Monitoring of serum amyloid A and human cartilage glycoprotein-39 levels of children with mycoplasma pneumoniae pneumonia and the prognostic value

doi:10.3877/cma.j.issn.1674-1358.2021.05.006

Abstract

Abstract:

Objective

To investigate the levels of serum amyloid A (SAA) and human cartilage glycoprotein-39 (HC-gp39) of children with mycoplasma pneumoniae pneumonia (MPP), and to explore their prognostic value.

Methods

The clinical data of 86 children with MPP admitted to Xuzhou Central Hospital from October 2018 to December 2019 (study group) and 79 healthy children who underwent physical examination during the same period (control group) were reviewed, retrospectively. The levels of SAA and HC-gp39 between cases in study group and control group, severe cases and mild cases in study group were compared, respectively. The incidence of poor prognosis of cases in study group was analyzed, serum SAA, HC-gp39 levels and change rates of poor prognosis cases and good prognosis cases were compared at admission, 3 days after treatment and 1 week after treatment, respectively. The influencing factors of poor prognosis of children with MPP were analyzed by Logistic regression analysis. The predictive value of serum SAA and HC-gp39 on the prognosis of MPP were evalued by area under curve (AUC) of receiver operating characteristic (ROC).

Results

The levels of serum SAA and HC-gp39 of cases in study group were higher than those of control group (t = 49.374, P < 0.001; t = 49.374, P < 0.001). Among study group, 45.35% (39/86) children were severe cases. The levels of serum SAA and HC-gp39 of severe cases were higher than those of mild cases, with significant differences (t =13.411, P < 0.001; t = 10.426, P < 0.001). The incidence of poor prognosis in study group was 6.98% (6/86). The levels of serum SAA and HC-gp39 of poor prognosis cases increased gradually, which decreased gradually in cases with good prognosis. Compared with the indexes at admission, the change rates of serum SAA and HC-gp39 of poor prognosis cases and good prognosis cases 1 week after treatment were [(57.10 ± 6.59)% vs. (-77.12 ± 9.87)%] and [(58.63 ± 7.79)% vs. (-29.09 ± 4.18)%], with significant differences (SAA: t = 4.873, P < 0.001, HC-gp39: t = 15.588, P < 0.001). Severity rate, SAA and HC-gp39 change rates of cases with poor prognosis were significantly higher than those with good prognosis [100.00% vs. 41.25%: χ² = 7.773, P = 0.005; (52.49 ± 6.59)% vs. (-77.12 ± 9.87)%: t = 4.873, P < 0.001; (58.63 ± 7.79) vs. (-29.09 ± 4.18): t = 15.588, P < 0.001], and severity (OR = 6.386, P = 0.003), SAA change rate (OR = 7.892, P < 0.001) and HC-gp39 change rate (OR = 8.654, P = 0.001) were all risk factors for poor prognosis. The best cut-off points of SAA and HC-gp39 change rates in predicting poor prognosis alone were 45.07% and 41.19%, the sensitivity were 83.33% and 66.67%, and the specificity were 82.15% and 87.65%, and the AUC were 0.817 and 0.765, respectively. The sensitivity, specificity and AUC of SAA combined with HC-gp39 change rates in predicting poor prognosis were 66.67%, 97.50% and 0.906, respectively, the specificity and AUC of SAA combined with HC-gp39 change rates for prediction were higher than individual index (specificity: χ² = 11.123, P = 0.001; χ² = 4.783, P = 0.029; AUC: Z = 3.012, P = 0.031; Z = 4.258, P = 0.014).

Conclusions

The serum levels of SAA and HC-gp39 of MPP children were higher than those of healthy children. The SAA change rate and HC-gp39 change rate were higher in children with severe MPP and poor prognosis, which were both risk factors for poor prognosis, and the combination of SAA and HC-gp39 change rates could predict the prognosis of MPP.

Key words: Mycoplasma pneumoniae pneumonia, Serum amyloid A, Human cartilage glycoprotein-39, Prognosis

Yang Chen, Xiangjun Cui, Min Li, Yingjun Sun. Monitoring of serum amyloid A and human cartilage glycoprotein-39 levels of children with mycoplasma pneumoniae pneumonia and the prognostic value[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2021, 15(05): 323-329.

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References 26

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组别	例数	性别[例（%）]		年龄（±s，岁）	病程（±s，d）
组别	例数	男性	女性	年龄（±s，岁）	病程（±s，d）
研究组	86	39（45.35）	47（54.65）	8.01 ± 1.23	2.34 ± 0.34
对照组	79	35（44.30）	44（55.70）	7.85 ± 1.27	—
统计量		χ² = 0.018^a		t = 0.822	—
P值		0.893		0.412	—

组别	例数	性别[例（%）]		年龄（±s，岁）	病程（±s，d）
组别	例数	男性	女性	年龄（±s，岁）	病程（±s，d）
研究组	86	39（45.35）	47（54.65）	8.01 ± 1.23	2.34 ± 0.34
对照组	79	35（44.30）	44（55.70）	7.85 ± 1.27	—
统计量		χ² = 0.018^a		t = 0.822	—
P值		0.893		0.412	—

组别	例数	SAA（mg/L）	HC-gp39（ng/ml）
研究组	86	109.24 ± 18.75	40.91 ± 7.12
对照组	79	4.95 ± 0.89	24.84 ± 4.37
t值		49.374	17.289
P值		< 0.001	< 0.001

组别	例数	SAA（mg/L）	HC-gp39（ng/ml）
研究组	86	109.24 ± 18.75	40.91 ± 7.12
对照组	79	4.95 ± 0.89	24.84 ± 4.37
t值		49.374	17.289
P值		< 0.001	< 0.001

组别	例数	SAA（mg/L）	HC-gp39（ng/ml）
重症患儿	39	139.41 ± 23.88	48.74 ± 7.75
轻症患儿	47	84.19 ± 13.74	34.41 ± 4.89
t值		13.411	10.426
P值		< 0.001	< 0.001

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