Changes and clinical significance of serum related factors in children with severe Mycoplasma pneumoniae pneumonia

Liu Kemei; Li Chan; Liu Jie; Huo Jingyu; Ma Maomao

doi:10.3760/j.issn.1673-4777.2025.03.007

Abstract：Objective To investigate the changes and clinical significance of serum lymphotoxin-like,exhibits inducible expression,competes with herpes simplex virus glycoprotein D for herpesvirus-entry mediator,a receptor expressed by T lymphocytes(LIGHT)and chitinase 3-like protein 1(CHI3L1)levels in children with severe Mycoplasma pneumoniae pneumonia(MPP).Methods A total of 110 children with severe MPP(SMPP group)and 55 children with general MPP(GMPP group)admitted to the Department of Pediatrics,the First Hospital of Yulin,Shaanxi Province from January 2021 to February 2024 were selected.The children with SMPP were divided into non-critical group(41 cases),critical group(38 cases)and extremely critical group(31 cases)according to pediatric critical illness score.According to the outcome 28 days after admission,the children were further divided into poor prognosis group(40 cases)and good prognosis group(70 cases).The serum levels of LIGHT and CHI3L1 at admission were detected by enzyme-linked immunosorbent assay.With the poor prognosis of children with SMPP as the dependent variable,multivariate unconditional Logistic regression analysis was used to determine its influencing factors.The receiver operating characteristic curve was drawn to evaluate the efficacy of serum LIGHT and CHI3L1 levels in predicting the poor prognosis of children with SMPP.Results The serum levels of LIGHT and CHI3L1 in the SMPP group were higher than those in the GMPP group[(8.2±1.8)ng/L vs(4.3±0.8)ng/L,(2 917±732)ng/L vs(1 825±388)ng/L](both P＜0.001).The serum levels of LIGHT and CHI3L1 in extremely critical group were higher than those in critical group and non-critical group,and those in critical group were higher than those in non-critical group(all P＜0.05).High pediatric critical illness score was an independent protective factor for poor prognosis in children with SMPP,and high procalcitonin,LIGHT,and CHI3L1 were independent risk factors for poor prognosis(all P＜0.05).The area under the curve of the combination of serum LIGHT and CHI3L1 levels for predicting the poor prognosis of children with SMPP was 0.868,which was larger than 0.781 and 0.784 of serum LIGHT and CHI3L1 levels alone(both P＜0.05).Conclusions Children with SMPP have elevated serum levels of LIGHT and CHI3L1,which are closely related to disease severity and poor prognosis.The combination of serum levels of LIGHT and CHI3L1 has a high predictive value for poor prognosis in children with SMPP.