儿童大叶性肺炎严重程度与血浆D-二聚体的相关性

Correlation between severity of lobar pneumonia and plasma D-dimer in children

目的探讨儿童大叶性肺炎严重程度与血浆D-二聚体的关系。方法回顾性分析2016年9月-2017年3月该院小儿呼吸二科收治住院的120例大叶性肺炎患儿临床病例,根据血浆D-二聚体水平将D-二聚体≥1 000μg/L的作为试验组,血浆D-二聚体<1 000μg/L为对照组,每组各60例。研究大叶性肺炎患儿血浆D-二聚体水平与炎症指标和临床表现间的关系。另根据血清支原体抗体结果及外周血细菌培养结果将其分为细菌感染组24例(外周血细菌培养结果为阳性,血清肺炎支原体抗体为阴性),支原体感染组16例(外周血细菌培养结果为阴性,血清肺炎支原体抗体为阳性),细菌并支原体感染组52例(外周血细菌培养结果和血清支原体抗体均为阳性)及其他组28例(外周血细菌培养结果和血清支原体抗体均为阴性),研究大叶性肺炎患儿血浆D-二聚体水平与病原体感染之间的关系。结果 120例大叶性肺炎患儿中,试验组D-二聚体水平较对照组高(P<0.05);试验组患儿肺内并发症的比例较对照组患儿高(P<0.05);试验组患儿肺外并发症发生率较对照组患儿高(P<0.05);试验组患儿的炎性指标,热程、白细胞计数(WBC)、中性粒细胞比例(NE)、C-反应蛋白(CRP)、红细胞沉降率(ESR)等与对照组相比差异有统计学意义(P<0.05)。细菌并支原体感染组肺内并发症发生率及D-二聚体平均值较仅细菌感染组、支原体感染组和其他组高(P<0.01)。结论大叶性肺炎患儿血浆D-二聚体水平可以反映疾病严重程度,D-二聚体水平可以作为大叶性肺炎严重程度的评价指标。

Objective To explore the relationship between severity of lobar pneumonia and plasma D-dimer in children.Methods The clinical data of 120 children with lobar pneumonia treated in the Second Department of Pediatric Respiration in the hospital from September 2016 to March 2017 was analyzed retrospectively,then the children were divided into experimental group（ plasma D-dimer level≥1 000 μg/L） and control group（ plasma D-dimer level1 000 μg/L）,60 children in each group. The relationships between plasma D-dimer level and inflammatory biomarkers,clinical manifestations were researched. All the children were divided into bacterial infection group（ 24 children with positive result of bacterial culture in peripheral blood and negative serum Mycoplasma pneumoniae antibody）,mycoplasma infection group（ 16 children with negative result of bacterial culture in peripheral blood and positive serum Mycoplasma pneumoniae antibody）,bacterial and mycoplasma infection group（ 52 children with positive result of bacterial culture in peripheral blood and serum Mycoplasma pneumoniae antibody）,and other group（ 28 children with negative result of bacterial culture in peripheral blood and serum Mycoplasma pneumoniae antibody） according to the results of serum Mycoplasma pneumoniae antibody and bacterial culture in peripheral blood.The relationship between pathogen infection and plasma D-dimer level in children with lobar pneumonia was researched. Results The level of serum D-dimer in experimental group was statistically significantly higher than that in control group（ P〈0. 05）. The proportion of children with intrapulmonary complications in experimental group was statistically significantly higher than that in control group（ P〈0. 05）. The incidence rate of extrapulmonary complications in experimental group was statistically significantly higher than that in control group（ P〈0. 05）. There were statistically significant differences in inflammatory indicators,duration of fever,white blood cell count（ WBC）,proportion of neutrophils（ NE）,C-reactive protein（ CRP）,erythrocyte sedimentation rate（ ESR） between experimental group and control group（ P〈0. 05）. The incidence rate of intrapulmonary complications and mean value of D-dimer in bacterial and mycoplasma infection group were statistically significantly higher than those in bacterial infection group,mycoplasma infection group,and other group（ P〈0. 01）. Conclusion Plasma D-dimer level can reflect the severity of lobar pneumonia in children,which can be used as an evaluaution index for severity of lobar pneumonia.