Analysis of correlations between serum severe mycoplasma pneumoniae pneumonia level with immunoglobulin E and C-reactive protein in children

doi:10.3969/j.issn.1004-583X.2023.05.008

Abstract

Abstract:

Objective To investigate the correlations between serum severe mycoplasma pneumoniae pneumonia (SMPP)levels with immunoglobulin E (IgE) and C-reactive protein (CRP) in children. Methods A total of 153 children with MPP hospitalized in the Department of Pediatrics of NO.2 Clinical Teaching Hospital, Chengde Medical University from July 2021 to May 2022 were enrolled in this retrospective study, including 84 SMPP and 69 non-SMPP. Clinical characteristics, laboratory examination results and pulmonary imaging features were compared between SMPP children and non-SMPP children. Meanwhile, the correlation between serum levels of IgE and CRP with the severity of SMPP in patients was determined. Results SMPP children had longer duration of fever and hospitalization duration than non-SMPP children, and the differences were statistically significant (P<0.05). The proportion of pulmonary complications in SMPP children was significantly higher than that in non-SMPP children (P<0.05). The percentage of neutrophil, the ratio of neutrophil/lymphocyte, and serum levels of IgE and CRP in SMPP children were significantly higher than those in non-SMPP children (P<0.05). However, the percentage of lymphocytes in SMPP children was remarkably lower (P<0.05). The proportion of SMPP children with large consolidation shadows on pulmonary imaging was obviously higher than that in non-SMPP children (P<0.05). IgE and CRP levels were positively correlated with SMPP, and elevated levels of IgE and CRP were independent risk factors for SMPP occurrence (P<0.05). Conclusion Serum IgE and CRP are independent risk factors for SMPP, which are of great significance for early identification of SMPP.

Key words: severe pneumonia, mycoplasma pneumoniae, immunoglobulin E, C-reactive protein

CLC Number:

R725.6

Cheng Tingting, Qi Caiying, Zhang Xuelian, Xiao Meng, Sui Weihang, Li Xiaoyan, Liu Jianying. Analysis of correlations between serum severe mycoplasma pneumoniae pneumonia level with immunoglobulin E and C-reactive protein in children[J]. Clinical Focus, 2023, 38(5): 433-437.

Add to citation manager EndNote|Ris|BibTeX

URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.05.008

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I5/433

Figures/Tables 7

References 24

[1]	陈志敏, 尚云晓, 赵顺英, 等. 儿童肺炎支原体肺炎诊治专家共识(2015年版)[J]. 中华实用儿科临床杂志, 2015, 30(17):1304-1308.
[2]	刘金荣, 赵成松, 赵顺英. 《儿童社区获得性肺炎诊疗规范(2019年版)》解读[J]. 中国实用儿科杂志, 2020, 35(3):185-187.
[3]	翁翠琦, 陈玉梅, 蒋蕾, 等. 小儿肺炎支原体肺炎血清CRP、PCT、ESR水平与病情严重程度的关系[J]. 中华医院感染学杂志, 2022, 32(8):1220-1223.
[4]	Wang L, Chen Q, Shi C, et al. Changes of serum TNF-alpha, IL-5 and IgE levels in the patients of mycoplasma pneumonia infection with or without bronchial asthma[J]. Int J Clin Exp Med, 2015, 8(3):3901-3906. pmid: 26064291
[5]	胡亚美, 江载芳. 褚福堂实用儿科学[M]. 8版. 北京: 人民卫生出版社, 2016:1280-1282.
[6]	Zheng B, Zhao J, Cao L. The clinical characteristics and risk factors for necrotizing pneumonia caused by Mycoplasma pneumoniae in children[J]. BMC Infect Dis, 2020, 20(1):391. doi: 10.1186/s12879-020-05110-7 pmid: 32487034
[7]	Ye Q, Mao J H, Shu Q, et al. Mycoplasma pneumoniae induces allergy by producing P1-specific immunoglobulin E[J]. Ann Allergy Asthma Immunol, 2018, 121(1):90-97. doi: 10.1016/j.anai.2018.03.014 URL
[8]	Medina JL, Brooks EG, Chaparro A, et al. Mycoplasma pneumoniae CARDS toxin elicits a functional IgE response in Balb/c mice[J]. PLoS One, 2017, 12(2):e172447.
[9]	Ye Q, Xu X J, Shao W X, et al. Mycoplasma pneumoniae infection in children is a risk factor for developing allergic diseases[J]. ScientificWorldJournal, 2014, 2014:986527.
[10]	Shi S, Zhang X, Zhou Y, et al. Immunosuppression Reduces Lung Injury Caused by Mycoplasma pneumoniae Infection[J]. Sci Rep, 2019, 9(1):7147. doi: 10.1038/s41598-019-43451-9 pmid: 31073201
[11]	Yan C, Xue G, Zhao H, et al. Molecular and clinical characteristics of severe Mycoplasma pneumoniae pneumonia in children[J]. Pediatr Pulmonol, 2019, 54(7):1012-1021. doi: 10.1002/ppul.v54.7 URL
[12]	Williams KW, Milner JD, Freeman AF. Eosinophilia Associated with Disorders of Immune Deficiency or Immune Dysregulation[J]. Immunol Allergy Clin North Am, 2015, 35(3):523-544. doi: 10.1016/j.iac.2015.05.004 URL
[13]	Magen E, Schlesinger M, David M, et al. Selective IgE deficiency, immune dysregulation, and autoimmunity[J]. Allergy Asthma Proc, 2014, 35(2):e27-e33.
[14]	Wang Z, Sun J, Liu Y, et al. Impact of atopy on the severity and extrapulmonary manifestations of childhood Mycoplasma pneumoniae pneumonia[J]. J Clin Lab Anal, 2019, 33(5):e22887.
[15]	Zhou L, Li Y, Xu Z, et al. Increased total serum immunoglobulin E is likely to cause complications of mycoplasma pneumoniae pneumonia in children[J]. Front Cell Infect Microbiol, 2021, 11:783635.
[16]	Poddighe D, Comi EV, Brambilla I, et al. Increased total serum immunoglobulin e in children developing mycoplasma pneumoniae-related extra-pulmonary diseases[J]. Iran J Allergy Asthma Immunol, 2018, 17(5):490-496.
[17]	Bao YX, Li J, Tian Y, et al. Atopy: A risk factor of refractory mycoplasma pneumoniae pneumonia?[J]. Clin Respir J, 2017, 11(6):931-934. doi: 10.1111/crj.2017.11.issue-6 URL
[18]	李冰, 张广超, 李夏. 小儿支原体肺炎的肺外并发症临床特征和预后影响因素[J]. 临床荟萃, 2020, 35(9):801-804..
[19]	Li F, Kong S, Xie K, et al. High ratio of C-reactive protein/procalcitonin predicts mycoplasma pneumoniae infection among adults hospitalized with community acquired pneumonia[J]. Scand J Clin Lab Invest, 2021, 81(1):65-71. doi: 10.1080/00365513.2020.1858491 URL
[20]	Wang J, Mao J, Chen G, et al. Evaluation on blood coagulation and C-reactive protein level among children with mycoplasma pneumoniae pneumonia by different chest imaging findings[J]. Medicine (Baltimore), 2021, 100(3):e23926.
[21]	Han C, Zhang T, Zheng J, et al. Analysis of the risk factors and clinical features of Mycoplasma pneumoniae pneumonia with embolism in children: A retrospective study[J]. Ital J Pediatr, 2022, 48(1):153. doi: 10.1186/s13052-022-01344-0 pmid: 35987653
[22]	邹映雪. 肺炎支原体肺炎炎症指标异常的临床意义[J]. 中华实用儿科临床杂志, 2021, 36(16):1209-1214.
[23]	Fang C, Mao Y, Jiang M, et al. Pediatric critical illness score, clinical characteristics and comprehensive treatment of children with severe mycoplasma pneumoniae pneumonia[J]. Front Surg, 2022, 9:897550.
[24]	Zhang C, Zhang Q, Du JL, et al. Correlation between the clinical severity, bacterial load, and inflammatory reaction in children with mycoplasma pneumoniae pneumonia[J]. Curr Med Sci, 2020, 40(5):822-828. doi: 10.1007/s11596-020-2261-6 pmid: 33123897

项目	SMPP组 (n=84)	非SMPP组 (n=69)	Z/χ²值	P值
年龄[岁,M(P25,P75)]	6.0(3,8)	2.0(1,4)	5.250	<0.01
发热[例(%)]	76(90)	57(83)	1.557	0.115
咳嗽[例(%)]	83(99)	68(99)	0.140	0.889
喘息[例(%)]	8(10)	8(12)	0.173	0.677
肺部并发症[例(%)]	16(19)	0	5.145	0.023
热程[d,M(P25,P75)]	7(5,10)	5(3,7)	3.381	<0.01
住院天数[d,M(P25,P75)]	9(7,12)	6(5,7)	6.642	<0.01

项目	SMPP组 (n=84)	非SMPP组 (n=69)	Z/χ²值	P值
年龄[岁,M(P25,P75)]	6.0(3,8)	2.0(1,4)	5.250	<0.01
发热[例(%)]	76(90)	57(83)	1.557	0.115
咳嗽[例(%)]	83(99)	68(99)	0.140	0.889
喘息[例(%)]	8(10)	8(12)	0.173	0.677
肺部并发症[例(%)]	16(19)	0	5.145	0.023
热程[d,M(P25,P75)]	7(5,10)	5(3,7)	3.381	<0.01
住院天数[d,M(P25,P75)]	9(7,12)	6(5,7)	6.642	<0.01

项目	SMPP组 (n=84)	非SMPP组 (n=69)	Z值	P值
白细胞计数(×10⁹/L)	7.1(5.8,9.2)	7.6(5.9,9.9)	0.981	0.327
中性粒细胞(%)	59.6(53.1,64.8)	49.6(34.2,64.1)	3.079	0.002
淋巴细胞(%)	29.9(26.1,36.5)	40.2(27.5,52.4)	3.078	0.002
中性粒细胞/淋巴细胞(%)	2.0(1.5,2.5)	1.3(0.6,2.3)	3.018	0.003
血红蛋白 (g/L)	128(120.0,135.0)	126(115.0,133. 0)	1.495	0.135
血小板(×10⁹/L)	242(191.0,283.0)	264(206.0,343.0)	1.701	0.089
乳酸脱氢酶(U/L)	267(225.0,323.0)	260(231.0,299.0)	0.945	0.345
IgE(IU/ml)	91.5(50.2,168.5)	40.15(13.2,141.3)	3.254	<0.01
CRP (mg/L)	16.5(8.0,49.8)	10(1.0,24.0)	3.693	<0.01

项目	SMPP组 (n=84)	非SMPP组 (n=69)	Z值	P值
白细胞计数(×10⁹/L)	7.1(5.8,9.2)	7.6(5.9,9.9)	0.981	0.327
中性粒细胞(%)	59.6(53.1,64.8)	49.6(34.2,64.1)	3.079	0.002
淋巴细胞(%)	29.9(26.1,36.5)	40.2(27.5,52.4)	3.078	0.002
中性粒细胞/淋巴细胞(%)	2.0(1.5,2.5)	1.3(0.6,2.3)	3.018	0.003
血红蛋白 (g/L)	128(120.0,135.0)	126(115.0,133. 0)	1.495	0.135
血小板(×10⁹/L)	242(191.0,283.0)	264(206.0,343.0)	1.701	0.089
乳酸脱氢酶(U/L)	267(225.0,323.0)	260(231.0,299.0)	0.945	0.345
IgE(IU/ml)	91.5(50.2,168.5)	40.15(13.2,141.3)	3.254	<0.01
CRP (mg/L)	16.5(8.0,49.8)	10(1.0,24.0)	3.693	<0.01

组别	例数	点片状阴影、斑片状阴影	大片实变影
SMPP组	84	25(30)	59(70)
非SMPP组	69	69(100)	0
χ²值		78.883
P值		<0.01