不同严重程度肺炎支原体肺炎患儿肺部NLRP3信号通路的变化及其临床价值

Changes and clinical significance of NLRP3 signaling pathway in children with mycoplasma pneumoniae pneumonia of different severity

摘要:

目的 探讨不同严重程度肺炎支原体肺炎（MPP）患儿肺部NLRP3信号通路的变化及临床价值。方法 选取2022年4月—2022年10月在湖南省人民医院进行肺泡灌洗的90例MPP患儿，并分为轻度组和重度组，分别有26和64例。选取同期该院行异物取出术后复查的10例儿童作为对照组。比较各组的临床资料，Spearman相关性分析MAP1LC3B水平与NF-KB、NLRP3水平的相关性。结果 对照组MAP1LC3B、NF-κB和NLRP表达量低于MPP组（P <0.05）。轻度组与重度组性别构成、发病年龄、WBC、PLT、PCT、ALT、MP拷贝数、IgG、IgM比较，差异均无统计学意义（P >0.05）。重度组的发热时间和住院时间较轻度组长（P <0.05），CRP、LDH、D二聚体、IgA、MAP1LC3B、NF-κB和NLRP3表达量较轻度组高（P <0.05）。Spearman相关性分析显示，MAP1LC3B表达与NF-KB水平（r_s =0.510，P <0.05）、NLRP3 水平（r_s =0.610，P <0.05）均呈正相关。结论 自噬-NLRP3信号通路参与了MPP的发病，且与病情严重程度有关。

关键词:肺炎支原体肺炎;儿童;自噬

Abstract:

Objective To investigate the changes and clinical significance of NLRP3 signaling pathway in children with mycoplasma pneumoniae pneumonia (MPP) of different severity.Methods A total of 90 children with MPP who were hospitalized for alveolar lavage in our hospital from April 2022 to October 2022 were divided into mild group (26 cases) and severe group (64 cases). Meanwhile, 10 children undergoing recheck after removal of foreign bodies in our hospital during the same period were set as the control group. Clinical data of the groups were compared, and the correlation of the level of MAP1LC3B with the levels of NF-KB and NLRP3 was analyzed via the Spearman method.Results Compared with the control group, the level of MAP1LC3B in the MPP group was significantly higher (P < 0.05). There was no difference in the sex composition, age, WBC, PLT, PCT, ALT, and the copy number, IgM and IgG of MP between the mild group and the severe group (P > 0.05), Compared with the mild group, the severe group had a longer duration of fever and length of hospital stay, and higher levels of CRP, LDH, D-dimer, IgA, MAP1LC3B, NF-KB and NLRP3 (P < 0.05). Spearman correlation analysis revealed that the expression of MAP1LC3B was positively correlated with the levels of NF-KB (r_s =0.510, P <0.05) and NLRP3 (r_s =0.610, P <0.05).Conclusions Autophagy-NLRP3 signaling pathway is involved in the pathogenesis of MPP, and is related to the severity of the disease.

Key words:mycoplasma pneumoniae pneumonia;child;autophagy