2026 年第 1 期 第 21 卷

肺炎链球菌肺炎患儿疾病治疗转归与血清白细胞介素8和淀粉样蛋白A水平的相关性

Correlation between serum interleukin-8 and serum amyloid A levels and treatment outcomes in children with Streptococcus pneumoniae pneumonia

作者：刘利李小双王瑶瑶魏荣胜李雪茹

英文作者：Liu Li Li Xiaoshuang Wang Yaoyao Wei Rongsheng Li Xueru

单位：复旦大学附属儿科医院安徽医院安徽省儿童医院急诊科，合肥230000

英文单位：Department of Emergency Anhui Hospital of Children′s Hospital of Fudan University Anhui Children′s Hospital Hefei 230000 China

关键词：肺炎链球菌肺炎；白细胞介素8；血清淀粉样蛋白A

英文关键词：Streptococcuspneumoniaepneumonia;Interleukin-8;SerumamyloidA

• 摘要：

• 目的 探究肺炎链球菌肺炎患儿疾病治疗转归与血清白细胞介素8（IL-8）、血清淀粉样蛋白A（SAA）水平的相关性。方法 回顾性分析2022年1月至2024年12月安徽省儿童医院收治的126例肺炎链球菌肺炎患儿临床资料，纳入病例组，另按照与病例组1∶2的比例，收集同期于本院进行健康体检的63例儿童相关资料，纳入对照组。病例组患儿根据治疗1周时的临床疗效分为治疗有效组（105例）与治疗无效组（21例），比较病例组治疗前与对照组体检时血清IL-8、SAA水平，以及治疗无效组与治疗有效组治疗前后血清IL-8、SAA水平变化情况，分析肺炎链球菌肺炎患儿疾病治疗转归与治疗前血清IL-8、SAA水平的相关性。结果 病例组治疗前血清IL-8、SAA水平均高于对照组（均P＜0.05）。治疗无效组治疗前、后血清IL-8、SAA水平均高于同时点治疗有效组［治疗前：（86±13）ng/L比（66±11）ng/L、（18.8±3.1）mg/L比（15.1±2.8）mg/L；治疗后：（85±12）ng/L比（33±6）ng/L、（17.3±3.0）mg/L比（9.1±2.6）mg/L］（均P＜0.05）；治疗有效组治疗后血清IL-8、SAA水平均低于治疗前（均P＜0.05）。治疗无效组治疗前临床肺部感染评分、C反应蛋白、IL-8、SAA水平及合并胸腔积液、营养不良比例均高于治疗有效组（P＜0.05）。Logistic回归分析结果显示，肺炎链球菌肺炎患儿治疗转归可能与合并胸腔积液、合并营养不良、治疗前血清IL-8、SAA水平有关（均P＜0.05）。限制性立方样条法分析结果显示，肺炎链球菌肺炎患儿治疗前血清IL-8、SAA水平与治疗无效风险呈非线性剂量-反应关系（均P＜0.05）。肺炎链球菌肺炎患儿治疗前血清IL-8、SAA对疾病治疗无效风险具有正向交互作用。结论 肺炎链球菌肺炎患儿疾病治疗转归与治疗前血清IL-8、SAA水平有密切关系，疾病治疗无效风险随二者水平升高而增加。

• Objective To explore the correlation between serum interleukin-8 (IL-8) and serum amyloid A (SAA) levels and treatment outcomes in children with Streptococcus pneumoniae pneumonia. Methods A retrospective analysis was performed on the clinical data of 126 children with Streptococcus pneumoniae pneumonia admitted to Anhui Children′s Hospital from January 2022 to December 2024, who were enrolled in the case group. In addition, relevant data of 63 children who underwent health check-ups in the hospital during the same period were collected at a ratio of 1∶2 to the case group, and they were included in the control group. According to the clinical efficacy at 1 week after treatment, the children in the case group were divided into the effective treatment group (105 cases) and the ineffective treatment group (21 cases). The serum IL-8 and SAA levels of the case group before treatment and the control group during physical examination were compared, as well as the changes in serum IL-8 and SAA levels of the ineffective treatment group and the effective treatment group before and after treatment. The correlation between the treatment outcomes of children with Streptococcus pneumoniae pneumonia and the serum IL-8 and SAA levels before treatment was analyzed. Results The serum IL-8 and SAA levels in the case group before treatment were significantly higher than those in the control group (both P<0.05). The serum IL-8 and SAA levels in the ineffective treatment group were higher than those in the effective treatment group at the same time points both before and after treatment ［before treatment: (86±13)ng/L vs (66±11)ng/L, (18.8±3.1)mg/L vs (15.1±2.8)mg/L; after treatment: (85±12)ng/L vs (33±6)ng/L, (17.3±3.0)mg/L vs (9.1±2.6)mg/L］(all P<0.05). After treatment, the serum IL-8 and SAA levels in the effective treatment group were significantly lower than those before treatment (both P<0.05). Before treatment, the clinical pulmonary infection score, C-reactive protein, IL-8, and SAA levels, as well as the proportions of complicated pleural effusion and malnutrition in the ineffective treatment group were all higher than those in the effective treatment group (all P<0.05). Logistic regression analysis showed that the treatment outcome of children with Streptococcus pneumoniae pneumonia may be associated with complicated pleural effusion, complicated malnutrition, and pre-treatment serum IL-8 and SAA levels (all P<0.05). Restricted cubic spline analysis revealed a non-linear dose-response relationship between pre-treatment serum IL-8 and SAA levels and the risk of treatment failure in children with Streptococcus pneumoniae pneumonia (both P<0.05). Pre-treatment serum IL-8 and SAA had a positive interactive effect on the risk of treatment failure in these children. Conclusion  The treatment outcome of children with Streptococcus pneumoniae pneumonia is closely related to the pre-treatment serum IL-8 and SAA levels, and the risk of treatment failure increases with the elevation of these two indicators.