A study on clinical value of serum ficolin-3,CD4+/CD8+T lymphocyte ratio combined with NLR in prognosis assessment of pediatric patients with Mycoplasma pneumoniae pneumonia complicated with Epstein-Barr virus infection

SUN Hui; LI Xiu'e; ZHENG Xiaowei; ZHANG Yan; REN Li

doi:10.3969/j.issn.1674-3806.2025.08.06

Abstract：Objective To study the clinical value of serum ficolin-3,CD4+/CD8+T lymphocyte ratio combined with neutrophil-to-lymphocyte ratio(NLR)in prognosis assessment of pediatric patients with Mycoplasma pneumoniae pneumonia(MPP)complicated with Epstein-Barr virus(EBV)infection.Methods The clinical data of 146 pediatric patients with MPP complicated with EBV infection who were admitted to Northwest University First Hospital from January 2021 to May 2023 were retrospectively analyzed.The levels of ficolin-3,CD4+/CD8+T lymphocyte ratio and NLR in the serum of the pediatric patients were detected after admission(before treatment).The pediatric patients were followed up for 12 months after hospital discharge.According to the prognosis,the pediatric patients were divided into good prognosis group(100 cases)and bad prognosis group(46 cases).Multivariate logistic regression was used to analyze the factors affecting the prognosis of the pediatric patients with MPP complicated with EBV infection.The efficacy of ficolin-3,CD4+/CD8+T lymphocyte ratio and NLR in predicting the prognosis of the pediatric patients with MPP complicated with EBV infection by using receiver operating characteristic(ROC)curve.Results Compared with the good prognosis group,the bad prognosis group had long fever duration,high proportion of pulmonary shadows ≥ two-thirds of the lung lobes and high proportion of severe cases,and high C-reactive protein and ficolin-3 levels and NLR,and low CD4+/CD8+T lymphocyte ratio,with statistically significant differences between the two groups(P＜0.05).The results of multivariate logistic regression analysis showed that higher ficolin-3 levels and NLR,lower CD4+/CD8+T lymphocyte ratio,severe MPP and pulmonary shadows≥two-thirds of the lung lobes were independent risk factors for poor prognosis of the pediatric patients with MPP complicated with EBV infection(P＜0.05).The results of ROC curve analysis showed that ficolin-3,CD4+/CD8+T lymphocyte ratio and NLR could predict poor prognosis of the pediatric patients with MPP complicated with EBV infection.The combined prediction efficacy of the three indicators[AUC(95％CI)=0.874(0.837-0.911)]was better than that of the single indicator(P＜0.05).Conclusion The combined detection of serum level of ficolin-3,CD4+/CD8+T lymphocyte ratio and NLR is helpful to predict the prognosis of the pediatric patients with MPP complicated with EBV infection.