血清PRDX1、TSG-6水平与难治性肺炎支原体肺炎患儿病情及预后的关系

doi:10.3969/j.issn.1673-8640.2026.08.003

摘要/Abstract

摘要：

目的探讨血清过氧化物还原酶1（PRDX1）、肿瘤坏死因子α刺激基因6蛋白（TSG-6）水平在难治性肺炎支原体肺炎（RMPP）患儿病情严重程度和预后评估中的价值。方法选取2022年5月—2023年6月衡水市第四人民医院RMPP患儿103例（RMPP组）、普通肺炎支原体肺炎（GMPP）患儿100例（GMPP组）、健康体检儿童105名（正常对照组）。收集所有研究对象的临床资料，并检测其血清PRDX1、TSG-6水平根据临床肺部感染评分（CPIS）将RMPP患儿分为轻症（CPIS<6分）组（59例）和重症（CPIS≥6分）组（44例）。根据RMPP患儿预后情况分为预后良好组（68例）和预后不良组（35例）。采用Spearman相关分析评估血清PRDX1、TSG-6水平与RMPP患儿病情严重程度的相关性。采用多因素Logistic回归分析评估RMPP患儿预后不良的影响因素。采用受试者工作特征（ROC）曲线和决策曲线评估血清PRDX1、TSG-6单项检测和联合检测判断RMPP患儿预后不良的效能和临床适用性。结果 RMPP组血清PRDX1、TSG-6水平均高于正常对照组（P<0.001）。重症组病变范围≥2个肺叶、病变类型为大片状阴影所占比例和血清PRDX1、TSG-6水平均显著高于轻症组（P<0.05）。其他指标2个组之间差异均无统计学意义（P>0.05）。血清PRDX1、TSG-6水平与RMPP患儿病情严重程度呈正相关（r值分别为0.586、0.537，P<0.05）。预后不良组病变范围≥2个肺叶、病变类型为大片状阴影所占比例和血清PRDX1、TSG-6水平均高于预后良好组（P<0.05）。其他指标2个组之间差异均无统计学意义（P>0.05）。血清PRDX1、TSG-6水平升高是RMPP患儿预后不良的危险因素[比值比（OR）值分别为2.851、2.947，95%可信区间（CI）分别为1.402~5.796、1.508~5.761，P<0.01]。血清PRDX1、TSG-6单项检测和联合检测判断RMPP患儿预后不良的曲线下面积（AUC）分别为0.824、0.840、0.923。当高风险阈值为0.05~0.83时，血清PRDX1、TSG-6联合检测的净收益率高于单项检测，联合检测的最大净收益率为1。结论 RMPP患儿血清PRDX1、TSG-6水平升高，且与病情严重程度、预后不良密切相关，或可成为评估病情严重程度和预后的生物标志物。

关键词: 过氧化物还原酶1, 肿瘤坏死因子α刺激基因6蛋白, 难治性肺炎支原体肺炎, 预后

Abstract:

Objective To investigate the roles of serum peroxiredoxin 1（PRDX1） and tumor necrosis factor-alpha-stimulated gene 6 protein（TSG-6） levels in the assessment of the severity and prognosis of children with refractory Mycoplasmal pneumoniae pneumonia（RMPP）. Methods A total of 103 children with RMPP（RMPP group），100 children with general Mycoplasmal pneumoniae pneumonia（GMPP）（GMPP group） and 105 healthy children（healthy control group） were enrolled from Hengshui Fourth People's Hospital. The clinical data were collected，and serum PRDX1 and TSG-6 levels were determined. According to the clinical pulmonary infection score（CPIS），the RMPP children were classified into mild（CPIS <6 points） group（59 cases） and severe（CPIS ≥6 points） group（44 cases）. The RMPP children were classified into good prognosis group（68 cases） and poor prognosis group（35 cases）. Spearman correlation analysis was used to evaluate the correlation between serum PRDX1 and TSG-6 and the severity of RMPP. Multivariate Logistic regression analysis was used to evaluate the influencing factors of poor prognosis in RMPP children. Receiver operating characteristic（ROC） curve and decision curve were used to evaluate the efficacy and clinical applicability of single and combined determinations of serum PRDX1 and TSG-6 in judging the poor prognosis of RMPP children. Results The serum PRDX1 and TSG-6 levels in RMPP group were higher than those in healthy control group（P<0.001）. The proportion of lesions≥2 lung lobes and the proportion of large patchy shadows in the lesion type in severe group were higher than those in mild group（P<0.05）. There was no statistical significance in the other indicators between the 2 groups（P>0.05）. Serum PRDX1 and TSG-6 levels were positively correlated with the severity of RMPP（r values were 0.586 and 0.537，respectively，P<0.05）. The proportion of lesions ≥2 lung lobes and the proportion of large patchy shadows in the lesion type in poor prognosis group were higher than those in good prognosis group（P<0.05）. There was no statistical significance in the other indicators between the 2 groups（P>0.05）. Increased serum PRDX1 and TSG-6 were risk factors for poor prognosis in RMPP children [odds ratios（OR） were 2.851 and 2.947，95% confidence intervals（CI） were 1.402-5.796 and 1.508-5.761，P<0.01]. The areas under curves（AUC） of single and combined determinations of serum PRDX1 and TSG-6 in judging the poor prognosis of RMPP children were 0.824，0.840 and 0.923，respectively，and the maximum net yield of combined determination was 1 when the high-risk cut-off value was 0.05-0.83. Conclusions The serum PRDX1 and TSG-6 levels in RMPP children were elevated and are related to the severity and prognosis. They may be biomarkers for assessing the severity and prognosis of RMPP.

Key words: Peroxiredoxin 1, Tumor necrosis factor-alpha-stimulated gene 6 protein, Refractory Mycoplasmal pneumoniae pneumonia, Prognosis

中图分类号:

Q554

陈云, 胡立杰, 王婷婷, 叶盛前. 血清PRDX1、TSG-6水平与难治性肺炎支原体肺炎患儿病情及预后的关系[J]. 检验医学, 2026, 41(8): 737-743.

CHEN Yun, HU Lijie, WANG Tingting, YE Shengqian. Relationship between serum PRDX1 and TSG-6 levels in children with refractory Mycoplasmal pneumoniae pneumonia and the disease condition and prognosis[J]. Laboratory Medicine, 2026, 41(8): 737-743.

图/表 8

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组别	例数	性别		年龄/岁	BMI/ （kg·m^-2）
组别	例数	男/例	女/例	年龄/岁	BMI/ （kg·m^-2）
正常对照组	105	52	53	6.05±0.78	18.63±2.74
GMPP组	100	49	51	6.11±0.64	18.41±3.07
RMPP组	103	55	48	6.24±1.27	18.25±3.86
统计值		0.473		1.111	0.357
P值		0.789		0.330	0.700

组别	例数	性别		年龄/岁	BMI/ （kg·m^-2）
组别	例数	男/例	女/例	年龄/岁	BMI/ （kg·m^-2）
正常对照组	105	52	53	6.05±0.78	18.63±2.74
GMPP组	100	49	51	6.11±0.64	18.41±3.07
RMPP组	103	55	48	6.24±1.27	18.25±3.86
统计值		0.473		1.111	0.357
P值		0.789		0.330	0.700

组别	例数	PRDX1/（ng·mL^-1）	TSG-6/（ng·mL^-1）
正常对照组	105	6.15±1.07	0.48±0.07
GMPP组	100	7.73±1.08^*	0.72±0.11^*
RMPP组	103	9.84±2.43^*#	1.65±0.38^*#
统计值		129.768	732.557
P值		<0.001	<0.001

组别	例数	PRDX1/（ng·mL^-1）	TSG-6/（ng·mL^-1）
正常对照组	105	6.15±1.07	0.48±0.07
GMPP组	100	7.73±1.08^*	0.72±0.11^*
RMPP组	103	9.84±2.43^*#	1.65±0.38^*#
统计值		129.768	732.557
P值		<0.001	<0.001

组别	例数	性别			年龄/岁	BMI/（kg·m^-2）	发病至入院时间/d		居住环境
组别	例数	男/[例（%）]		女/[例（%）]	年龄/岁	BMI/（kg·m^-2）	发病至入院时间/d		乡镇/[例（%）]		城市/[例（%）]
轻症组	59	32（54.24）		27（45.76）	6.18±0.75	18.17±1.95	2.25±0.34		24（40.68）		35（59.32）
重症组	44	23（52.27）		21（47.73）	6.32±0.79	18.36±2.03	2.37±0.39		20（45.45）		24（54.55）
统计值		0.039			0.909	0.478	1.630		0.235
P值		0.843			0.366	0.634	0.106		0.628
组别	早产儿/ [例（%）]		先天性气道发育异常/[例（%）]	病变范围			病变类型			PRDX1/（ng·mL^-1）	TSG-6/（ng·mL^-1）
组别	早产儿/ [例（%）]		先天性气道发育异常/[例（%）]	单肺叶/ [例（%）]	≥2个肺叶/[例（%）]		大片状阴影/[例（%）]	云絮状或斑片状阴影/[例（%）]		PRDX1/（ng·mL^-1）	TSG-6/（ng·mL^-1）
轻症组	8（13.56）		4（6.78）	34（57.63）	25（42.37）		30（50.85）	29（49.15）		8.79±1.04	1.51±0.17
重症组	5（11.36）		2（4.55）	9（20.45）	35（79.55）		34（77.27）	10（22.73）		11.25±1.36	1.86±0.21
统计值	0.110		0.003	14.321			7.481			10.009	9.058
P值	0.740		0.957	<0.001			0.006			<0.001	<0.001