传染病信息

目的 探讨血清可溶性血红蛋白清道夫受体（soluble cluster differentiation 163, sCD163)、1-磷酸鞘氨醇（sphingosine 1-phosphate, S1P)及平均血小板体积/淋巴细胞比值（mean platelet volume-to-lymphocyte ratio, MPVLR）与肺炎支原体肺炎伴肺不张患儿病情严重程度及预后的关系。方法 选取2021年1月至2024年12月间淮安市第五人民医院收治的120例肺炎支原体肺炎患儿作为研究对象，根据是否伴肺不张分为肺不张组（64例）和非肺不张组（56例）。检测所有患儿血清sCD163、S1P、MPVLR水平及动脉血二氧化碳分压、动脉血氧分压，并随访预后情况。采用Pearson相关分析探讨各指标与血气参数的相关性，使用受试者工作特征（receiver operating characteristic, ROC）曲线评估各指标对预后不良的预测效能。结果 肺不张组血清sCD163、S1P、MPVLR水平均显著高于非肺不张组（均P<0.05）。肺不张组动脉血二氧化碳分压高于非肺不张组，动脉血氧分压低于非肺不张组（均P<0.05）。Pearson相关性分析显示，肺炎支原体肺炎伴肺不张患儿血清sCD163、S1P、MPVLR水平与动脉血二氧化碳分压呈正相关（P<0.05），与动脉血氧分压呈负相关（P<0.05）。预后不良组血清sCD163、S1P、MPVLR水平均明显高于预后良好组（P<0.05）。ROC曲线分析表明，血清sCD163、S1P联合MPVLR预测肺炎支原体肺炎伴肺不张患儿预后不良的敏感度为91.42%、特异度为58.73%、曲线下面积为0.893。结论 血清sCD163、S1P及MPVLR水平与肺炎支原体肺炎伴肺不张的严重程度紧密相关，3者联合评估预后的效能较好，值得临床予以重视。

Objective To investigate the association of serum soluble cluster differentiation 163(sCD163), sphingosine-1-phosphate(S1P), mean platelet volume-to-lymphocyte ratio(MPVLR) and the severity and prognosis of Mycoplasma pneumoniae pneumonia with atelectasis. Methods A total of 120 children with Mycoplasma pneumoniae pneumonia admitted to our hospital from January 2021 to December 2024 were selected, and divided into a group with atelectasis(64 cases) and a group without atelectasis(56 cases) according to whether they were accompanied by atelectasis. The serum sCD163, S1P, MPVLR levels, arterial carbon dioxide partial pressure, and arterial oxygen partial pressure of all children were detected to observe the prognosis, and the predictive efficacy was analyzed by receiver operating characteristic(ROC) curve. Results Compared with the non-atelectasis group, serum levels of sCD163, S1P, and MPVLR in the atelectasis group were significantly increased(P<0.05). Compared with the non-atelectasis group, the partial pressure of carbon dioxide in arterial blood was higher in the atelectasis group(P<0.05), and the partial pressure of oxygen in arterial blood was lower(P<0.05). Through Pearson correlation analysis, the levels of serum sCD163, S1P, and MPVLR in children with Mycoplasma pneumoniae pneumonia accompanied by atelectasis were positively correlated with the partial pressure of carbon dioxide in arterial blood(P<0.05) and negatively correlated with the partial pressure of oxygen in arterial blood(P<0.05). Serum levels of s CD163, S1P, and MPVLR in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05). ROC curve analysis showed that serum sCD163 and S1P combined with MPVLR had a sensitivity of 91.42%, specificity of 58.73%, and AUC of 0.893 in predicting poor prognosis of children with Mycoplasma pneumoniae pneumonia with atelectasis. Conclusion Serum sCD163, S1P, and MPVLR are closely related to the severity of Mycoplasma pneumoniae pneumonia with atelectasis, and the combination of these three indicators showed good predictive performance for prognosis and worthy of clinical attention.