肺炎支原体肺炎患儿血清D-二聚体和白细胞介素6水平变化的临床意义

Changes and clinical significance of D-dimer and interleukin-6 levels in children with Mycoplasma pneumoniae pneumonia

目的探讨肺炎支原体肺炎(MPP)患儿血清D-二聚体和白细胞介素6(IL-6)水平变化的临床意义。方法选取2017年11月至2018年12月河南省人民医院收治的MPP患儿106例,根据病情严重程度将患儿分为轻度MPP组(52例)和重度MPP组(54例),另选取58名健康儿童作为对照组。轻度和重度MPP组按照有无肺外并发症各分为2个亚组。受试者均进行血清D-二聚体和IL-6检测,观察这2种标志物的水平变化及相关性。结果重度MPP组D-二聚体及IL-6水平明显高于轻度MPP组和对照组[(505±188)μg/L比(336±87)、(66±22)μg/L,(149.1±60.6)ng/L比(72.9±25.6)、(6.6±2.8)ng/L],轻度MPP组D-二聚体及IL-6水平明显高于对照组,差异均有统计学意义(均P<0.05)。无论轻度MPP组还是重度MPP组,有肺外并发症者D-二聚体及IL-6水平高于无肺外并发症者,差异均有统计学意义(均P<0.05)。Spearman相关性分析结果显示,MPP患儿血浆D-二聚体水平与IL-6水平呈正相关(r=0.422,P<0.001)。结论MPP患儿D-二聚体和IL-6水平评估有助于了解病情和预测肺外并发症。

Objective To investigate the changes and clinical significance of D-dimer and interleukin-6(IL-6)levels in children with Mycoplasma pneumoniae pneumonia(MPP).Methods Totally 106 children with MPP admitted to Henan Provincial People's Hospital from November 2017 to December 2018 were selected.According to the severity of the disease,the patients were divided into mild MPP group(52 cases)and severe MPP group(54 cases),and 58 healthy children were selected as the control group.The mild and severe MPP groups were divided into 4 subgroups according to the presence or absence of extrapulmonary complications.D-dimer and IL-6 were detected in all subjects to observe the level changes and correlation of the two markers.Results The levels of D-dimer and IL-6 in severe MPP group were significantly higher than those in mild MPP group and control group[(505±188)μg/L vs(336±87),(66±22)μg/L;(149.1±60.6)ng/L vs(72.9±25.6),(6.6±2.8)ng/L];the levels of D-dimer and IL-6 in mild MPP group were significantly higher than those in control group,and the differences were statistically significant(all P<0.05).No matter mild MPP group or severe MPP group,the levels of D-dimer and IL-6 in patients with extrapulmonary complications were significantly higher than those without extrapulmonary complications(all P<0.05).Spearman correlation analysis showed that there was a positive correlation between plasma D-dimer level and IL-6 level in MPP children(r=0.422,P<0.001).Conclusion The levels of D-dimer and IL-6 in children with MPP increase,and the evaluation of them will be helpful for early understanding of the disease and prediction of extrapulmonary complications.