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

doi:10.11958/20252960

Abstract

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

CLC Number:

R725.631.3

Figures/Tables 8

References 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