Background To investigate the clinical value of inflammatory markers and cytokines at admission in evaluating the efficacy of different doses of glucocorticoids in the treatment of severe Mycoplasma pneumoniae pneumonia (MPP) in children. Methods A total of 159 children who were hospitalized and diagnosed with severe MPP in our hospital were selected for the study. The patients were divided into three groups according to the dose of glucocorticoid used for severe MPP and the changes in chest imaging data on day 6: the low-dose (1–2 mg/kg/d) effective group (group A), the medium-dose (4–6 mg/kg/d) effective group (group B) and the medium-dose (4–6 mg/kg/d) ineffective group (group C). We compared demographic characteristics, clinical features, and laboratory and imaging findings. ROC curves were used to assess the predictive value of each individual indicator for the efficacy of glucocorticoid treatment for severe MPP. Results (1): The serum CRP, PCT, IL-8, IL-6 and INF-<InlineEquation ID="IEq1"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="44337_2025_257_Article_IEq1.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="13" /> </InlineMediaObject> <EquationSource Format="TEX">$\gamma$</EquationSource> <EquationSource Format="MATHML"><math> <mi>γ</mi> </math></EquationSource> </InlineEquation> levels of the children in Groups A, B and C tended to gradually increase, whereas there was a decreasing trend in the levels of IL-4, IL-2 and IL-10, and the difference was statistically significant. (2): A two-by-two comparison of the laboratory parameters that differed significantly among the three groups of children revealed significant differences in the efficacy of low-dose glucocorticoids in the treatment of severe MPP in terms of the serum CRP, PCT, IL-6 and IL-2 levels. Serum CRP, PCT, IL-6, IL-4, IL-10, and INF-<InlineEquation ID="IEq2"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="44337_2025_257_Article_IEq2.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="13" /> </InlineMediaObject> <EquationSource Format="TEX">$\gamma$</EquationSource> <EquationSource Format="MATHML"><math> <mi>γ</mi> </math></EquationSource> </InlineEquation> levels showed significantly differed in the efficacy of medium-dose glucocorticoids in the treatment of severe MPP. (3): The analysis of receiver operating characteristic curves showed that serum CRP, PCT, and IL-6 had good predictive value in predicting the ineffectiveness of low-dose and medium-dose glucocorticoids in the treatment of severe MPP. Conclusions Serum CRP, PCT, and IL-6 levels can predict the efficacy of glucocorticoid therapy for severe MPP to a certain extent, or may be useful biomarkers for adjusting glucocorticoid therapy in children with severe MPP.

The value of cytokines in evaluating the efficacy of glucocorticoids in the treatment of severe Mycoplasma pneumoniae pneumonia in children

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2025年3月11日

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Zhaoqian Shan,
Wanyu Jia,
Shuqin Fu,
Caili Guo,
Chunlan Song

摘要

Background

To investigate the clinical value of inflammatory markers and cytokines at admission in evaluating the efficacy of different doses of glucocorticoids in the treatment of severe Mycoplasma pneumoniae pneumonia (MPP) in children.

Methods

A total of 159 children who were hospitalized and diagnosed with severe MPP in our hospital were selected for the study. The patients were divided into three groups according to the dose of glucocorticoid used for severe MPP and the changes in chest imaging data on day 6: the low-dose (1–2 mg/kg/d) effective group (group A), the medium-dose (4–6 mg/kg/d) effective group (group B) and the medium-dose (4–6 mg/kg/d) ineffective group (group C). We compared demographic characteristics, clinical features, and laboratory and imaging findings. ROC curves were used to assess the predictive value of each individual indicator for the efficacy of glucocorticoid treatment for severe MPP.

Results

(1): The serum CRP, PCT, IL-8, IL-6 and INF- $\gamma$ $γ$ levels of the children in Groups A, B and C tended to gradually increase, whereas there was a decreasing trend in the levels of IL-4, IL-2 and IL-10, and the difference was statistically significant. (2): A two-by-two comparison of the laboratory parameters that differed significantly among the three groups of children revealed significant differences in the efficacy of low-dose glucocorticoids in the treatment of severe MPP in terms of the serum CRP, PCT, IL-6 and IL-2 levels. Serum CRP, PCT, IL-6, IL-4, IL-10, and INF- $\gamma$ $γ$ levels showed significantly differed in the efficacy of medium-dose glucocorticoids in the treatment of severe MPP. (3): The analysis of receiver operating characteristic curves showed that serum CRP, PCT, and IL-6 had good predictive value in predicting the ineffectiveness of low-dose and medium-dose glucocorticoids in the treatment of severe MPP.

Conclusions

Serum CRP, PCT, and IL-6 levels can predict the efficacy of glucocorticoid therapy for severe MPP to a certain extent, or may be useful biomarkers for adjusting glucocorticoid therapy in children with severe MPP.