| 摘要: |
| ［摘要］ 目的 研究血清纤维胶凝蛋白-3（ficolin-3）、CD4+/CD8+ T淋巴细胞比值联合中性粒细胞与淋巴细胞比值（NLR）在肺炎支原体肺炎（MPP）合并EB病毒（EBV）感染患儿预后评估中的临床价值。方法 回顾性分析2021年1月至2023年5月西北大学附属第一医院收治的146例MPP合并EBV感染患儿的临床资料。于患儿入院后（治疗前）检测血清ficolin-3、CD4+/CD8+ T淋巴细胞比值及NLR。患儿出院后随访12个月，根据患儿预后情况将其分为预后良好组（100例）和预后不良组（46例）。采用多因素logistic回归分析MPP合并EBV感染患儿预后的影响因素。通过受试者工作特征（ROC）曲线分析ficolin-3、CD4+/CD8+ T淋巴细胞比值、NLR对MPP合并EBV感染患儿预后的预测效能。结果 与预后良好组比较，预后不良组发热时间较长，肺部阴影≥2/3肺叶占比、重症占比较高，C反应蛋白、ficolin-3水平及NLR较高，CD4+/CD8+ T淋巴细胞比值较低，差异有统计学意义（P<0.05）。多因素logistic回归分析结果显示，较高的ficolin-3水平及NLR，较低的CD4+/CD8+ T淋巴细胞比值以及重症MPP、肺部阴影≥2/3肺叶是MPP合并EBV感染患儿预后不良的独立危险因素（P<0.05）。ROC曲线分析结果显示，ficolin-3、CD4+/CD8+ T淋巴细胞比值、NLR可预测MPP合并EBV感染患儿预后不良（P<0.05），且三者联合检测的预测效能［AUC（95%CI）=0.874（0.837～0.911）］优于单项指标（P<0.05）。结论 血清ficolin-3、CD4+/CD8+ T淋巴细胞比值、NLR联合检测有助于预测MPP合并EBV感染患儿的预后。 |
| 关键词: 纤维胶凝蛋白-3 CD4+/CD8+ T淋巴细胞比值 中性粒细胞与淋巴细胞比值 肺炎支原体肺炎 EB病毒 预后 |
| DOI：10.3969/j.issn.1674-3806.2025.08.06 |
| 分类号:R 725.6 |
| 基金项目:陕西省卫生健康科研项目（编号：2021D041） |
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| A study on clinical value of serum ficolin-3, CD4+/CD8+ T lymphocyte ratio combined with NLR in prognosis assessment of pediatric patients with Mycoplasma pneumoniae pneumonia complicated with Epstein-Barr virus infection |
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SUN Hui1, LI Xiu′e1, ZHENG Xiaowei1, ZHANG Yan2, REN Li1
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1.Department of Laboratory Medicine, Northwest University First Hospital, Xi′an 710001, China; 2.Department of Pediatrics, Northwest University First Hospital, Xi′an 710001, China
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| Abstract: |
| ［Abstract］ Objective To study the clinical value of serum ficolin-3, CD4+/CD8+ T lymphocyte ratio combined with neutrophil-to-lymphocyte ratio(NLR) in prognosis assessment of pediatric patients with Mycoplasma pneumoniae pneumonia(MPP) complicated with Epstein-Barr virus(EBV) infection. Methods The clinical data of 146 pediatric patients with MPP complicated with EBV infection who were admitted to Northwest University First Hospital from January 2021 to May 2023 were retrospectively analyzed. The levels of ficolin-3, CD4+/CD8+ T lymphocyte ratio and NLR in the serum of the pediatric patients were detected after admission(before treatment). The pediatric patients were followed up for 12 months after hospital discharge. According to the prognosis, the pediatric patients were divided into good prognosis group(100 cases) and bad prognosis group(46 cases). Multivariate logistic regression was used to analyze the factors affecting the prognosis of the pediatric patients with MPP complicated with EBV infection. The efficacy of ficolin-3, CD4+/CD8+ T lymphocyte ratio and NLR in predicting the prognosis of the pediatric patients with MPP complicated with EBV infection by using receiver operating characteristic(ROC) curve. Results Compared with the good prognosis group, the bad prognosis group had long fever duration, high proportion of pulmonary shadows ≥two-thirds of the lung lobes and high proportion of severe cases, and high C-reactive protein and ficolin-3 levels and NLR, and low CD4+/CD8+ T lymphocyte ratio, with statistically significant differences between the two groups(P<0.05). The results of multivariate logistic regression analysis showed that higher ficolin-3 levels and NLR, lower CD4+/CD8+ T lymphocyte ratio, severe MPP and pulmonary shadows ≥two-thirds of the lung lobes were independent risk factors for poor prognosis of the pediatric patients with MPP complicated with EBV infection(P<0.05). The results of ROC curve analysis showed that ficolin-3, CD4+/CD8+ T lymphocyte ratio and NLR could predict poor prognosis of the pediatric patients with MPP complicated with EBV infection. The combined prediction efficacy of the three indicators［AUC(95%CI)=0.874(0.837-0.911)］ was better than that of the single indicator(P<0.05). Conclusion The combined detection of serum level of ficolin-3, CD4+/CD8+ T lymphocyte ratio and NLR is helpful to predict the prognosis of the pediatric patients with MPP complicated with EBV infection. |
| Key words: Ficolin-3 CD4+/CD8+ T lymphocyte ratio Neutrophil-to-lymphocyte ratio(NLR) Mycoplasma pneumoniae pneumonia(MPP) Epstein-Barr virus(EBV) Prognosis |
