OBJECTIVE To observe the association between nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome pathway and severe Mycoplasma pneumoniae pneumonia in the children and analyze the diagnostic value.

METHODS A total of 187 children with M.pneumoniae pneumonia who were treated in the Jinan Second Maternal and Child Health Hospital from May 2020 to Dec 2022 were enrolled in the study and were divided into the severe group with 86 cases and the mild group with 101 cases. Meanwhile, 120 healthy children who received physical examination were chosen as the control group. The expression levels of peripheral blood NLRP3, apoptosis associated speck-like protein (ASC) and caspase-1 (caspase-1) messenger ribonucleic acid(mRNA) were detected. The levels of community-acquired respiratory distress syndrome toxin (CARDSTx), interleukin (IL)- 1β and IL-18 were compared among the children with different illness condition. The association between the two types of indexes and the values of NLRP3, ASC and caspase-1 mRNA in diagnosis of severe M. pneumoniae pneumonia were analyzed.

RESULTS The levels of NLRP3, ASC and caspase-1 mRNA of the control group, the mild group and the severe group showed upward trends(P < 0.05). The levels of CARDSTx, IL-1β and IL-18 of the severe group were higher than those of the mild group(P < 0.05). The two types of indexes of the children with M. pneumoniae pneumonia were positively correlated(P < 0.05). The area under curve (AUC) of the joint detection of NLRP3, ASC and caspase-1 mRNA was 0.869 in diagnosis of the severe M. pneumoniae pneumonia, with the sensitivity 79.07%, the specificity 82.18%.

CONCLUSION There is significant association between the levels of NLRP3, ASC, caspase-1 mRNA and the levels of CARDSTx, IL-1β and IL-18 of the children with M. pneumoniae pneumonia. The NLRP3, ASC and caspase-1 mRNA have high values in diagnosis of the severe M. pneumoniae pneumonia.