ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2022, Vol. 14 ›› Issue (1): 29-32.

• 临床研究 • 上一篇    下一篇

儿童重症肺炎支原体肺炎中D-二聚体水平的临床意义

  

  • 出版日期:2022-02-25 上线日期:2023-12-05

The clinical significance of D-dimer level in children with severe Mycoplasma pneumoniae pneumonia

  • Published:2022-02-25 Online:2023-12-05

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摘要： 目的 分析D-二聚体(D-D)水平对判断儿童肺炎支原体肺炎(MPP)病情严重程度的临床价值及对重症MPP(SMPP)早期识别的意义。方法 选取2018年8月至2020年12月于包头市第四医院儿科住院部收治的MPP患儿255例，其中包含SMPP患儿80例(SMPP组)及非SMPP患儿175例(非SMPP组)。观察比较SMPP组及非SMPP组D-D、外周血白细胞计数、中性粒细胞百分比、超敏C反应蛋白(hs-CRP)、铁蛋白、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)的水平变化。结果 (1)SMPP组中性粒细胞百分比、hs-CRP、铁蛋白、ALT、AST、LDH、D-D水平均高于非SMPP组(P<0.05);(2)Logistic多因素回归分析显示，hs-CRP、LDH、D-D为预测SMPP的独立危险因素(P<0.01);(3)hs-CRP、LDH及D-D的联合检测ROC曲线下面积为0.944,95%CI为0.909～0.979,敏感度及特异度分别高达为83.80%和95.40%;(4)D-D水平也具有良好的预测SMPP合并胸腔积液的能力(P<0.01);(5)SMPP患儿恢复期D-D水平较急性期明显下降。结论 (1)SMPP患儿的D-D水平显著升高；(2)D-D水平升高可作为SMPP和并发症发生的早期预测指标；(3)hs-CRP、LDH、D-D 3个指标的联合检测对判断患儿SMPP的发生具有一定指导价值，有助于SMPP的早期识别。

关键词: 肺炎支原体肺炎, D-二聚体, 超敏C反应蛋白, 乳酸脱氢酶, 儿童

Abstract: ObjectiveAnalyze the clinical value of D-dimer(D-D) level in judging the severity of childhood Mycoplasma pneumoniae pneumonia(MPP) and its significance in early identification of severe MPP.MethodsSelected 255 children with MPP admitted to the pediatric inpatient department of Baotou Fourth Hospital from August 2018 to December 2020,including 80 children with severe MPP(SMPP group) and 175 children with non-SMPP(non-SMPP group).Observe and compare the D-D,peripheral blood white blood cell (WBC),neutrophil percentage (NEU%),high sensitivity C-reactive protein (hs-CRP),ferritin (SF),changes in the levels of alanine aminotransferase (ALT),aspartate aminotransferase (AST) and lactate dehydrogenase (LDH).Results(1) The levels of NEU%,hs-CRP,SF,ALT,AST,LDH，D-D in SMPP group were higher than those in non-SMPP group(P<0.05);(2) Logistic multivariate regression analysis showed that hs-CRP,LDH,and D-D were independent risk factors for predicting SMPP(P<0.01);(3) The area under the ROC curve of hs-CRP,LDH and D-D combined detection is 0.944,95%CI is 0.909～0.979,sensitivity and specificity are as high as 83.80% and 95.40%,respectively;(4)D-D level also has a good ability to predict SMPP with pleural effusion(P<0.01);(5) The level of D-D in children with SMPP in the recovery phase was significantly lower than that in the acute phase.Conclusion(1)The D-D level of children with SMPP increased significantly;(2)Elevated D-D levels can be used as an early predictor of SMPP and complications;(3)The combined detection of the three indicators of hs-CRP,LDH,and D-D has certain guiding value for judging the occurrence of SMPP in children,and is helpful for early identification of SMPP.

Key words:

Mycoplasma pneumoniae pneumonia, D-dimer, Hypersensitive C-reactive protein, Lactate dehydrogenase, Children