Study on the value of peripheral blood MxA and YKL-40 levels in evaluating the condition and clinical outcome of children with RSV Pneumonia
Hao Chiqiang
Lei Donghong
Liu Jie
Wu Xufeng
Gao Xingxing
Abstract：Objective To study the value of peripheral blood myxovirus resistance-A(MxA)and chitinase 3-like protein 1(YKL-40)levels in evaluating the condition and clinical outcome of respiratory syncytial virus(RSV)pneumonia in children.Methods From January 2022 to January 2024,120 children with RSV pneumonia[divided into severe pneumonia group(n=40)and non-severe pneumonia group(n=80)]were diagnosed and treated in the Department of Pediatrics of Yulin First Hospital(Second Affiliated Hospital of Yan'an University),and 60 healthy children(healthy control group)were studied.The data of gender,age,course of disease,arterial partial pressure of oxygen(PaO2),arterial partial pressure of car-bon dioxide(PaCO2),heart rate,blood routine indexes and inflammatory factor levels(IL-6,CRP,TNF-α)were collected.The CURB-65 score of the severity of RSV pneumonia in children was evaluated.The levels of MxA and YKL-40 in peripheral blood were detected by enzyme-linked immunosorbent assay.The clinical outcome of children with RSV pneumonia was evaluated.The levels of MxA and YKL-40 in children with RSV pneumonia were compared with those in the control group.Pearson correlation analysis was used to analyze the correlation between MxA and YKL-40 and inflammatory factors and CURB-65 score.Multivariate logistic regression analysis was used to analyze the factors affecting the clinical outcome of children.The receiver operating curve was used to evaluate the predictive efficacy of MxA and YKL-40 on clinical outcome.Results The levels of MxA and YKL-40 in severe pneumonia group were higher than those in non-severe pneumonia group and control group(F=116.970,48.810,P＜0.001).The levels of MxA and YKL-40 in peripheral blood of children with RSV pneumonia were positively correlated with IL-6,CRP,TNF-α and CURB-65 scores(r=0.631,0.564,0.631,0.712,0.675,0.581,0.689,0.741,all P＜0.001).High levels of MxA,YKL-40 and elevated CURB-65 scores were independent risk factors for ad-verse outcomes in children with RSV pneumonia[OR(95％CI)=2.013(1.463-2.979),1.865(1.132-2.358),1.477(1.813-3.005),all P＜0.01].The area under the curve(AUC)of MxA combined with YKL-40 for adverse outcomes in children with RSV pneu-monia(AUC=0.861)was higher than that of MxA and YKL-40 alone(A UC=0.727,0.745)(Z=5.136,4384,all P＜0.001).Con-clusion The levels of MxA and YKL-40 in children with RSV pneumonia are increased,which are related to the inflammato-ry response and the severity of the disease.They are independent indicators for evaluating the clinical outcome of children with RSV pneumonia.The combined detection of MxA and YKL-40 has a high predictive efficiency for the occurrence of adverse outcomes in children with RSV pneumonia.
Keywords：Pneumoniarespiratory syncytial virusMyxovirus resistance protein AChitinase 3-like protein 1Clini-cal outcome
Publication Date：2025-02-17
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)