| 摘要: |
| 目的:探讨血清高迁移率族蛋白B1(HMGB1)、诱骗受体3(DcR3)、心型脂肪酸结合蛋白3(FABP3) 对肺炎支原体肺炎
患儿心肌损伤的诊断价值。方法:选取2022 年3 月至2024 年2 月我院收治的93 例肺炎支原体肺炎合并心肌损伤患儿为试验
组,另选取同期我院就诊的93 例肺炎支原体肺炎无心肌损害患儿为对照组。利用酶联免疫吸附试验( ELISA) 法检测血清中
HMGB1、DcR3、FABP3 水平。绘制受试者工作特征(ROC)曲线分析血清HMGB1、DcR3、FABP3 对肺炎支原体肺炎患儿心肌损
伤的诊断价值。Pearson 相关分析血清HMGB1、DcR3、FABP3 水平与心肌损伤相关指标[乳酸脱氢酶(LDH)、天冬氨酸氨基转
移酶(AST)、α-羟丁酸脱氢酶(α-HBDH)、血清磷酸肌酸激酶同工酶(CK-MB)、CK、超敏肌钙蛋白I(hs-cTnI)] 的相关性。多元
logistic 回归分析影响肺炎支原体肺炎患儿心肌损伤的因素。结果:试验组患儿LDH、AST、α-HBDH、CK、CK-MB、hs-cTnI、HMGB1、
DcR3、FABP3 水平均高于对照组(P<0. 05)。血清HMGB1、DcR3、FABP3 联合诊断肺炎支原体肺炎患儿心肌损伤的曲线下面积
(AUC)为0. 933(95%CI 0. 897~0. 968),三者联合诊断肺炎支原体肺炎患儿心肌损伤的价值较HMGB1(Z =3. 097,P =0. 002)、DcR3 (Z =3. 512,P<0. 001)、FABP3(Z =2. 402,P =0. 016)单独诊断的价值高。血清HMGB1、DcR3、FABP3 水平与LDH、AST、α-HBDH、
CK、CK-MB、hs-cTnI 分别呈正相关(P<0. 05)。HMGB1、DcR3、FABP3 是影响肺炎支原体肺炎患儿心肌损伤的危险因素(P<0. 05)。
结论:肺炎支原体肺炎心肌损伤患儿血清HMGB1、DcR3、FABP3 水平异常升高,且与心肌损伤相关指标呈正相关,三者联合诊断肺
炎支原体肺炎患儿心肌损伤的价值较高。 |
| 关键词: 肺炎支原体肺炎 心肌损伤 高迁移率族蛋白B1 诱骗受体3 心型脂肪酸结合蛋白3 诊断 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2026.08.005 |
|
| 基金项目:基金项目:邯郸市科技专项计划项目,编号22422083089ZC。 |
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| Construction of Predictive Myocardial Injury Model and Early Intervention and Prevention StrategiesBased on Serum High Mobility Group Protein B1, Decoy Receptor 3, Heart-Fatty Acid Binding Protein 3in Children with Mycoplasma Pneumoniae Pneumonia |
| Zhang Junguang, Ma Xingming, Zhang Shuli, Zhang Huiying |
| (Fengfeng General Hospital, North China Medical and Health
Group, Hebei Handan 056200, China) |
| Abstract: |
| Objective: To explore the diagnostic value of serum high mobility group protein B1 (HMGB1), decoy receptor 3 (DcR3),
and heart-fatty acid binding protein 3 (FABP3) in myocardial injury of children with Mycoplasma pneumoniae pneumonia. Methods:
From Mar. 2022 to Feb. 2024, totally 93 children with M. pneumoniae pneumonia complicated with myocardial injury admitted into our
hospital were extracted as the experimental group, and another 93 children with M. pneumoniae pneumonia without myocardial injury
were extracted as the control group. Enzyme linked immunosorbent assay (ELISA) was applied to detect the serum HMGB1, DcR3, and
FABP3 levels. Receiver operating characteristic (ROC) curve was plotted to analyze the diagnostic value of serum HMGB1, DcR3, and
FABP3 to myocardial injury in children with M. pneumoniae pneumonia. Pearson correlation was used to analyze the correlation between
serum HMGB1, DcR3, FABP3 levels and myocardial injury related indicators such as lactate dehydrogenase ( LDH), aspartate
aminotransferase (AST), α-hydroxybutyrate dehydrogenase (α-HBDH), serum creatine kinase isoenzyme (CK-MB), CK, and highsensitivity
cardiac troponin I(hs-cTnI). Multiple logistic regression was applied to analyze the factors affecting myocardial injury in
children with M. pneumoniae pneumonia. Results The LDH, AST, α-HBDH, CK, CK-MB, hs-cTnI, HMGB1, DcR3, and FABP3
levels in experimental group were higher than those in control group (P < 0. 05). The area under the curve (AUC) for combined
diagnosis of HMGB1, DcR3, and FABP3 for myocardial injury in children with M. pneumoniae pneumonia was 0. 933 (95% CI 0. 897
to 0. 968). The combined diagnosis of the three markers for myocardial injury in children with M. pneumoniae pneumonia had higher
value than that of the individual diagnosis of HMGB1 (Z = 3. 097, P = 0. 002), DcR3 (Z = 3. 512, P <0. 001), and FABP3 (Z =
2. 402, P =0. 016). The HMGB1, DcR3, and FABP3 levels were positively correlated with LDH, AST, α-HBDH, CK, CK-MB, and
hs-cTnI, respectively (P<0. 05). HMGB1, DcR3, and FABP3 were risk factors for myocardial injury in children with M. pneumoniae
pneumonia (P<0. 05). Conclusion: The HMGB1, DcR3, and FABP3 levels are abnormally elevated in children with myocardial injury
induced by M. pneumoniae pneumonia, which are positively correlated with myocardial injury indicators. The combined diagnosis of the
three indicators has high value in diagnosing myocardial injury in children with M. pneumoniae pneumonia. |
| Key words: Mycoplasma pneumoniae pneumonia myocardial injury high mobility group protein B1 decoy receptor 3 heart-fatty acid
binding protein 3 diagnosis |
