通讯作者: 管峥, 404033462@qq.com

DOI：10.12201/bmr.202606.00009

Value of serum IgE, LDH, and IL-18 in the early identification of refractory mycoplasma pneumoniae pneumonia in children

• 摘要：目的 探讨血清免疫球蛋白E(serum immunoglobulin E, IgE)、乳酸脱氢酶(lactate dehydrogenase, LDH)及白细胞介素18(interleukin-18, IL-18)对儿童难治性肺炎支原体肺炎(refractory mycoplasma pneumoniae pneumonia, RMPP)的早期识别作用。方法 本研究回顾性分析2022年8月至2024年6月期间于我院住院治疗的166例肺炎支原体肺炎(mycoplasma pneumoniae pneumonia, MPP)患儿，其中RMPP有48例，普通型肺炎支原体肺炎(general mycoplasma pneumoniae pneumonia, GMPP)有118例。比较两组患儿血清IgE、LDH及IL-18水平的差异。采用二元Logistic回归分析筛选MPP进展为RMPP的独立危险因素，并利用受试者操作特征(receiver operating characteristic, ROC)曲线评估IgE、LDH、IL-18单独及联合早期识别RMPP的临床价值。采用Bootstrap法(1000次重抽样)进行内部验证，并构建Nomogram列线图以实现RMPP早期识别的可视化评估。 结果 RMPP组血清IgE、LDH及IL-18水平均显著高于GMPP组(均P<0.01)。单项指标中，IgE、LDH及IL-18早期识别RMPP的最佳截断值分别为112.40 U/mL(AUC=0.830，敏感度79.2%，特异性79.7%）、296.15 U/L(AUC=0.859，敏感度83.3%，特异性72.9%)及397.70 pg/mL(AUC=0.840，敏感度77.1%，特异性76.3%)。三者联合检测的AUC为0.924，敏感度为91.7%，特异性为75.4%。经Bootstrap内部验证(1000次重抽样)，联合模型的校正后AUC为0.910(95%CI: 0.863–0.957)。 结论 血清IgE、LDH及IL-18水平在RMPP早期识别中具有一定辅助诊断价值，可为临床决策提供参考。

  关键词： 难治性肺炎支原体肺炎； 免疫球蛋白E； 乳酸脱氢酶； 白细胞介素18； 早期识别; ; ; ; 

   

  Abstract: Objective To investigate the role of serum immunoglobulin E (IgE), lactate dehydrogenase (LDH), and interleukin-18 (IL-18) in the early identification of refractory mycoplasma pneumoniae pneumonia (RMPP) in children. Methods This study retrospectively analyzed 166 children with mycoplasma pneumoniae pneumonia (MPP) hospitalized in our hospital between August 2022 and June 2024, including 48 cases of refractory MPP (RMPP) and 118 cases of general MPP (GMPP). Serum levels of IgE, LDH, and IL-18 were compared between the two groups. Binary logistic regression analysis was performed to identify independent risk factors for progression from MPP to RMPP, and receiver operating characteristic (ROC) curves were used to evaluate the clinical value of IgE, LDH, and IL-18 alone and in combination, in the early identification of RMPP. Internal validation was performed using the Bootstrap method (1000 resamples), and a nomogram was constructed to visually assess the early identification of RMPP. Results Serum levels of IgE, LDH, and IL-18 in the RMPP group were significantly higher than those in the GMPP group (all P<0.01). For individual markers, the optimal cut-off values for IgE, LDH, and IL-18 were 112.40 U/mL (AUC=0.830, sensitivity 79.2%, specificity 79.7%), 296.15 U/L (AUC=0.859, sensitivity 83.3%, specificity 72.9%), and 397.70 pg/mL (AUC=0.840, sensitivity 77.1%, specificity 76.3%), respectively. The combined model yielded an AUC of 0.924 with a sensitivity of 91.7% and specificity of 75.4%. After Bootstrap internal validation (1000 iterations), the corrected AUC of the combined model was 0.910 (95%CI: 0.863–0.957). Conclusion Serum levels of IgE, LDH, and IL-18 have certain auxiliary diagnostic value in the early identification of RMPP and may provide reference for clinical decision-making.

  Key words: refractory mycoplasma pneumoniae pneumonia; immunoglobulin E; lactate dehydrogenase; interleukin-18; early identification

  提交时间：2026-06-03

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• 序号	提交日期	编号	操作
  1	2026-03-06	10.12201/bmr.202606.00009V1	下载

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