D-二聚体升高肺炎支原体肺炎患儿的临床特点及治疗方法探讨

目的探讨D-二聚体(D-D)升高肺炎支原体肺炎患儿的临床特点及治疗方法。方法选取2018年1月至12月收治的180例肺炎支原体肺炎患儿的临床资料,将其按照血浆D-D水平分为A组(≥500μg/L)和B组(<500μg/L),其中A组102例,B组78例,分别对A、B两组入院时的热峰、热程及白细胞计数、中性粒细胞比例、C反应蛋白(CRP)、乳酸脱氢酶(LDH)、降钙素原(PCT)、支气管镜下表现,肺内并发症、肺外并发症的发病率进行分析。并将A组随机分为观察组和对照组,每组各51例,两组均积极抗感染及其他常规治疗,其中观察组给予皮下注射低分子肝素进行治疗,比较观察组和对照组两组患儿的热退时间、咳嗽好转时间、肺部影像学好转时间、住院天数。结果A组的D-D、热峰、热程及白细胞计数(WBC)、中性粒细胞比例(NE)、CRP、LDH、PCT、肺外并发症发病率均显著高于B组(均P<0.05)。两组患儿的热退时间比较差异无统计学意义(P>0.05),观察组的热退时间、咳嗽好转时间、肺部影像学好转时间和住院天数均显著低于对照组(均P<0.05)。结论D-D水平可以用于评估患儿机体的炎症反应程度,用于临床上早期预测肺炎支原体肺炎患儿机体感染的严重程度。低分子肝素可以显著改善D-D升高MPP患儿的肺微循环,促进肺部病区吸收,从而缩短病程,减少住院时间。

Objective To investigate the clinical features and treatment of D-dimer in children with mycoplasma pneumoniae.Methods The clinical data of 180 children with Mycoplasma pneumoniae pneumonia admitted to our hospital from January 2018 to December 2018 were divided into group A according to plasma D-dimer level(plasma D-dimer≥500μg/L)and group B(plasma D-dimer<500μg/L),including 102 patients in group A and 78 patients in group B.The heat peak,heat history and white blood cell count of patients in group A and group B were analyzed respectively.The incidence of neutrophils,CRP,LDH,PCT,bronchoscopy,intrapulmonary complications,and extrapulmonary complications were analyzed.Group A was randomly divided into observation group and control group according to random number method,51 cases in each group.Both groups were active anti-infective and other conventional treatments.The observation group was also given subcutaneous injection of low molecular weight heparin for treatment.The heat withdrawal time,cough improvement time,lung imaging improvement time,and hospitalization days of the two groups in the control group.Results In group A D-dimer,heat peak,heat history and white blood cell count(WBC),neutrophil ratio(NE),CRP,LDH,PCT and extrapulmonary complications were significantly higher than those in group B(all P<0.05).There was no significant difference in the heat withdrawal time between the two groups(P>0.05).The heat withdrawal time,cough improvement time,lung imaging improvement time and hospitalization days in the observation group were significantly lower than those in the control group(all P<0.05).Conclusion D-dimer levels can be used to assess the degree of inflammatory response in the body of the child for clinically early prediction of the severity of infection in children with pneumonia mycoplasma pneumonia.Low molecular weight heparin can significantly improve D-dimer elevation in the lung microcirculation of children with MPP,promote lung ward absorption,thereby shortening the course of disease and reducing hospital stay.