Early warning indicators for refractory mycoplasma pneumoniae pneumonia in children
Objective To study the early warning indicators for refractory mycoplasma pneumoniae pneumonia in children.Methods Retrospective analysis of the clinical datas of 220 children with mycoplasma pneumoniae pneumonia diagnosed and treated in the First People's Pediatric Respiratory Ward of Jining NO.1 People's Hospital from June 2021 to July 2022.According to the clinical manifestations,laboratory tests,and clinical efficacy,the patients were divided into the ordinary mycoplasma pneumonia group(MPP group,120 cases)and the refractory mycoplasma pneumonia group(RMPP group,100 cases).After comparing the general clinical data and laboratory tests of two groups of children,logistic(LR)stepwise regression analysis was carried out on the statistically significant indicators to obtain independent predictive indicators for refractory mycoplasma pneumoniae pneumonia,and then,the critical(cut off)value with the maximum diagnostic value for each predictive indicator is found,through the analysis of the receiver operating characteristic curve(ROC).Results There was no significant differences in WBC count and neutrophil percentage(NEUT%)between the two groups(all P>0.05).The RMPP group had higher levels of platelet count(PLT),C-reactive protein,lactate dehydrogen-ase(LDH),and plasma D-dimer than the MPP group,while the CD4+/CD8+ratio of blood T lymphocytes was significantly lower than that of the MPP group,and the differences were statistically significant(Z=-6.415、-9.632、-7.467、-10.106、-9.686,all P<0.05).Bringing them into logistic stepwise regression analysis,the results showed that C-reactive protein(B-value=0.046,SE=0.023,OR=1.047,P=0.048),D-dimer(B=0.001,SE=0.001,OR=1.001,P=0.04),and CD4+/CD8+ ratio(B=-1.975,SE=0.961、OR=0.139,P=0.04)were independent predictors of refractory Mycoplasma pneumoniae pneu-monia in children,The areas under the ROC curves of CRP,plasma D-dimer,CRP+D-dimer,and CD4+/CD8+ratio are 0.876,0.905,0.901,and 0.872,respectively.Therefore,the diagnostic accuracy of CRP and CD4+/CD8+ is moderate,and the diagnos-tic accuracy of the plasma D-dimer and D-dimer+CRP is relatively high.Conclusion C-reactive protein≥52.5mg/L,D-di-mer≥2750ng/ml,and T lymphocyte CD4+/CD8+ ratio≤1.375 are early independent warning indicators for refractory myco-plasma pneumonia in children,among which D-dimer has the greatest diagnostic value.
万方数据
维普
