D二聚体与肺炎支原体肺炎严重程度相关性分析

Analysis of the relationship between plasma levels of D-dimer and the severity of mycoplasma pneumoniae pneumonia

目的探讨通过D二聚体评估儿童肺炎支原体肺炎(MPP)严重程度的意义。方法回顾性分析2015年1月至2015年6月南京医科大学附属南京儿童医院呼吸科165例MPP住院患儿的临床资料,研究MPP患儿血浆D二聚体水平与临床表现、影像学特征及炎症指标之间的关系。结果 (1)165例MPP患儿中,重症95例,轻症70例,重症病例血浆D二聚体水平较轻症高,差异有统计学意义(P<0.01)。(2)影像学表现为肺实变(95例)、胸腔积液(68例)、肺不张(35例)的患儿血浆D二聚体水平较无相关表现者高,差异均有统计学意义(P<0.01)。(3)27例有肺外并发症患儿血浆D二聚体水平较无肺外并发症组高,差异有统计学意义(P<0.01)。(4)血浆D二聚体水平与MPP患儿热程、白细胞计数(WBC)、中性比例(N%)、C反应蛋白(CRP)、红细胞沉降率(ESR)呈正相关(P<0.01)。结论 MPP患儿血浆D二聚体水平能反映疾病严重程度,检测D二聚体水平有助于评估MPP病情,具有重要临床意义。

Objective To investigate the significance of D-dimer in the clinical evaluation of children with mycoplasma pneumoniae pneumonia （MPP）. Methods Retrospective analysis of clinical data of 165 cases of MPP hospitalized children from January 2015 to June 2015 was made, and the relationship of plasma D-dimer level with clinical manifestation, imaging features and inflammatory markers in children with MPP was studied. Results 1.Among 165 cases of MPP children, 95 cases were severe, while 70 cases were mild. The level of D-dimer in the severe cases was higher than that in the mild, the difference being statistically significant （P 〈 0.01 ）. 2.D-dimer levels of the cases who had the image feature of lung patchy shadow （95 cases） , pleural effusion （68 cases） , and atelectasis （35 cases） were obviously higher than those who had not （P 〈 0.01, respectively）. 3.The plasma D-dimer level in cases with extrapulmonary complications （27 cases） was higher than that in cases without extrapulmonary complications, and the difference was statistically significant （P〈 0.01）. 4.Positive correlation was found between level of D-dimer and fever procedure, white blood counts （WBC）, neutrophile granulecyte ratio （ N% ）, C -reactive protein （ CRP ）, as well as erythrocyte sedimentation rate （ESR） （all P 〈 0.01 ）. Conclusion The level of D-dimer in MPP patients can reflect the severity of the disease. Detection of D-dimer levels is helpful to evaluate the condition of MPP, which has important clinical significance.