血清CCL3、PGRN、LCN2在肺炎支原体肺炎患儿病情程度及预后评估中的临床价值

陈泽福

文章摘要

血清CCL3、PGRN、LCN2在肺炎支原体肺炎患儿病情程度及预后评估中的临床价值

The clinical value of serum CCL3, PGRN and LCN2 in the assessment of the severity and the judgment of prognosis of children with mycoplasma pneumoniae pneumonia

投稿时间：2025-12-23 修订日期：2026-08-02

DOI：

中文关键词: 肺炎支原体肺炎趋化因子配体3 颗粒蛋白前体脂质运载蛋白2 病情预后

英文关键词: Mycoplasma pneumoniae pneumonia CC chemokine ligand 3 progranulin lipocalin-2 disease severity prognosis

基金项目:海南省卫生健康科技创新联合项目(编号:WSJK2025QN091)

作者	单位	邮编
陈泽福^*	海南省人民医院/海南医科大学附属海南医院	571330

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中文摘要:

目的:探讨血清趋化因子配体3(CCL3)、颗粒蛋白前体(PGRN)、脂质运载蛋白2(LCN2)在肺炎支原体肺炎(MPP)患儿病情程度评估及预后判断中的临床价值。方法:前瞻性选取2024年1月至2025年1月本院儿科收治的150例MPP患儿为MPP组,根据病情程度分为轻症组(92例)、重症组(58例),另选取同期150例体检健康儿童为健康对照组。收集临床资料并对患儿进行随访,根据预后情况将其分为预后良好组(113例)、预后不良组(37例)。采用Pearson相关分析血清CCL3、PGRN、LCN2与肺功能指标的相关性；通过Lasso回归筛选MPP患儿预后的核心影响因素,再采用Logistic回归分析预后不良的危险因素；采用ROC曲线分析血清CCL3、PGRN、LCN2对预后不良的预测价值。结果:MPP组血清CCL3、PGRN、LCN2水平高于健康对照组(P<0.05)。重症组血清CCL3、PGRN、LCN2水平和呼吸频率(RR)高于轻症组,潮气量、达峰时间比(TPTEF/TE)、达峰容积比(VPEF/VE)低于轻症组(P<0.05)。血清CCL3、PGRN、LCN2与潮气量、TPTEF/TE、VPEF/VE呈负相关,与RR呈正相关(P<0.05)。预后不良组发热持续时间、咳嗽持续时间、住院时间、PLT、WBC、CCL3、LCN2、PGRN及RR高于预后良好组,潮气量、TPTEF/TE、VPEF/VE低于预后良好组(P<0.05)。高CCL3、高PGRN、高LCN2是MPP患儿预后不良的危险因素(P<0.05)。血清CCL3、PGRN、LCN2单独预测MPP患儿预后不良的AUC低于三者联合预测(P<0.05)。结论:MPP患儿血清CCL3、PGRN、LCN2水平较高,其升高趋势与病情程度加重和肺功能降低相关,联合检测血清CCL3、PGRN、LCN2水平可能预测患儿预后不良。

英文摘要:

Objective: To explore the clinical value of serum CC chemokine ligand 3 (CCL3), progranulin (PGRN), and lipocalin-2 (LCN2) in the assessment of the severity and the judgment of prognosis of children with mycoplasma pneumoniae pneumonia (MPP). Methods: A total of 150 children with MPP admitted to the pediatrics department of our hospital from January 2024 to January 2025 were prospectively selected as the MPP group. Complying with the severity of the disease, they were separated into the mild group (92 cases) and the severe group (58 cases). Another 150 healthy children who underwent physical check ups were regarded as the healthy control group. Clinical data were collected and the children were followed up. Complying with the prognosis, they were classified into the good prognosis group (113 cases) and the poor prognosis group (37 cases). Pearson correlation analysis was implemented to explore the correlations between serum CCL3, PGRN, LCN2 and pulmonary function indicators. The core influencing factors of prognosis in children with MPP were screened through Lasso regression, and then the risk factors of poor prognosis were explored by Logistic regression. The predictive value of serum CCL3, PGRN and LCN2 for poor prognosis was analyzed by ROC curve. Results: The MPP group had higher levels of serum CCL3, PGRN and LCN2 than the healthy control group (P<0.05). The severe group had higher levels of serum CCL3, PGRN, LCN2 and respiratory rate (RR) than the mild group, and lower tidal volume, ratio of time to peak tidal expiratory flow to total expiratory time (TPTEF/TE), and ratio of volume at peak tidal expiratory flow to expiratory tidal volume (VPEF/VE) than the mild group (P<0.05). Serum CCL3, PGRN and LCN2 were negatively correlated with tidal volume, TPTEF/TE and VPEF/VE, and directly correlated with RR (P<0.05). The poor prognosis group had higher fever duration, cough duration, hospital stay, PLT, WBC, CCL3, LCN2, PGRN and RR than the good prognosis group, and lower tidal volume, TPTEF/TE and VPEF/VE than the good prognosis group (P<0.05). High CCL3, high PGRN and high LCN2 were risk factors for poor prognosis in children with MPP (P<0.05). The AUC of serum CCL3, PGRN and LCN2 alone in predicting poor prognosis of children with MPP was lower than that of the combined prediction of the three (P<0.05). Conclusion: The levels of serum CCL3, PGRN and LCN2 in children with MPP are relatively high, and their increasing trend is related to the aggravation of the disease severity and the reduction of lung function. Combined detection of serum CCL3, PGRN and LCN2 levels may predict a poor prognosis for children.

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