242146)

The clinical significance of serum LXA4 and KLF5 expression in children with Mycoplasma Pneumoniae pneumonia

ZHANG Runchun(), LI Shuhua^△(), WANG Yuzhen, WANG Qiaowen

Department of Pediatric, Tangshan Maternal and Child Health Hospital, Tangshan 063000, China

Received:2025-09-19 Revised:2025-12-09 Published:2026-03-15 Online:2026-03-17
Contact: △E-mail：181843718@qq.com

张润春, 李树华, 王玉珍, 王巧文. 肺炎支原体肺炎患儿血清LXA4和KLF5表达的临床意义[J]. 天津医药, 2026, 54(3): 269-274.

ZHANG Runchun, LI Shuhua, WANG Yuzhen, WANG Qiaowen. The clinical significance of serum LXA4 and KLF5 expression in children with Mycoplasma Pneumoniae pneumonia[J]. Tianjin Medical Journal, 2026, 54(3): 269-274.

摘要/Abstract

摘要：

目的探讨肺炎支原体肺炎（MPP）患儿血清脂氧素A4（LXA4）、Kruppel样因子5（KLF5）的表达及其临床意义。方法纳入158例MPP患儿（MPP组）并根据病情分为重症组97例，轻症组61例，另根据患儿28 d预后情况分为预后良好组（105例）和预后不良组（53例），再同期选取健康儿童91例作为对照组。采用酶联免疫吸附试验（ELISA）检测血清LXA4、KLF5水平，多因素Logistic回归分析影响预后的因素，受试者工作特征（ROC）曲线分析血清LXA4、KLF5水平对病情的诊断及对预后的预测价值。结果与对照组相比，MPP组血清LXA4水平降低，KLF5水平升高（P<0.05）；与轻症组相比，重症组血清LXA4水平降低，KLF5水平升高（P<0.05）；血清LXA4、KLF5联合诊断患儿病情的ROC曲线下面积（AUC）为0.936（95%CI：0.886~0.969），二者联合优于各自单独诊断（Z_{二者联合-LXA4}=2.728、Z_{二者联合-KLF5}=4.208，P<0.05）；预后不良组重症患儿占比、降钙素原（PCT）、C反应蛋白、住院时间以及血清KLF5水平较预后良好组升高，血清LXA4水平较预后良好组降低（P<0.05）；重症病情，PCT、KLF5水平升高是影响MPP患儿预后不良的危险因素，而LXA4水平升高是保护因素（P<0.05）；血清LXA4、KLF5联合预测预后AUC为0.935（95%CI：0.885~0.968），二者联合优于各自单独预测（Z_{二者联合-LXA4}=4.270、Z_{二者联合-KLF5}=3.136，P<0.05）。结论 MPP患儿血清LXA4水平降低，KLF5水平升高，二者联合对诊断MPP患儿病情及预测预后有较高的临床应用价值。

关键词: 肺炎, 支原体, 脂氧素类, Kruppel样转录因子类, 预后, 脂氧素A4, Kruppel样因子5

Abstract:

Objective To discuss the expression and clinical significance of serum lipoxin A4 (LXA4) and Kruppel-like factor 5 (KLF5) in children with Mycoplasma Pneumoniae pneumonia (MPP). Methods A total of 158 children with MPP were enrolled (MPP group) and further classified into the severe group (n=97) and the mild group (n=61) according to disease severity. Based on the 28-day clinical outcome, patients were also categorized into the good prognosis group (n=105) and the poor prognosis group (n=53). In addition, 91 healthy children were included as the control group. Serum levels of LXA4 and KLF5 were measured using enzyme-linked immunosorbent assay (ELISA). Multivariate Logistic regression analysis was used to identify factors influencing prognosis, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of serum LXA4 and KLF5 levels for disease and predictive value for prognosis. Results Compared with the control group, the serum level of LXA4 was decreased and the level of KLF5 was increased in the MPP group (P<0.05). Compared with the mild group, the serum level of LXA4 was decreased, and the level of KLF5 was increased in the severe group (P<0.05). The area under the ROC curve (AUC) for the combined diagnosis of disease severity in children using serum LXA4 and KLF5 was 0.936 (95%CI:0.886-0.969), indicating that the combined diagnostic performance was superior to that of LXA4 or KLF5 alone (Z _{joint - LXA4}=2.728, Z _{joint - KLF5}=4.208, P<0.05). The proportion of severe cases, levels of procalcitonin (PCT), C-reactive protein, length of hospital stay and serum KLF5 level were significantly higher in the poor prognosis group than those in the good prognosis group, while serum LXA4 level was significantly lower in the poor prognosis group (P<0.05). Severe disease, elevated levels of PCT and KLF5 were identified as risk factors for poor prognosis in children with MPP, whereas elevated LXA4 levels were protective factors (P<0.05). The area under the ROC curve (AUC) for the combined prediction of prognosis using serum LXA4 and KLF5 was 0.935 (95%CI: 0.885-0.968), which was significantly higher than that of LXA4 or KLF5 alone (Z _{joint - LXA4}=4.270, Z_{joint - KLF5}=3.136, P<0.05). Conclusion Serum LXA4 is decreased and KLF5 is increased in children with MPP. The combination of the two has high clinical application value in diagnosing disease condition and predicting the prognosis of children with MPP.

Key words: pneumonia, mycoplasma, lipoxins, Kruppel-like transcription factors, prognosis, lipoxin A4, Kruppel like factor 5

中图分类号:

R725.631.3

图/表 8

参考文献 21

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组别	n	年龄/岁	性别（男/女）	LXA4/（μg/L）	KLF5/（μg/L）
对照组	91	7.26±2.15	54/37	32.54±6.73	2.81±0.64
MPP组	158	7.80±2.39	91/67	20.20±4.28	6.02±1.59
t或χ²		1.780	0.072	17.675^＊＊	18.407^＊＊

组别	n	年龄/岁	性别（男/女）	LXA4/（μg/L）	KLF5/（μg/L）
对照组	91	7.26±2.15	54/37	32.54±6.73	2.81±0.64
MPP组	158	7.80±2.39	91/67	20.20±4.28	6.02±1.59
t或χ²		1.780	0.072	17.675^＊＊	18.407^＊＊

组别	n	LXA4	KLF5
轻症组	61	23.97±5.64	4.83±1.23
重症组	97	17.83±3.59	6.77±1.69
t		8.367^＊＊	7.762^＊＊

组别	n	LXA4	KLF5
轻症组	61	23.97±5.64	4.83±1.23
重症组	97	17.83±3.59	6.77±1.69
t		8.367^＊＊	7.762^＊＊

变量	AUC	截断值	95%CI	敏感度/%	特异度/%	约登指数
LXA4	0.845	22.40 μg/L	0.779~0.898	81.44	77.05	0.585
KLF5	0.826	6.50 μg/L	0.758~0.881	61.86	93.44	0.553
二者联合	0.936	-	0.886~0.969	91.75	83.61	0.754

肺炎支原体肺炎患儿血清LXA4和KLF5表达的临床意义

The clinical significance of serum LXA4 and KLF5 expression in children with Mycoplasma Pneumoniae pneumonia

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组别	n		年龄/岁		性别（男/女）					病程/d				发热持续时间/d
预后良好组	105		7.85±2.46		62/43					3.79±0.86				6.59±1.41
预后不良组	53		7.69±2.31		29/24					4.05±1.03				7.05±1.62
t或χ²			0.394		0.270					1.677				1.840
组别		病情严重程度（轻症/重症）					呼吸困难（有/无）						胸部影像实变面积>1/3肺野（有/无）
预后良好组		56/49					36/69						25/80
预后不良组		5/48					24/29						19/34
χ²		28.638^＊＊					1.808						2.541
组别		多肺叶受累（有/无）		胸腔积液（有/无）				WBC/ （×10⁹/L）							Hb/ （g/L）
预后良好组		41/64		28/77				10.57±2.88							124.21±15.42
预后不良组		29/24		21/32				11.49±2.93							119.83±14.69
t或χ²		3.505		2.763				1.885							1.712
组别		PLT/（×10⁹/L）				ALT/（U/L）			AST/（U/L）						PCT/（μg/L）
预后良好组		312.52±91.38				29.06±6.02			47.13±8.48						0.19±0.03
预后不良组		291.46±72.37				30.61±6.34			47.95±7.84						0.28±0.07
t		1.462				1.501			0.588						11.302^＊＊
组别		CRP/（mg/L）				氧疗时间/d					使用抗菌药物时间/d
预后良好组		29.36±7.14				3.92±0.96					8.92±1.37
预后不良组		34.67±8.56				4.26±1.24					9.36±1.64
t		4.123^＊＊				1.901					1.782
组别		住院时间/d				LXA4/（μg/L）						KLF5/（μg/L）
预后良好组		9.94±1.78				22.48±5.29						5.32±1.46
预后不良组		11.69±2.12				15.67±3.43						7.41±1.92
t		5.466^＊＊				8.506^＊＊						7.620^＊＊

变量	β	SE	Wald χ²	P	OR	OR 95%CI
病情严重程度	1.079	0.325	11.031	0.001	2.943	1.556~5.565
PCT	0.722	0.327	4.871	0.027	2.058	1.084~3.907
CRP	0.624	0.338	3.412	0.065	1.867	0.963~3.621
住院时间	0.655	0.364	3.237	0.072	1.925	0.943~3.929
LXA4	-0.459	0.119	14.869	<0.001	0.632	0.501~0.798
KLF5	1.147	0.295	15.120	<0.001	3.149	1.766~5.614
常数项	-14.665	4.161	12.423	<0.001	0.000	-

变量	AUC	截断值	95%CI	敏感度/%	特异度/%	约登指数
LXA4	0.823	19.01 μg/L	0.754~0.879	79.25	72.38	0.516
KLF5	0.816	6.18 μg/L	0.746~0.873	71.70	85.71	0.574
二者联合	0.935	-	0.885~0.968	90.57	83.81	0.744

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