Relationship between Serum GM-CSF and sCD163 Levels and the Condition and Prognosis of Children with Refractory Mycoplasma Pneumoniae Pneumonia
CHEN Lei
GONG Qian
CHENG Haiyan
SHEN Huaiyun
Abstract：Objective To investigate the relationship between the levels of serum granulocyte-macrophage colo-ny-stimulating factor(GM-CSF)and soluble cluster of differentiation 163(sCD163)and the disease severity and prognosis in children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods A total of 152 children with RMPP(RMPP group),60 children with general Mycoplasma pneumoniae pneumonia(GMPP group),and 60 healthy children who under-went physical examination during the same period(control group)were enrolled from January 2021 to April 2024 at The First People's Hospital of Mengcheng County.The RMPP patients were further classified into severe RMPP group(n=81)and mild RMPP group(n=71)based on disease severity,and into poor prognosis group(n=55)and good prognosis group(n=97)based on 28-day prognosis.Enzyme-linked immunosorbent assay was used to measure the serum levels of GM-CSF and sCD163.The prognosis of RMPP children was taken as the dependent variable,and multivariate unconditional Logistic regression anal-ysis was conducted to determine its influencing factors.Receiver operating characteristic(ROC)curves were plotted to ana-lyze the predictive efficacy of serum GM-CSF and sCD163 levels.Results The serum levels of GM-CSF and sCD163 in the RMPP group[(12.96±4.17)ng/mL,(188.88±28.23)pg/mL]were significantly higher than those in the GMPP group[(9.40±2.29)ng/mL,(148.49±24.00)pg/mL]and the control group[(4.58±1.17)ng/mL,(99.18±20.30)pg/mL](both P<0.01).The serum levels of GM-CSF and sCD163 in the severe RMPP group[(11.37±3.97)ng/mL,(178.19±25.88)pg/mL)]were signifi-cantly below those in the mild RMPP group[(14.77±3.64)ng/mL,(201.07±25.91)pg/mL](both P<0.01).The serum levels of GM-CSF and sCD163 in the poor prognosis group[(15.55±3.61)ng/mL,(207.13±23.66)pg/mL]were significantly higher than those in the good prognosis group[(11.49±3.74)ng/mL,(178.53±25.29)pg/mL](both P<0.01).Independent risk factors for poor prognosis in RMPP children included prolonged fever(OR=1.515,95%CI:1.120-2.049),severe RMPP(OR=5.615,95%CI:1.992-15.829),high GM-CSF(OR=1.284,95%CI:1.114-1.480),and high sCD163(OR=1.046,95%CI:1.023-1.069)(all P<0.05).The area under the ROC curve(AUC)for the combined prediction of poor prognosis using serum GM-CSF and sCD163 levels was 0.861(95%CI:0.796-0.912),which was higher than the AUC for GM-CSF alone(0.784,95%CI:0.710-0.846)and sCD163 alone(0.785,95%CI:0.711-0.847)(both P<0.05).Conclusion Elevated serum levels of GM-CSF and sCD163 in children with RMPP are associated with increased disease severity and poor prognosis.The combined measurement of serum GM-CSF and sCD163 levels exhibits high predictive efficacy for poor prognosis in RMPP patients.
Keywords：ChildrenRefractory mycoplasma pneumoniae pneumoniaGranulocyte-macrophage colony-stimulating factorSoluble cluster of differentiation 163Disease severityPrognosis
Publication Date：2025-03-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 5-10 )