The Change of Monocyte/HDL-C Ratio in Children with Community Acquired Pneumonia and Its Predictive Value for Myocardial Injury
Objectives To explore the relationship and predictive value of MHR changes with myocardial injury in children with CAP,provide theoretical support for clinical prevention and treatment of myocardial injury in children with CAP.Methods From December 31st,2020 to December 31st,2022,80 children with CAP among who were diagnosed and treated in a certain hospital were randomly selected as the observation group,and 80 healthy children matched according to age and gender during the same period were selected as the control group.Monocyte and HDL-C were detected in the observation group at admission and in the control group at physical examination,and MHR was calculated.The incidence of myocardial injury in the observation group during hospitalization was statistically analyzed.The incidence of myocardial injury in children with different MHR levels was compared.The independent relationship between MHR and myocardial injury in children with CAP was analyzed,and the value of MHR in predicting myocardial injury in children with CAP was evaluated.The restricted cubic spline model(RCS)was used to analyze whether there was a nonlinear correlation between MHR and myocardial injury in children with CAP.Results Monocyte and MHR in observation group were higher than control group,while HDL-C was lower than control group(P＜0.05).The incidence of myocardial injury in 80 children with CAP was 41.25%(33/80).With the increase of MHR,the incidence of myocardial injury showed an increasing trend.According to Logsitic regression model analysis,MHR level was still independently correlated with myocardial injury in children with CAP after adjusting for confounding factors(P＜0.05).The AUC value of MHR was 0.810,the confidence interval was 0.707-0.889,and the highest Youden index was 0.517.The sensitivity was 87.88%and the specificity was 63.83%.There was a nonlinear dose-response relationship between MHR and the myocardial injury rate in children with CAP(P=0.036),and the curve was roughly"J"shape.When MHR≥0.70,there was a positive correlation between MHR and the myocardial injury rate in children with CAP(β =1.142,95%CI= 1.189-8.253,P=0.034).Conclusions MHR in children with CAP was significantly increased,and the more significant the increase in MHR,the greater the risk of myocardial injury in children,and the two showed a roughly"J"shaped relationship.When MHR≥0.70,the prediction of myocardial injury was higher.
ChildrenCommunity acquired pneumoniaMonocyte HDL-C ratioMyocardial injuryPredictive value
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