儿童难治性肺炎支原体肺炎早期诊断生物学标志物的研究

Study of early diagnostic biomarkers of refractory Mycoplasma pneumoniae pneumonia in children

目的探索能够早期识别儿童难治性肺炎支原体肺炎(RMPP)的生物学标志物。方法选择67例RMPP患儿(RMPP组)及70例普通肺炎支原体肺炎(MPP)患儿(MPP组),收集2组患儿应用大环内酯类药物治疗72 h后的ESR、降钙素原、CRP、乳酸脱氢酶(LDH)及可溶性E-选择素(sE-选择素)水平,比较组间差异,并进行多因素Logistic回归分析。结果RMPP组患儿的LDH、D-二聚体、ESR、sE-选择素水平均高于MPP组患儿(P均<0.05)。多因素Logistic回归分析示LDH(OR=1.016,95%CI 1.004~1.028)、D-二聚体(OR=1.005,95%CI 1.001~1.008)、sE-选择素(OR=1.342,95%CI 1.210~1.660)、ESR(OR=1.343,95%CI 1.164~1.549)均与儿童RMPP有关,ROC曲线分析显示sE-选择素、LDH、ESR和D-二聚体的曲线下面积分别为0.842、0.732、0.839及0.731(P均<0.001)。结论sE-选择素、D-二聚体、血清LDH、ESR是早期诊断RMPP的潜在生物学标志物。

Objective To explore the early diagnostic biomarkers of refractory Mycoplasma pneumoniae pneumonia(RMPP)in children.Methods Sixty-seven RMPP children(RMPP group)and 70 children with conventional Mycoplasma pneumoniae pneumonia(MPP,MPP group)were recruited in this study.The erythrocyte sedimentation rate(ESR),procalcitonin,C-reactive protein(CRP),lactate dehydrogenase(LDH)and soluble E-selectin(sE-selectin)levels were detected and statistically compared between two groups after macrolides therapy for 72 h.Multivariate Logistic regression analysis was performed.Results In the RMPP group,the levels of LDH,D-dimer,ESR and sE-selectin were significantly higher compared with those in the MPP group(all P<0.05).Multivariate Logistic regression analysis indicated that LDH(OR=1.016,95%CI 1.004-1.028),D-dimer(OR=1.005,95%CI 1.001-1.008),sE-selectin(OR=1.342,95%CI 1.210-1.660)and ESR(OR=1.343,95%CI 1.164-1.549)were correlated with the incidence of pediatric RMPP.ROC curve analysis demonstrated that the area under ROC curve of sE-selectin,LDH,ESR and D-dimer was 0.842,0.732,0.839 and 0.731,respectively(all P<0.001).Conclusion The serum E-selectin,LDH,D-dimer and ESR are potential biomarkers for the early diagnosis of RMPP.