IL–6、CRP和NLR、WBC、NEUT%水平对儿童肺炎支原体肺炎的早期诊断和严重程度评估价值

王婉; 罗兵; 胡东; 冯坤丽; 王可; 徐雅丽; 张吉卿

doi:10.13898/j.cnki.issn.2097-5252.2026.02.006

IL–6、CRP和NLR、WBC、NEUT%水平对儿童肺炎支原体肺炎的早期诊断和严重程度评估价值

Diagnostic and prognostic value of IL-6, CRP, NLR, WBC, and NEUT% levels in the early diagnosis and severity assessment of Mycoplasma pneumoniae pneumonia in children

摘要

摘要:
目的： 探讨白细胞介素–6（IL–6）、C反应蛋白（CRP）和中性粒细胞/淋巴细胞比值（NLR）、白细胞计数（WBC）、中性粒细胞比率（NEUT%）对儿童肺炎支原体肺炎（MPP）的早期诊断和严重程度评估价值。
方法： 选择MPP患儿84例，根据疾病严重程度分为重症组42例和非重症组42例。以健康体检儿童42名为健康对照组。收集临床资料，比较MPP患儿和健康对照组IL–6、CRP和NLR、WBC、NEUT%水平；比较重症组和非重症组IL–6、CRP和NLR、WBC、NEUT%水平；ROC曲线分析各指标对MPP的临床检测价值；多因素logistic回归模型分析IL–6、CRP和NLR、WBC、NEUT%水平与MPP患儿病情严重程度的关系。
结果： MPP组患儿IL–6、CRP和NLR、WBC、NEUT%水平高于健康对照组，差异均有统计学意义（P ＜ 0.01）；重症组患儿IL–6、CRP和WBC、NLR、NEUT%水平均高于非重症组，差异均有统计学意义（P ＜ 0.05～P ＜ 0.01）。ROC曲线分析IL–6、CRP和NLR、WBC、NEUT%诊断MPP的曲线下面积为0.945、0.982、0928、0.693、0.924。多因素logistic回归分析IL–6、CRP和NLR、WBC、NEUT%值升高均可能为影响MPP患儿病情严重程度的独立危险因素（P ＜ 0.05～P ＜ 0.01）。
结论： 通过检测MPP患儿IL–6、CRP和NLR、WBC、NEUT%水平变化能够辅助儿童MPP的早期诊断，且这5个项指标水平均与儿童MPP病情严重程度密切相关，可为临床诊治提供重要指导价值。

Abstract:
Objective To investigate the value of interleukin -6(IL-6), C reactive protein (CRP), and neutrophil/lymphocyte ratio (NLR), white blood cell count (WBC), neutrophil percentage (NEUT%) for early diagnosis and severity assessment of Mycoplasma pneumoniae pneumonia (MPP).
Methods A total of 84 pediatric patients diagnosed with MPP were retrospectively enrolled in the study. Based on established clinical criteria for disease severity, the patients were divided into the severe group (n = 42) and non-severe group (n = 42). The clinical data were collected from 42 cases of healthy physical examination population as the healthy control group, and the IL-6, CRP and NLR, WBC, NEUT% levels in MPP pediatric patient and healthy control group were compared; the CRP, NLR, WBC and NEUT% levels in the severe group and non-severe group were compared; ROC curve was used to analyze the clinical value of IL-6, CRP and NLR, WBC, NEUT% for the diagnosis of MPP. The relationship between IL-6, CRP and NLR, WBC, NEUT% levels and the severity of MPP pediatric patient was analysed by multifactor logistic regression models.
Results The levels of IL-6, CRP, NLR, WBC, and NEUT% were significantly higher in children with MPP than in healthy control group (P ＜ 0.01). The levels of IL-6, CRP, WBC, NLR and NEUT% in the severe group were higher than those in the non-severe group, and the differences were statistically significant (P ＜ 0.05 to P ＜ 0.01). The area under the curve (AUC) of IL-6, CRP and NLR, WBC, NEUT% for diagnosing MPP was 0.982, 0928, 0.693, 0.945, 0.924. Multifactorial logistic regression analysis indicated that IL-6, CRP and NLR, WBC and NEUT% were independent risk factors affecting the severity of MPP pediatric patient (P ＜ 0.05 to P ＜ 0.01).
Conclusions Detecting changes in IL-6, CRP, NLR, WBC, and NEUT% levels can assist in the early diagnosis of pediatric MPP. Moreover, the levels of these five indicators are closely associated with disease severity, providing valuable guidance for clinical management and therapeutic decision-making.

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