2026 年第 3 期 第 21 卷

入院早期感染标志物及T细胞亚群对儿童重症肺炎支原体肺炎的预测价值

Predictive value of early admission infection markers and T-cell subsets in children with severe Mycoplasma pneumoniae pneumonia

作者：陈芳赵凌郑敏

英文作者：Chen Fang Zhao Ling Zheng Min

单位：川北医学院附属医院儿科，南充637000

英文单位：Department of Pediatrics Affiliated Hospital of North Sichuan Medical College Nanchong 637000 China

关键词：肺炎支原体肺炎；重症肺炎；C反应蛋白；降钙素原；T细胞亚群

英文关键词：Mycoplasmapneumoniaepneumonia;Severepneumonia;C-reactiveprotein;Procalcitonin; T-cellsubsets

• 摘要：

• 目的 探究入院早期感染标志物及T细胞亚群对儿童重症肺炎支原体肺炎（MPP）的预测价值。方法 选取2023年1月至2024年12月川北医学院附属医院收治的MPP患儿100例作为研究对象。按照病情严重程度将患儿分为轻症组（70例）和重症组（30例）。比较2组患儿的一般资料、主要临床表现、外周血感染标志物、T细胞亚群。采用多因素Logistic回归方法分析C反应蛋白（CRP）、降钙素原、血清淀粉样蛋白A（SAA）、CD+4、CD+8、CD+4/CD+8比值与儿童重症MPP的关联性，绘制受试者工作特征（ROC）曲线评估各指标单独/联合预测效能。结果 重症组患儿发热时间和气促比例长于/高于轻症组，差异均有统计学意义（均P＜0.05）。重症组血清CRP、降钙素原、SAA均高于轻症组，CD+4、CD+8、CD+4/CD+8比值均低于轻症组，差异均有统计学意义（均P＜0.05）。多因素Logistic回归分析结果显示，CRP、降钙素原、SAA的升高及CD+4、CD+8、CD+4/CD+8比值的降低与儿童重症MPP的发生关系密切（均P＜0.05）。ROC曲线分析结果显示CRP、降钙素原、SAA、CD+4、CD+8、CD+4/CD+8比值六项联合预测儿童重症MPP的曲线下面积大于各指标单独检测（0.953比0.756、0.852、0.861、0.777、0.724、0.719）（均P＜0.05）。结论 CRP、降钙素原、SAA及CD+4、CD+8、CD+4/CD+8比值均对儿童重症MPP有一定预测价值，且六项联合的预测效能更高。

• Objective To explore the predictive value of early admission infection markers and T-cell subsets in children with severe Mycoplasma pneumoniae pneumonia (MPP). Methods A total of 100 children with MPP admitted to the Affiliated Hospital of North Sichuan Medical College from January 2023 to December 2024 were enrolled as research subjects. According to the severity of the disease, the children were divided into the mild MPP group (70 cases) and the severe MPP group (30 cases). The general data, main clinical manifestations, peripheral blood infection markers and T-cell subsets were compared between the two groups. Multivariate Logistic regression analysis was used to explore the correlation of C-reactive protein (CRP), procalcitonin, serum amyloid A (SAA), CD+4, CD+8 and CD+4/CD+8 ratio with severe MPP in children. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive efficacy of each indicator alone or in combination. Results The duration of fever and the proportion of tachypnea in the severe MPP group were longer/higher than those in the mild MPP group (all P<0.05). The serum levels of CRP, procalcitonin and SAA in the severe MPP group were higher than those in the mild MPP group, while CD+4, CD+8 and CD+4/CD+8 ratio were lower than those in the mild MPP group (all P<0.05). Multivariate Logistic regression analysis showed that the increased levels of CRP, procalcitonin and SAA, as well as the decreased levels of CD+4, CD+8 and CD+4/CD+8 ratio were closely associated with the occurrence of severe MPP in children (all P<0.05). ROC curve analysis showed that the area under the curve of the combined detection of the six indicators (CRP, procalcitonin, SAA, CD+4, CD+8 and CD+4/CD+8 ratio) for predicting severe MPP in children was larger than that of each indicator alone (0.953 vs 0.756, 0.852, 0.861, 0.777, 0.724, 0.719, all P<0.05). Conclusion CRP, procalcitonin, SAA, CD+4, CD+8 and CD+4/CD+8 ratio all have certain predictive value for severe MPP in children, and the combined detection of the six indicators has higher predictive efficacy.