Exploring of the Role of IL-17A in the Predictive Diagnosis and Treatment of Refractory Mycoplasma Pneumoniae Pneumonia in Children

Liu Siyuan; Zhang Li; Yuan Bo

doi:10.3969/j.issn.1004-5775.2025.12.001

Abstract：Objective:To explore the predictive value of blood interleukin(IL)-17A for the diagnosis of refractory mycoplasma pneumonia and guide the meaning of treatment.Methods:40 children with Mycoplasma pneumoniae pneumonia(MPP)and 40 children with refractory mycoplasma pneumoniae children(RMPP)admitted to the hospital in Department of Pediatrics from February 2023 to February 2024 were selected.Fasting peripheral venous blood was drawn,IL-17A by ELISA,and relevant clinical data were also collected.Results:The proportions of lung consolidation,pleural effusion and lobar changes in children of the RMPP group were significantly higher than those in the MPP group,and the differences were statistically significant(χ2=14.066,16.970,16.200;P＜0.05).The proportion of children in the RMPP group who chose non-macrolide drugs for anti-Mycoplasma pneumoniae and glucocorticoids was significantly higher than that in the MPP group,and the differences were statistically significant(χ2=19.948,24.2321;P＜0.05).The levels of IL-6,IL-17A,PCT and LDH in children of the RMPP group were all higher than those in the MPP group,and the differences were statistically significant(Z=3.305,4.754,2.308,3.975;P＜0.05).Spearman correlation analysis revealed that IL-17A was significantly positively correlated with PCT and IL-6(r=0.777,0.598;P＜0.001).The areas under the ROC curves(AUC)of LDH,IL-6 and IL-17A were 0.74,0.71 and 0.81,respectively.The levels of IL-6,IL-17A,CRP and LDH in children of the non-macrolide substance treatment group were all higher than those in the macrolide drug treatment group,and the differences were statistically significant(Z=2.541,2.973,2.148,2.127;P＜0.05).The area under the ROC curve(AUC)of IL-17A as an independent predictor in guiding the medication of RMPP was 0.73.Conclusion:The IL-17A＞54.60 pg·mL-1 can relatively accurately predict the RMPP in children.The area under the ROC curve(AUC)of the IL-17A-guided RMPP medication was 0.73,with corresponding cutoff value was 115.0 pg/mL.