基础医学与临床 ›› 2026, Vol. 46 ›› Issue (2): 261-266.doi: 10.16352/j.issn.1001-6325.2026.02.0261

• 临床研究 • 上一篇    下一篇

MICA和CXCR1水平与重症肺炎患儿预后相关

王天骄1, 宋义琴2*, 王敬3   

  1. 首都医科大学附属北京儿童医院保定医院 1.风湿免疫科 2.呼吸科; 3.新生儿科,河北 保定 071000
  • 收稿日期:2025-01-07 修回日期:2025-04-29 出版日期:2026-02-05 发布日期:2026-01-21
  • 通讯作者: * 756527211@qq.com
  • 基金资助:
    河北省保定市科技计划(2241ZF359)

Association of MICA and CXCR1 with prognosis in children with severe pneumonia

WANG Tianjiao1, SONG Yiqin2*, WANG Jing3   

  1. 1. Department of Rheumatology and Immunology; 2. Department of Respiratory; 3. Department of Neonatology, Baoding Hospital, Beijing Children's Hospital, Capital Medical University, Baoding 071000, China
  • Received:2025-01-07 Revised:2025-04-29 Online:2026-02-05 Published:2026-01-21
  • Contact: * 756527211@qq.com

摘要: 目的 探究主要组织相容复合物Ⅰ链相关蛋白A(MICA)、C-X-C型趋化因子受体1(CXCR1)水平与重症肺炎患儿免疫功能及临床预后关系。方法 选取2021年1月至2024年1月首都医科大学附属北京儿童医院保定医院收治的202例重症肺炎患儿为研究组,根据28 d预后分为预后良好组和预后不良组。另纳入以同期202例体检健康儿童为对照组。采用ELISA测定各组血清MICA、CXCR1水平。Pearson法分析相关性。多因素Logistic回归分析患儿预后的影响因素。绘制受试者工作特征(ROC)曲线分析血清MICA、CXCR1对患儿预后不良的预测价值。结果 与对照组相比,研究组CD4+T、CD4+T/CD8+T降低(P<0.05),CD8+T及血清MICA、CXCR1水平升高(P<0.05)。重症肺炎患儿血清MICA、CXCR1水平与CD4+T、CD8+T、CD4+T/CD8+T相关(P<0.05)。预后不良组、预后良好组CD4+T、CD8+T、CD4+T/CD8+T、MICA、CXCR1水平差异显著(P<0.05),均为重症肺炎患儿预后的影响因素(P<0.05)。血清MICA、CXCR1联合预测重症肺炎患儿预后不良的曲线下面积(AUC)为0.909,显著大于MICA(Z=2.337,P=0.019)、CXCR1(Z=2.555,P=0.011)单独预测。结论 重症肺炎患儿血清MICA、CXCR1水平升高,与免疫功能及预后相关,二者联合测定具有较高的预后评估价值。

关键词: 重症肺炎, 主要组织相容复合物Ⅰ链相关蛋白A, C-X-C型趋化因子受体1, 免疫功能, 预后

Abstract: Objective To investigate the relationship between serum levels of major histocompatibility complex class Ⅰ chain-related molecule A (MICA) and C-X-C motif chemokine receptor 1 (CXCR1) and the immune function and clinical prognosis of children with severe pneumonia. Methods A total of 202 children with severe pneumonia who visited Baoding Hospital, Beijing Children's Hospital Capital Medical University from January 2021 to January 2024 were enrolled as research group, which were divided into good prognosis group and poor prognosis group according to the 28-day prognosis. Another 202 healthy children who underwent physical examination during the same period were included as control group. ELISA was applied to measure the levels of serum MICA and CXCR1. Correlation was analyzed by Pearson's method. Multivariate Logistic regression was applied to analyze the factors influencing the prognosis of children. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of serum MICA and CXCR1 for poor prognosis in children. Results Compared with the control group, the research group showed a decrease in CD4+T and CD4+T/CD8+T (P<0.05), and an increase in CD8+T, and the serum MICA and CXCR1 levels (P<0.05).The serum MICA and CXCR1 levels in children with severe pneumonia was correlated with CD4+T, CD8+T and CD4+T/CD8+T (P<0.05). There were significant differences in the levels of CD4+T, CD8+T, CD4+T/CD8+T, MICA and CXCR1 between the poor prognosis group and the good prognosis group (P<0.05), all of which were prognostic factors of children with severe pneumonia. The area under the curve (AUC) of combined prediction of serum MICA and CXCR1 was 0.909, which was greatly larger than that of MICA (Z=2.337, P=0.019) and CXCR1 (Z=2.555, P=0.011) alone. Conclusions Serum MICA and CXCR1 levels are increased in children with severe pneumonia, and associated with immune function and prognosis. The combination of the two has high prognostic evaluation value.

Key words: severe pneumonia, major histocompatibility complex class Ⅰ chain-related molecule A(MICA), C-X-C motif chemokine receptor 1(CXCR1), immune function, prognosis

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