Study On The Clinical Value Of IL-6 And FeNO In Children With Mycoplasma Pneumoniae Infection Complicated With Bronchial Hyperresponsiveness

ObjectiveTo analyze the diagnosis and prediction value of fractional exhaled nitric oxide(FeNO)and serum IL-6 for hyperresponsiveness(BHR)in children with Mycoplasma pneumoniae(MP)infection.MethodsThree to seven-year-old children with MP infection,children with high airway responsiveness,and healthy children treated at the shangrao pople's hospital were selected as the study subjects,30 children with Mycoplasma pneumoniae infection complicated withBHR(Group A);30 children with MP infection alone(Group B);30BHR children without MP infection(Group C);and 30 healthy controls(Group D).General information survey form was used to collect basic data,Nacoulomb electricity sensor was used to detect exhaled nitric oxide after admission,and impulse oscillometry(IOS)was tested by Master Screen IOS.After admission,fasting venous blood was collected to measure serum IL-6 and IgE antibody levels and the percentage of eosinophilic granulocyte(Eos).Terbutaline was used as reversibility for bronchial dilation test(BDT)using.TAED pulmonary function tester was used for pulmonary function test.Data analysis was performed using SPSS22.0 software.Results(1)One hundred and twenty cases were aged Three to seven years,with an average age of 5.23±1.07 years;56 males and 64 females.Group A13 males and 17 females,with an average age of 5.47±1.18years;Group B16 males and 14 females,with an average age of 4.84±0.99 years;Group C 12 males and 18 females,with an average age of 5.29±0.88 years;Group D 15 males and 15 females,with an average age of 5.29±1.17 years;There were no statistical differences in the age,gender,height,weight,and BMI distribution among different groups(P > 0.05).(2)The mean FeNO values of children in group A,B,C and D were 34.8±11.0?18.5±11.2?35.0±16.5and22.3±9.7 at the time of admission.The average FeNO values of children in group A and C were significantly higher than group B and group D(P<0.05),and there was no statistical difference between Group A and C(P > 0.05).(3)Serological test results showed that the circulating IL-6 levels,IgE levels and Eos levels of children in group A,B,and C increased significantly(P <0.05),and IL-6 Group A>Group B> Group C(P <0.05);The serum IgE and ratios of circulating Eos in group A and group C were significantly higher than those in group B and group D,and group B was significantly higher than group D(P <0.05).(4)The predicated values of FVC,FEV1,FEV1% FVC,PEP,MEF25,MEF50,and MEF25-75 were all significantly lower in children in groups A,B,and C compared to group D(P<0.05).The predicted values of FVC,FEV1% FVC,MEF25,MEF50,and MEF25-75 in group A were significantly lower than those in group B(P<0.05).(5)The FeNO was negatively correlated with PEF25,MEF50 and MEF25-75 predicted value and the correlation coefficient is statistically significant(P<0.05).There was no statistical correlation between the predicted values of FeNO and FVC and FEV1% FVC(P >0.05).Serum IL-6 was negatively correlated with the predicted value of FVC,FMEF25,MEF50 and MEF25-75(P <0.05).(6)FeNO was positively correlated with serum IgE and Eos,serum IL-6 was highly positively correlated with serum IgE and Eos,and the correlation coefficients were statistically significant(P <0.05).(7)ROC curve evaluation results show that AUC for FeNO for airway hyperresponsiveness diagnosiswas 0.787(95% CI: 0.715 ~ 0.859,P<0.001),and AUC for serum IL-6 was 0.677(95% CI: 0.596 ~ 0.758,P<0.001),FeNO was significantly higher than that of serum IL-6(Z = 2.082,P = 0.037).Among them,the best cut-off value of FeNO = 28.5ppb,and the best cut-off value of serum IL-6 =245.0 pg / ml.The AUC of combined index of FeNO and serum IL-6 was 0.808(95%CI: 0.730 ~ 0.866,P<0.05),which is significantly higher than serum IL-6,but with no statistical difference with FeNO(P > 0.05).Conclusions(1)MP infection can cause airway hyperresponsiveness in children,MP infection can cause airway hyperresponsiveness in children,and exhaled nitric oxide and serum IL-6 in children with airway hyperresponsiveness increase significantly(2)Exhaled nitric oxide and serum IL-6 are highly correlated with children's lung function,eosinophils,and IgE levels,which may indicate the possibility of BHR in children;(3)Exhaled nitric oxide and serum IL-6 can be used as predictors of BHR in the respiratory tract of children with MP infection...