淋巴细胞亚群绝对计数与难治性肺炎支原体肺炎患儿的早期预测关系分析

Analysis of the relationship between absolute count of lymphocyte subsets and early prediction of children with refractory mycoplasma pneumoniae

目的研究分析淋巴细胞亚群绝对计数与难治性肺炎支原体肺炎(RMMP)患儿的早期预测关系。方法纳入我院从2018年5月-2019年5月收治的肺炎支原体肺炎(MPP)患儿100例进行研究。将其按照类型的不同分为RMMP组26例与普通MPP组76例。比较两组基线资料(主要涵盖年龄、病程、住院天数、肺实变以及胸腔积液等),外周血淋巴细胞绝对计数,外周血C反应蛋白(CRP)、降钙素原(PCT)、乳酸脱氢酶(LDH)水平。并予以受试者工作特征(ROC)曲线分析淋巴细胞亚群绝对计数在RMMP中的诊断效能。结果 RMMP组年龄以及肺实变、胸腔积液发生率均显著高于普通MPP组,且住院时间长于普通MPP组(均P<0.05)。RMMP组外周血CD3^+、CD56^+绝对计数均显著高于普通MPP组,而CD4^+、CD19^+绝对计数均显著低于普通MPP组(均P<0.05)。经ROC曲线分析可得:CD3^+、CD4^+、CD19^+、CD56^+绝对计数预测RMMP的敏感性分别为87%、90%、83%、74%,特异性分别为76%、71%、80%、64%,而上述指标联合诊断RMMP的敏感性、特异性分别97%、91%。RMMP组外周血CRP、LDH水平均显著高于普通MPP组(均P<0.05)。结论外周血CD3^+、CD4^+、CD19^+、CD56^+绝对计数预测RMMP具有较高的敏感性以及特异性,可作为RMMP的潜在预测指标。

Objective To study and analyze the relationship between lymphocyte subgroup absolute count and early prediction of children with refractory mycoplasma pneumoniae pneumonia(RMMP).Methods 100 children with mycoplasma pneumoniae pneumonia(MPP)admitted to our hospital from May 2018 to May 2019 were included in the study.The patients were divided into the RMMP group(26 cases)and the ordinary MPP group(76 cases).Their baseline data of the two groups were compared(mainly including age,course of disease,duration of hospital stay,pulmonary consolidation and pleural effusion,etc.),and the levels of absolute lymphocyte count in peripheral blood,C-reactive protein(CRP),procalcitonin(PCT)and lactate dehydrogenase(LDH)in peripheral blood were also compared.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of lymphocyte subsets in RMMP.Results The age,incidence of pulmonary consolidation and pleural effusion in the RMMP group were significantly higher than those in the ordinary MPP group,and the duration of hospital stay was longer than that in the ordinary MPP group(all P<0.05).The absolute counts of CD3^+ and CD56^+ in peripheral blood of the RMMP group were significantly higher than those of the ordinary MPP group,while the absolute counts of CD4^+ and CD19^+ were significantly lower than those of the ordinary MPP group(all P<0.05).According to ROC curve analysis,the sensitivity of absolute counts of CD3^+,CD4^+,CD19^+ and CD56^+ predicting RMMP was 87%,90%,83% and 74% respectively,and the specificity was 76%,71%,80% and 64% respectively,while the sensitivity and specificity rose to 97%and 91% respectively in the combined diagnosis of RMMP by the above indicators.The levels of CRP and LDH in peripheral blood of the RMMP group were significantly higher than those of the ordinary MPP group(all P<0.05).Conclusion The absolute counts of CD3^+,CD4^+,CD19^+ and CD56^+ inperipheral blood have high sensitivity and specificity in predicting RMMP,and they can be used as potential predictors of RMMP.