肺炎支原体感染相关生物标志物的研究进展
Research Progress on Biomarkers Related to Mycoplasma pneumoniae Pneumonia
DOI: 10.12677/acm.2025.1572024, PDF,    科研立项经费支持
作者: 黑倩雯, 王尉蓉, 雷 雯*:昆明医科大学第二附属医院呼吸与危重症医学科,云南 昆明
关键词: 肺炎支原体肺炎生物标志物重症难治性Mycoplasma pneumoniae Pneumonia Biomarkers Severe Case Refractory
摘要: 肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia, MPP)是社区获得性肺炎的常见类型,由肺炎支原体(Mycoplasma pneumoniae, MP)感染引起,临床表现为干咳,常伴有头痛、发热和肌肉疼痛等症状。可通过分子检测、血清学抗体检测、快速抗原检测和分离培养多种实验室方式诊断。MP感染通常是自限性的,但部分患者仍需药物治疗,目前,大环内酯类药物是MPP患者的首选药物,但大环内酯类药物耐药率不断提高,导致治疗无效、病情加重,引起严重并发症及死亡,近年来有研究提出,血清生物标志物对MPP病情发展具有指导意义,本文就目前研究的血清生物标志物进行综述。
Abstract: Mycoplasma pneumoniae pneumonia (MPP) is a common type of community-acquired pneumonia, caused by Mycoplasma pneumoniae (MP) infection, characterized by dry cough, often accompanied by symptoms such as headache, fever, and muscle pain. At present, various laboratory methods such as molecular detection, serological antibody detection, rapid antigen detection, and isolation and cultivation can be used for diagnosis. MP infection is usually self-limiting, but some patients still require medication treatment. Macrolide antibiotics are the preferred drugs for MPP patients, but the resistance rate to Macrolide antibiotics continues to increase, leading to ineffective treatment and worsening of the condition. Currently, research suggests that serum biomarkers have guiding significance for the development of MPP. This article reviews the current research on serum biomarkers.
文章引用:黑倩雯, 王尉蓉, 雷雯. 肺炎支原体感染相关生物标志物的研究进展[J]. 临床医学进展, 2025, 15(7): 561-568. https://doi.org/10.12677/acm.2025.1572024

参考文献

[1] Gao, L. and Sun, Y. (2024) Laboratory Diagnosis and Treatment of Mycoplasma pneumoniae Infection in Children: A Review. Annals of Medicine, 56, Article ID: 2386636. [Google Scholar] [CrossRef] [PubMed]
[2] Chen, Y., Li, X., Fu, Y., Yu, Y. and Zhou, H. (2024) The Lancet Microbe, 5, Article ID: 100870. [Google Scholar] [CrossRef] [PubMed]
[3] Xie, Q., Zhang, X., Cui, W. and Pang, Y. (2022) Construction of a Nomogram for Identifying Refractory Mycoplasma pneumoniae Pneumonia among Macrolide-Unresponsive Mycoplasma pneumoniae Pneumonia in Children. Journal of Inflammation Research, 15, 6495-6504. [Google Scholar] [CrossRef] [PubMed]
[4] Li, L., Guo, R., Zou, Y., Wang, X., Wang, Y., Zhang, S., et al. (2024) Construction and Validation of a Nomogram Model to Predict the Severity of Mycoplasma pneumoniae Pneumonia in Children. Journal of Inflammation Research, 17, 1183-1191. [Google Scholar] [CrossRef] [PubMed]
[5] Tamiya, S., Yoshikawa, E., Ogura, M., Kuroda, E., Suzuki, K. and Yoshioka, Y. (2021) Neutrophil-Mediated Lung Injury Both via TLR2-Dependent Production of IL-1α and IL-12 p40, and TLR2-Independent CARDS Toxin after Mycoplasma pneumoniae Infection in Mice. Microbiology Spectrum, 9, e01588-21. [Google Scholar] [CrossRef] [PubMed]
[6] Li, D., Gu, H., Chen, L., Wu, R., Jiang, Y., Huang, X., et al. (2023) Neutrophil-to-Lymphocyte Ratio as a Predictor of Poor Outcomes of Mycoplasma pneumoniae Pneumonia. Frontiers in Immunology, 14, Article 1302702. [Google Scholar] [CrossRef] [PubMed]
[7] Fan, L., Xu, N., Guo, Y. and Li, L. (2024) Enhanced Insights into the Neutrophil-Driven Immune Mechanisms during Mycoplasma pneumoniae Infection. Heliyon, 10, e38950. [Google Scholar] [CrossRef] [PubMed]
[8] Zhang, Z., Wan, R., Yuan, Q., Dou, H., Tu, P., Shi, D., et al. (2022) Cell Damage and Neutrophils Promote the Infection of Mycoplasma pneumoniae and Inflammatory Response. Microbial Pathogenesis, 169, Article ID: 105647. [Google Scholar] [CrossRef] [PubMed]
[9] Ling, Y., Ning, J. and Xu, Y. (2021) Explore the Predictive Value of Peripheral Blood Cell Parameters in Refractory Mycoplasma pneumoniae Pneumonia in Children over 6 Years Old. Frontiers in Pediatrics, 9, Article 659677. [Google Scholar] [CrossRef] [PubMed]
[10] Chen, P., Huang, Z., Chen, L., Zhuang, S., Lin, H., Xie, J., et al. (2021) The Relationships between LncRNA NNT-AS1, CRP, PCT and Their Interactions and the Refractory Mycoplasma pneumoniae Pneumonia in Children. Scientific Reports, 11, Article No. 2059. [Google Scholar] [CrossRef] [PubMed]
[11] Plebani, M. (2023) Why C-Reactive Protein Is One of the Most Requested Tests in Clinical Laboratories? Clinical Chemistry and Laboratory Medicine (CCLM), 61, 1540-1545. [Google Scholar] [CrossRef] [PubMed]
[12] Shen, F., Dong, C., Zhang, T., Yu, C., Jiang, K., Xu, Y., et al. (2022) Development of a Nomogram for Predicting Refractory Mycoplasma pneumoniae Pneumonia in Children. Frontiers in Pediatrics, 10, Article 813614. [Google Scholar] [CrossRef] [PubMed]
[13] Horns, H., Draenert, R. and Nistal, M. (2021) Procalcitonin (PCT). MMWFortschritte der Medizin, 163, 54-55. [Google Scholar] [CrossRef] [PubMed]
[14] Schuetz, P. (2022) How to Best Use Procalcitonin to Diagnose Infections and Manage Antibiotic Treatment. Clinical Chemistry and Laboratory Medicine (CCLM), 61, 822-828. [Google Scholar] [CrossRef] [PubMed]
[15] Huang, Z., Fu, Z., Huang, W. and Huang, K. (2020) Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Sepsis: A Meta-Analysis. The American Journal of Emergency Medicine, 38, 641-647. [Google Scholar] [CrossRef] [PubMed]
[16] Zhang, H., Ge, Y., Wang, H., Zhang, Q., Li, W., Chen, Y., et al. (2019) Neutrophil-to-Lymphocyte Ratio Improves the Accuracy and Sensitivity of Pneumonia Severity Index in Predicting 30-Day Mortality of CAP Patients. Clinical Laboratory, 65. [Google Scholar] [CrossRef] [PubMed]
[17] Shen, W. and Sun, X. (2024) Construction of a Nomogram for Early Diagnosis of Refractory Mycoplasma pneumoniae Pneumonia in Children. Translational Pediatrics, 13, 1119-1129. [Google Scholar] [CrossRef] [PubMed]
[18] Yang, B., Zhang, W., Gu, W., Zhang, X., Wang, M., Huang, L., et al. (2021) Differences of Clinical Features and Prognosis between Mycoplasma pneumoniae Necrotizing Pneumonia and Non-Mycoplasma pneumoniae Necrotizing Pneumonia in Children. BMC Infectious Diseases, 21, Article No. 797. [Google Scholar] [CrossRef] [PubMed]
[19] Bi, Y., Zhu, Y., Ma, X., Xu, J., Guo, Y., Huang, T., et al. (2021) Development of a Scale for Early Prediction of Refractory Mycoplasma pneumoniae Pneumonia in Hospitalized Children. Scientific Reports, 11, Article No. 6595. [Google Scholar] [CrossRef] [PubMed]
[20] Kim, G. and Jun, J. (2022) Altered Serum Uric Acid Levels in Kidney Disorders. Life, 12, Article 1891. [Google Scholar] [CrossRef] [PubMed]
[21] Allegrini, S., Garcia-Gil, M., Pesi, R., Camici, M. and Tozzi, M.G. (2022) The Good, the Bad and the New about Uric Acid in Cancer. Cancers, 14, Article 4959. [Google Scholar] [CrossRef] [PubMed]
[22] Luis-Rodríguez, D., Donate-Correa, J., Martín-Núñez, E., Ferri, C., Tagua, V.G., Pérez Castro, A., et al. (2020) Serum Urate Is Related to Subclinical Inflammation in Asymptomatic Hyperuricaemia. Rheumatology, 60, 371-379. [Google Scholar] [CrossRef] [PubMed]
[23] Pan, C., Chen, Y., Wang, S., Li, M. and Qu, S. (2021) The Study of Routine Laboratory Factors in Children with Mycoplasma pneumoniae Pneumonia: Serum Uric Acid May Have Anti‐inflammatory Effect. Journal of Clinical Laboratory Analysis, 35, e24026. [Google Scholar] [CrossRef] [PubMed]
[24] Huang, X., Li, D., Liu, F., Zhao, D., Zhu, Y. and Tang, H. (2021) Clinical Significance of D-Dimer Levels in Refractory Mycoplasma pneumoniae Pneumonia. BMC Infectious Diseases, 21, Article No. 14. [Google Scholar] [CrossRef] [PubMed]
[25] Liu, J., He, R., Wu, R., Wang, B., Xu, H., Zhang, Y., et al. (2020) Mycoplasma pneumoniae Pneumonia Associated Thrombosis at Beijing Children’s Hospital. BMC Infectious Diseases, 20, Article No. 51. [Google Scholar] [CrossRef] [PubMed]
[26] Fonseca, Ó., Ramos, A.S., Gomes, L.T.S., Gomes, M.S. and Moreira, A.C. (2023) New Perspectives on Circulating Ferritin: Its Role in Health and Disease. Molecules, 28, Article 7707. [Google Scholar] [CrossRef] [PubMed]
[27] Horvat, C.M., Fabio, A., Nagin, D.S., Banks, R.K., Qin, Y., Park, H., et al. (2022) Mortality Risk in Pediatric Sepsis Based on C-Reactive Protein and Ferritin Levels. Pediatric Critical Care Medicine, 23, 968-979. [Google Scholar] [CrossRef] [PubMed]
[28] Gayam, V., Konala, V.M., Naramala, S., Garlapati, P.R., Merghani, M.A., Regmi, N., et al. (2020) Presenting Characteristics, Comorbidities, and Outcomes of Patients Coinfected with COVID‐19 and Mycoplasma pneumoniae in the USA. Journal of Medical Virology, 92, 2181-2187. [Google Scholar] [CrossRef] [PubMed]
[29] DePalma, R.G., Hayes, V.W. and O’Leary, T.J. (2021) Optimal Serum Ferritin Level Range: Iron Status Measure and Inflammatory Biomarker. Metallomics, 13, mfab030. [Google Scholar] [CrossRef] [PubMed]
[30] Tishkowski, K. and Gupta, V. (2023) Erythrocyte Sedimentation Rate. StatPearls.
[31] Xu, W., Zhao, W., Qian, R., et al. (2021) [Clinical Observation of Extremely Elevated Erythrocyte Sedimentation Rate]. Chinese Critical Care Medicine, 33, 613-617.
[32] Kotsiou, O.S., Papagiannis, D., Papadopoulou, R. and Gourgoulianis, K.I. (2021) Calprotectin in Lung Diseases. International Journal of Molecular Sciences, 22, Article 1706. [Google Scholar] [CrossRef] [PubMed]
[33] Havelka, A., Sejersen, K., Venge, P., Pauksens, K. and Larsson, A. (2020) Calprotectin, a New Biomarker for Diagnosis of Acute Respiratory Infections. Scientific Reports, 10, Article No. 4208. [Google Scholar] [CrossRef] [PubMed]
[34] Venge, P., Eriksson, S. and Pauksen, K. (2021) Blood Biomarker Algorithms for the Diagnosis of Mycoplasma pneumoniae Respiratory Infections. Journal of Immunological Methods, 489, Article ID: 112908. [Google Scholar] [CrossRef] [PubMed]
[35] Pan, T., Guo, X., Yang, D., Ding, J. and Chen, C. (2024) Expression and Significance of Procalcitonin, Leukotriene B4, Serum Amyloid A, and C-Reactive Protein in Children with Different Types of Pneumonia: An Observational Study. Medicine, 103, e37817. [Google Scholar] [CrossRef] [PubMed]
[36] Fan, F., Lv, J., Yang, Q. and Jiang, F. (2023) Clinical Characteristics and Serum Inflammatory Markers of Community‐acquired Mycoplasma Pneumonia in Children. The Clinical Respiratory Journal, 17, 607-617. [Google Scholar] [CrossRef] [PubMed]
[37] 胡志南, 孙文. 分析支原体肺炎患儿预后结局的影响因素并基于炎症指标、免疫学指标、影像学特征构建预测模型[J]. 大医生, 2025, 10(2): 35-38.
[38] Ehrencrona, E., Gallego, P., Trillo‐Muyo, S., Garcia‐Bonete, M., Recktenwald, C.V., Hansson, G.C., et al. (2025) The Structure of FCGBP Is Formed as a Disulfide‐mediated Homodimer between Its C‐terminal Domains. The FEBS Journal, 292, 582-601. [Google Scholar] [CrossRef] [PubMed]
[39] 刘洁, 王勇, 霍倩雯, 等. 重症肺炎支原体肺炎老年患者血清FCGBP、ITGB4水平及其预后预测价值分析[J]. 国际检验医学杂志, 2024, 45(24): 2989-2994.
[40] Liu, J., Shen, R., Feng, L., Cheng, S., Chen, J., Xiao, T., et al. (2021) Proteomics Study of Mycoplasma pneumoniae Pneumonia Reveals the Fc Fragment of the Igg-Binding Protein as a Serum Biomarker and Implicates Potential Therapeutic Targets. Frontiers of Medicine, 16, 378-388. [Google Scholar] [CrossRef] [PubMed]
[41] Hrabar, D., Bakula, D., Vrkljan, N., Ratkajec, V., Glavcic, G., Miler, M., et al. (2023) YKL-40 as a Biomarker in Various Inflammatory Diseases: A Review. Biochemia medica, 34, 42-56. [Google Scholar] [CrossRef] [PubMed]
[42] 韩瑞芳, 高玲, 陈飞, 等. 血清SAA/CRP、LDH、YKL-40联合常规影响因素对难治性支原体肺炎患儿预后的预测价值分析[J/OL]. 解放军医学杂志, 2025: 1-11.
http://kns.cnki.net/kcms/detail/11.1056.R.20250123.1648.004.html, 2025-04-07.
[43] Zhao, Q., Ji, S., Jiang, H., Lu, D., Qian, L., Zhang, J., et al. (2025) Predictive Value of Plasma sB7-H3 and YKL-40 in Pediatric Refractory Mycoplasma pneumoniae Pneumonia. Open Medicine, 20, Article ID: 20241114. [Google Scholar] [CrossRef] [PubMed]