Expression and clinical significance of AOPP and AXT in bronchoalveolar lavage fluid of children with refractory mycoplasma pneumoniae pneumonia

WANG Li-li; FAN Xiao-kang; YAN Xing-zi

doi:10.13820/j.cnki.gdyx.20252156

Abstract：Objective To investigate the expression levels of advanced oxidation protein products(AOPP)and autocrine motility factor(AXT)in bronchoalveolar lavage fluid(BALF)of children with refractory Mycoplasma pneumoni-ae pneumonia(RMPP)and to evaluate their clinical significance.Methods A total of 118 children diagnosed with My-coplasma pneumoniae pneumonia(MPP)and admitted to Xianyang Central Hospital between January 2022 and February 2025 were prospectively enrolled.According to disease progression,patients were divided into a refractory MPP group(RMPP,n=42)and a non-refractory MPP group(n=76).Levels of inflammatory markers,including C-reactive protein(CRP),interleukin-6(IL-6),and procalcitonin(PCT),as well as AOPP and AXT in BALF were measured.Differences between groups were compared.Spearman correlation analysis was performed to assess the relationships be-tween BALF AOPP and AXT levels and inflammatory markers in children with RMPP.Multivariate logistic regression anal-ysis was used to identify independent risk factors for RMPP.Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the predictive value of BALF AOPP,AXT,and inflammatory markers for RMPP.Results BALF levels of CRP,IL-6,PCT,AOPP,and AXT were significantly higher in the RMPP group than in the non-refractory MPP group(all P＜0.05).Spearman correlation analysis showed that BALF AOPP and AXT levels were positively corre-lated with inflammatory markers.Multivariate logistic regression analysis identified high fever(OR=3.314,95％CI:1.056-10.398),pleural effusion(OR=3.262,95％CI:1.334-7.973),elevated AOPP(OR=1.020,95％CI:1.010-1.030),and elevated AXT(OR=1.348,95％CI:1.182-1.537)as independent risk factors for RMPP.ROC curve analysis demonstrated that the areas under the curve(AUCs)for BALF CRP,IL-6,PCT,AOPP,and AXT in predicting RMPP were 0.730,0.749,0.695,0.835,and 0.863,respectively.The predictive performance of AOPP and AXT was superior to that of CRP,IL-6,and PCT(P＜0.05).Furthermore,the combination of AOPP and AXT yielded a significantly higher AUC than either marker alone(P＜0.05).Conclusion BALF AOPP and AXT levels are markedly elevated in children with RMPP and are closely associated with enhanced inflammatory responses and disease progression.Combined assessment of BALF AOPP and AXT shows good predictive value for RMPP and may be useful for early identifi-cation and risk stratification in pediatric patients.