摘要
目的 分析儿童难治性肺炎支原体肺炎(RMPP)早期预测中血清乳酸脱氢酶(LDH)、降钙素原(PCT)、C反应蛋白(CRP)的应用价值.方法 选取 2021 年 1 月至 2023 年 12月我院收治的 96 例小儿肺炎支原体肺炎(MPP)为MPP组,以疾病类型将MPP组分为普通性肺炎支原体肺炎(GMPP组)62 例,与RMPP组 34 例;以不同预后将RMPP组分为有效组(28 例)与无效组(6 例);同期选取 60 名健康体检儿童作为对照组;入组者均采集静脉血检测PCT、LDH及CRP,对比各组LDH、CRP及PCT水平,并分析不同指标检测对儿童RMPP早期预测价值.结果 MPP组LDH[(202±62)U/L与(367±61)U/L,t=16.380,P<0.001]、CRP[(5.1±1.1)mg/L与(30.6±3.5)mg/L,t=55.079,P<0.001]及PCT[(0.061±0.011)μg/L与(0.452±0.130)μg/L,t=23.167,P<0.001]水平较对照组更高;RMPP组LDH[(277±66)U/L与(403±55)U/L,t=9.477,P<0.001]、CRP[(21.3±2.1)mg/L与(39.9±3.3)mg/L,t=33.930,P<0.001]及PCT[(0.312±0.111)μg/L与(0.530±0.212)μg/L,t=6.748,P<0.001]水平较GMPP组更高;无效组LDH[(163±53)U/L与(224±60)U/L,t=2.534,P=0.016]、CRP[(4.8±1.1)mg/L 与(8.9±1.5)mg/L,t=7.719,P<0.001]及 PCT[(0.081±0.020)μg/L 与(0.130±0.052)μg/L,t= 4.118,P<0.001]水平较有效组更高.PCT、LDH及CRP对儿童RMPP的评估价值曲线下面积(AUC)分别为0.715、0.771、0.805;灵敏度分别为 66.7%、69.2%、75.5%;特异度分别为 76.0%、82.6%、87.1%.结论 儿童RMPP早期预测中血清LDH、PCT及CRP的应用价值较高,可为疾病诊治提供可靠依据.
Abstract
Objective To analyze the value of serum lactate dehydrogenase(LDH),procalcitonin(PCT),and C-reactive protein(CRP)in the early prediction of refractory mycoplasma pneumoniae(RMPP)in children.Methods Ninety-six cases of pediatric MPP admitted to Tianjin Children's Hospital from January 2021 to December 2023 were selected as the MPP group,and the MPP group was divided into the GMPP group(generalized mycoplasma pneumonia)pneumoniae and the RMPP group(refractory mycoplasma pneumonia)pneumoniae by the type of disease,which consisted of 62 cases and 34 cases,respectively;the RMPP group was divided into the effective group and the ineffective group by the different prognosies,which consisted of 28 cases The RMPP group was divided into the effective group and the ineffective group with different prognosis,which were of 28 cases and 6 cases,respectively;60 healthy children were selected as the control group during the same period of time;venous blood was collected to test the PCT,LDH and CRP in the enrolled group,and the levels of LDH,CRP and PCT were compared between the groups,and the predictive value of different indexes for the early prediction of RMPP in children was also analyzed.Results The levels of LDH[(202±62)U/L vs.(367±61)U/L,t=16.380,P<0.001]、CRP[(5.1±1.1)mg/L vs.(30.6±3.5)mg/L,t=55.079,P<0.001],and PCT[(0.061±0.011)μg/L vs.(0.452±0.130)μg/L,t=23.167,P<0.001]in the MPP group were higher than those in the control group.The levels of LDH[(277±66)U/L vs.(403±55)U/L,t=9.477,P<0.001]、CRP[(21.3±2.1)mg/L vs.(39.9±3.3)mg/L,t=33.930,P<0.001]、PCT[(0.312±0.111)μg/L vs.(0.530±0.212)μg/L,t=6.748,P<0.001]in the RMPP group were higher than those in the GMPP group.The levels of LDH[(163±55)U/L vs.(224±60)U/L,t=2.534,P=0.016]、CRP[(4.8±1.1)mg/L vs.(8.9±1.5)mg/L,t=7.719,P<0.001],and PCT[(0.081±0.020)μg/L vs.(0.130±0.052)μg/L,t=4.118,P<0.001]in the ineffective group were higher than those in the effective group.The areas under the curves of the evaluative values of PCT,LDH and CRP for RMPP in children(AUC)were 0.715,0.771,and 0.805,respectively;sensitivity was 66.7%,69.3%,and 75.5%,respectively;and specificity was 76.0%,82.6%,and 87.1%,respectively.Conclusion The application value of serum LDH,PCT and CRP in the early prediction of RMPP in children is high,which can provide a reliable basis for the diagnosis and treatment of the disease.
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