Clinical Research Of Serum Cytokine Profiles?C-Reactive Protein?Procalcitonin And Erythrocyte Sedimentation Rate In Diagnosis Of Severe Children Mycoplasma Pneumoniae Pneumonia

Objective: To early identify the mycoplasma infection and assess the severity of mycoplasma pneumonia,detecting the serum changing levels of interleukin-1?,interleukin-6,interleukin-8,interleukin-10,tumor necrosis factor-? ? c-reactive protein(CRP)?procalcitonin(PCT)and erythrocyte sedimentation rate(ESR)in the acute phase of pediatric pneumonia and performing ROC curve analysis.Methods: A total of 157 children with pneumonia were randomly selected from July 2015 to June 2016 in our hospital.The selected cases were in accordance with the standard of pneumonia developed by the Chinese Medical Association Pediatrics Respiratory Group.84 cases were served as the studyed group(MPP)and divided the severe and mild group,73 cases were served as the control group(NMPP);The severe group was also divided into the acute and recovery phase.ELISA,Immune turbidimetric method,Chemiluminescence immunoassay and Wei Shi law were used to observe the levels of serum interleukin-1?,interleukin-6,interleukin-8,interleukin-10,tumor necrosis factor-?,c-reactive protein,procalcitonin and erythrocyte sedimentation rate in the acute phase of the studied group and control group,also in the recovery phase of the severe group.Carrying out the statistical analysis of the samples,The skewness date was expressed as the median P50(P25,P75)and being analyzed by using nonparametric rank sum test,normally distributed data X—— ± s said,using t-test to means comparison for significance test.All data were recorded and analyzed by SPSS16.0 software,the result of P <0.05 for the difference was statistically significant.Results: 1.Sexuality was measured by chi-square test,Age distribution was performed by nonparametric test.The results were described as median P50(P25,P75).The three groups of children in the gender,age were comparable,Because they were not statistically significant(P> 0.05);2.The levels of Interleukin-1? in the study group(severe MPP group and mild MPP group)and the control group were less than 5 pg/ml,The differences were not statistically significant(P>0.05);The levels of interleukin-6,interleukin-8,interleukin-10,tumor necrosis factor-?,c-reactive protein,procalcitonin and erythrocyte sedimentation rate in the serum were the skewering data,they were analyzed by using nonparametric rank sum test,The levels of serum interleukin-6,interleukin-8,tumor necrosis factor-?,c-reactive protein,procalcitonin and erythrocyte sedimentation rate were significantly different between the three groups in the severe group,the mild group and the control group(P<0.05),there was no significant difference between the mild group and the control group(P> 0.0167).The levels of serum interleukin-10 had not differences in the three groups,There was no statistically significant difference comparison(P>0.05).The levels of interleukin-6,interleukin-8,interleukin-10,tumor necrosis factor-?,c-reactive protein,procalcitonin and erythrocyte sedimentation rate in the acute phase were significantly higher than those in the recovery phase(P <0.05).3.The levels of serum interleukin-6,interleukin-8,tumor necrosis factor-?,c-reactive protein,procalcitonin and erythrocyte sedimentation rate were used as test variables,and severe MPP group(1=the severe group,0=the control group)was the effect variable.ROC curve showed that the sensitivity was 89.2% and the specificity was 72.6%(AUC=0.853,P<0.000)when the cut-off value of serum interleukin-6 was 7.65 pg/ml;The sensitivity was 59.5% and the specificity was 93.2%(AUC=0.0.769,P<0.000)when the cut-off value of serum interleukin-8 was 63.6 pg/ml;The sensitivity was 78.4% and the specificity was 64.4%(AUC = 0.768,P<0.000),when the cut-off value of serum tumor necrosis factor-? was 13.45 pg/ml;When the cut-off value of serum c-reactive protein was 13.36 mg/L,the sensitivity was 91.9% and the specificity was 72.6%(AUC=0.903,P<0.000);When the cut-off value of serum procalcitonin was 0.1695 ng/ml,the sensitivity was 83.8% and the specificity was 57.5%(AUC=0.754,P<0.000);When the cut-off value of serum erythrocyte sedimentation rate was 23 mm /h,the sensitivity was 81.1% and the specificity was 65.8%(AUC= 0.75,P<0.000).Conclusion: The results of this study showed that: 1.There was no significant difference in interleukin-1? between the study group and the control group,suggesting that interleukin-1? did not play a significant role in the pathogenesis of mycoplasma pneumonia.2.Serum concentrations of interleukin-6,interleukin-8,tumor necrosis factor-? of the severe group in acute phase were higher than the mild group,control group and the recovery phase of its,Indicating that they played a positive phase regulation during the onset of severe mycoplasma pneumonia pneumonia.And by ROC curve analysis,IL-6 in the diagnosis of severe mycoplasma pneumonia pneumonia is higher.Clinically,serum interleukin-6,interleukin-8,tumor necrosis factor-? can be used as an important basis for early diagnosis of mycoplasma pneumonia pneumonia.3.The level of serum interleukin-10 had not differences in the severe group,the mild group and the control group,But the level of serum interleukin-10 in the acute phase of severe group was higher than the recovery phase.Indicating that IL-10 as an inhibitory factor to inhibit the inflammatory response in the early stages of inflammatory response.4.Serum concentrations of c-reactive protein,procalcitonin and erythrocyte sedimentation rate of the severe group in acute phase were higher than the mild group,control group and the recovery phase of its,We can confirm that there is also a mixed infection in the severe mycoplasma pneumonia pneumonia.And by ROC curve analysis,c-reactive protein in the diagnosis of severe mycoplasma pneumonia pneumonia is higher.