血清1,25(OH)<sub>2</sub>D<sub>3</sub>联合4-HNE、YKL-40、sTREM-1诊断儿童难治性肺炎支原体肺炎的临床价值

doi:10.3969/j.issn.1671-7171.2026.01.029

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摘要 【目的】 探讨血清1,25-二羟基维生素D₃[1,25(OH)₂D₃]联合4-羟基壬烯醛(4-HNE)、人软骨糖蛋白-39(YKL-40)、可溶性髓系细胞触发受体-1(sTREM-1)诊断儿童难治性肺炎支原体肺炎(RMPP)的临床价值。【方法】 选取2024年12月至2025年6月本院收治的50例RMPP患儿(RMPP组)和50例普通型肺炎支原体肺炎(GMPP)患儿(GMPP组),另选取同期体检的50例健康儿童作为对照组。比较三组血清1,25(OH)₂D₃、4-HNE、YKL-40、sTREM-1水平,采用Pearson分析血清1,25(OH)₂D₃与4-HNE、YKL-40、sTREM-1的相关性,采用受试者工作特征(ROC)曲线分析血清1,25(OH)₂D₃联合4-HNE、YKL-40、sTREM-1水平对RMPP的诊断价值。【结果】 三组血清1,25(OH)₂D₃、4-HNE、YKL-40、sTREM-1水平比较,差异有统计学意义(P<0.05);RMPP组血清1,25(OH)₂D₃水平低于GMPP组、对照组,血清4-HNE、YKL-40、sTREM-1水平高于GMPP组、对照组,差异有统计学意义(P<0.05);GMPP组的血清1,25(OH)₂D₃水平低于对照组,血清4-HNE、YKL-40、sTREM-1高于对照组,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示,血清1,25(OH)₂D₃与4-HNE、YKL-40、sTREM-1均呈负相关(r=－0.652、－0.713、－0.785,均P<0.05)。ROC曲线分析显示,血清1,25(OH)₂D₃联合4-HNE、YKL-40、sTREM-1诊断RMPP的曲线下面积(AUC)为0.925,优于各指标单独诊断(P<0.05)。【结论】 血清1,25(OH)₂D₃、4-HNE、YKL-40、sTREM-1与儿童RMPP病情及预后存在一定的相关性,可作为此类患儿临床诊断及预后评估的预测指标。

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	王哲
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关键词 ：肺炎,支原体, 支气管炎, 软骨蛋白聚糖类, 髓系细胞触发受体-1

Abstract：【Objective】 To explore the clinical value of serum 1,25-dihydroxyvitamin D₃[1,25(OH)₂D₃] combined with 4-hydroxynonenal(4-HNE), human cartilage glycoprotein-39(YKL-40) and soluble triggering receptor expressed on myeloid cells-1(sTREM-1) in the diagnosis of refractory Mycoplasma pneumoniae pneumonia(RMPP) in children. 【Methods】 A total of 50 children with RMPP(RMPP group) and 50 children with general Mycoplasma pneumoniae pneumonia(GMPP group) admitted to our hospital from December 2024 to June 2025 were selected, and 50 healthy children who underwent physical examination during the same period were selected as the control group. The serum levels of 1,25(OH)₂D₃, 4-HNE, YKL-40 and sTREM-1 were compared among the three groups. Pearson correlation analysis was used to analyze the correlation between serum 1,25(OH)₂D₃ and 4-HNE, YKL-40, sTREM-1. Receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of serum 1,25(OH)₂D₃ combined with 4-HNE, YKL-40 and sTREM-1 levels for RMPP. 【Results】 There were statistically significant differences in serum levels of 1,25(OH)₂D₃, 4-HNE, YKL-40 and sTREM-1 among the three groups(P<0.05). The serum level of 1,25(OH)₂D₃ in the RMPP group was lower than that in the GMPP group and the control group, while the serum levels of 4-HNE, YKL-40 and sTREM-1 were higher than those in the GMPP group and the control group, with statistically significant differences(P<0.05). The serum level of 1,25(OH)₂D₃ in the GMPP group was lower than that in the control group, while the serum levels of 4-HNE, YKL-40 and sTREM-1 were higher than those in the control group, with statistically significant differences(P<0.05). Pearson correlation analysis showed that serum 1,25(OH)₂D₃ was negatively correlated with 4-HNE, YKL-40 and sTREM-1(r=－0.652, －0.713, －0.785, all P<0.05). ROC curve analysis showed that the area under the curve(AUC) of serum 1,25(OH)₂D₃ combined with 4-HNE, YKL-40 and sTREM-1 in the diagnosis of RMPP was 0.925, which was better than that of each index alone(P<0.05). 【Conclusion】 Serum 1,25(OH)₂D₃, 4-HNE, YKL-40 and sTREM-1 are correlated with the condition and prognosis of RMPP in children, and can be used as predictive indicators for clinical diagnosis and prognosis evaluation.

Key words： Pneumonia, Mycoplasma Bronchitis Aggrecans Triggering Receptor Expressed on Myeloid Cells-1

收稿日期: 2025-08-28

中图分类号:

R725.631

引用本文:

王哲, 朱蕴奇, 王偲颖, 朱雅琴, 刘珊, 邹超雄. 血清1,25(OH)₂D₃联合4-HNE、YKL-40、sTREM-1诊断儿童难治性肺炎支原体肺炎的临床价值[J]. 医学临床研究, 2026, 43(1): 102-105.
WANG Zhe, ZHU Yunqi, WANG Siying, ZHU Yaqin, LIU Shan, ZOU Chaoxiong. Clinical Value of Serum 1,25(OH)₂D₃ Combined with 4-HNE, YKL-40 and sTREM-1 in the Diagnosis of Refractory Mycoplasma Pneumoniae Pneumonia in Children. JOURNAL OF CLINICAL RESEARCH, 2026, 43(1): 102-105.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.01.029 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I1/102

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