血浆D-二聚体、干扰素γ联合检测在评估小儿肺炎支原体肺炎中的临床意义

Clinical significance of combined detection of plasma D-dimer and interferon-γ in evaluating Mycoplasma pneumoniae pneumonia in children

目的探讨血浆D-二聚体、干扰素γ联合检测在评估小儿支原体肺炎中的临床意义.方法按病情严重程度,将2017年10月至2018年11月大同市第一人民医院儿童重症医学科、儿七科收治的85例小儿肺炎支原体肺炎(MPP)患者分为轻症MPP组(45例)和重症MPP组(40例),同期选取40例健康儿童作为对照组,测定并比较治疗前3组儿童D-二聚体、干扰素γ水平,比较治疗后2组MPP患者的表达水平变化及组间差异,并进一步比较轻、重症MPP组中有无合并肺外症状患者的差异.结果治疗前,轻症MMP组D-二聚体、干扰素γ表达水平明显高于对照组,并明显低于重症MPP组(P<0.05).治疗120 h后轻、重症MPP患者的血浆D-二聚体水平、干扰素γ水平显著降低,差异有统计学意义(P<0.05),重症MPP组显著高于轻症MPP组(P<0.05).重症MPP合并肺外症状组的D-二聚体水平明显高于重症MPP无肺外症状组、轻症MMP合并和不合并肺外症状组(P<0.05),重症MPP合并和不合并肺外症状组的干扰素γ水平均高于轻症MPP合并和不合并肺外症状组,重症MPP合并肺外症状组高于重症MPP无肺外症状组(P<0.05).结论D-二聚体和干扰素γ水平在MPP患儿中存在不同程度的升高,在MPP急性期及重症MPP时升高明显,通过检测D-二聚体和干扰素γ水平有助于MPP患儿的诊断、病情评估及预测重症MPP肺外并发症的发生,有利于指导临床治疗.

Objective To explore the clinical significance of plasma D-dimer and interferon-γ in the evaluation of mycoplasma pneumonia in children.Methods According to the illness severity,85 cases of pediatric mycoplasma pneumoniae pneumonia(M PP)patients infection in the PICU and Pediatrics Department Seven in the First People’s Hospital of Datong City,Shanxi Province from October 2017 to November 2018 were divided into the light MPP group(n=45)and the severe MPP group(n=40),at the same time selected 40 cases of healthy children as control group,to determine and compare the levels of the D-dimer and interferon-γ between the treatment of three groups,compare the two groups after treatment the changes of the expression level of MPP patients and differences between groups.Furthermore,to compare the difference between the light and the severe MPP group with or without extrapulmonary symptoms.Results Before treatment,the expression levels of D-dimer and interferon-γ in the light MPP group were significantly higher than those of in control group,and significantly lower than those of in the severe MPP group(P<0.05).After 120 hours of treatm ent,the plasma D-dimer and the interferon-γ level were significantly reduced in the light and severe MPP group,the difference was statistically significant(P<0.05),the level of the severe MPP group was significantly higher than the light MPP group(P<0.05).The level of D-dimer in the severe MPP with extrapulmonary symptoms group was significantly higher than the severe MPP without extrapulmonary symptoms group and the light MPP group with and without extrapulmonary symptoms group(P<0.05),the level of interferon-γ in the severe MPP group with and without extrapulmonary symptoms were higher than the light MPP group with and without extrapulmonary symptoms group,the severe MPP with extrapulmonary symptoms group was higher than the severe MPP without extrapulmonary symptoms group(P<0.05).Conclusions The D-dimer and the interferon-γ levels are increased to different degrees in MPP children,and are significantly increased in the acute phase of MPP and in the severe MPP.To detection of D-dimer and interferon-γ levels is helpful for diagnosis and disease evaluation of MPP children,to predict the occurrence of severe MPP extrapulmonary complications.It is helpful to guide clinical treatment.