【摘要】 目的:探讨诱导痰中基质细胞衍生因子-1(SDF-1)、血清活化蛋白C(APC)水平与重症支原体肺炎(SMPP)患儿病情严重程度的相关性及对不良预后的预测价值。方法:选取2024年1月—2025年1月某院收治的150例SMPP患儿为重症组，另选取同期150例普通支原体肺炎患儿为轻症组，150例健康体检儿童为对照组，依据治疗10 d后的临床转归将重症肺炎组分为预后良好组(n=104)和预后不良组(n=46),比较3组及不同预后患儿痰SDF-1、血清APC水平，绘制ROC曲线分析痰SDF-1、血清APC水平对SMPP患儿不良预后的预测价值。结果:3组痰SDF-1水平比较：重症组>轻症组>对照组，血清APC水平比较：对照组>轻症组>重症组，轻症组小儿危重病例(PCIS)评分高于重症组，差异均有统计学意义(P<0.05)。相关性分析显示，痰SDF-1水平与PCIS评分呈负相关(r=-0.601,P<0.05),血清APC水平与PCIS评分呈正相关(r=0.510,P<0.05)。预后不良组痰SDF-1水平高于预后不良组，血清APC水平低于预后良好组，差异有统计学意义(P<0.05)。ROC分析显示，痰SDF-1、血清APC预测SMPP患儿发生不良预后的AUC为0.749、0.883,二者联合预测的AUC为0.907,敏感度为91.30%、特异度为79.81%。结论:痰SDF-1水平与SMPP患儿PCIS评分呈负相关，血清APC水平与PCIS评分呈正相关，联合检测二者水平能实现对其不良预后的早期预测。更多还原

【Abstract】 Objective: To investigate the predictive value of inducing levels of stromal cell-derived factor-1(SDF-1) and serum activated protein C(APC) in sputum for assessing the condition and prognosis of children with severe mycoplasma pneumonia(SMPP).Methods:A total of 150 children with SMPP admitted to a hospital from January 2024 to January 2025 were selected as the severe group. Additionally, 150 children with ordinary mycoplasma pneumonia during the same period were selected as the mild group, and 150 healthy children undergoing physical examinations were selected as the control group. The levels of sputum SDF-1 and serum APC were compared among the three groups. Pearson correlation analysis was used to analyze the correlation between sputum SDF-1 and serum APC levels with the Pediatric Critical Illness Score(PCIS) scores. Based on clinical outcomes after 10 days of treatment, the severe pneumonia group was divided into a good prognosis group(n=104) and a poor prognosis group(n=46).Sputum SDF-1 and serum APC levels in the SMPP patients with different prognoses were compared and ROC curves were plotted to analyze the predictive value of sputum SDF-1 and serum APC levels for the outcomes of severe mycoplasma pneumonia patients.Results:Sputum SDF-1 levels were higher in the severe group than in the mild group and the control group, while serum APC levels were lower in the severe group than in the mild group and the control group, with statistically significant differences(P<0.05). ROC analysis showed that sputum SDF-1 was negatively correlated with PCIS scores(r=-0.601,P<0.05), while serum APC was positively correlated with PCIS scores(r=0.510,P<0.05).Children in the poor prognosis group had higher sputum SDF-1 levels than those in the good prognosis group, and their serum APC levels were lower than those in the good prognosis group(P<0.05).ROC analysis showed that the AUC of sputum SDF-1 and serum APC in predicting poor prognosis in children with SMPP was 0.749 and 0.883, respectively. The combined AUC for diagnosing poor prognosis in children with severe pneumonia was 0.907, with sensitivity of 91.30% and specificity of 79.81%.Conclusion:In children with SMPP,higher sputum SDF-1 level, or lower serum APC level may indicate more severe disease and poorer prognosis.These markers can serve as auxiliary indicators for assessing the severity and prognosis of severe pneumonia in children.更多还原