外周血炎症因子水平在重症肺炎支原体肺炎合并胸腔积液患儿临床转归中的意义OA

Objective To investigate the changes in peripheral blood inflammatory factors in children with severe mycoplasmal pneumoniae pneumonia(SMPP)complicated by pleural effusion and their relationship with clinical outcomes.Methods A retrospective study was conducted,in which 200 children with SMPP complicated by pleural effusion who were admitted to Nanchong Central Hospital from February 2020 to December 2023 were enrolled as the observation group.Additionally,50 children with SMPP without pleural effusion admitted during the same period were selected as the control group.The levels of interleukin-6(IL-6),procalcitonin(PCT),C-reactive protein(CRP),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),and soluble interleukin-2 receptor(sIL-2R)were compared between the two groups.Moreover,the levels of inflammatory factors were analyzed among children in the observation group with different treatment responses and clinical outcomes,and the relationship between inflammatory levels and clinical outcomes was explored.Results The levels of IL-6,IL-8,PCT,CRP,TNF-α,and sIL-2R in the observation group were significantly higher than those in the control group(all P<0.05).Seven days after treatment,the peripheral blood levels of IL-6,PCT,CRP,IL-8,TNF-α,and sIL-2R in the ineffective treatment group were significantly higher than those in the effective treatment group(all P<0.05).At discharge,the peripheral blood levels of IL-6,PCT,CRP,IL-8,TNF-α,and sIL-2R in the non-recovery group were significantly higher than those in the recovery group(all P<0.05).Multivariate binary logistic regression analysis showed that high levels of sIL-2R[(O^R)=7.608(95%CI:1.418,40.820)],IL-6[(O^R)=1.591(95%CI:1.294,1.958)],IL-8[(O^R)=1.240(95%CI:1.072,1.434)],and PCT[(O^R)=3.555(95%CI:1.174,10.763)]were independent risk factors for ineffective treatment response in children(all P<0.05);while high levels of PCT[(O^R)=3.397(95%CI:1.069,10.793)],IL-6[(O^R)=1.601(95%CI:1.279,2.003)],IL-8[(O^R)=1.216(95%CI:1.038,1.424)],and TNF-α[(O^R)=1.236(95%CI:1.060,1.441)]were independent risk factors for non-recovery as the clinical outcome in children(all P<0.05).Conclusion The peripheral blood inflammatory cytokine levels in children with SMPP complicated by pleural effusion are closely related to clinical outcomes.Monitoring the levels of IL-6,IL-8,PCT,and TNF-α can provide important information for assessing treatment effectiveness and short-term clinical outcomes,thereby aiding in the adjustment and optimization of clinical treatment strategies.