D-二聚体、乳酸脱氢酶、CRP在儿童难治性肺炎支原体肺炎中的预测价值研究

The Predictive Value of D-dimer,Lactate Dehydrogenase and CRP in Children with Refractory Mycoplasma Pneumoniae Pneumonia

目的研究D-二聚体、乳酸脱氢酶、CRP对儿童难治性肺炎支原体肺炎(refractory mycoplasma pneumoniae pneumonia,RMPP)的预测价值。方法选取2020年1月~2022年5月南京鼓楼医院集团宿迁医院收治的42例RMPP患儿(RMPP组)和77例普通性肺炎支原体肺炎(general mycoplasma pneumoniae pneumonia,GMPP)患儿(GMPP组)作为研究对象。比较两组患儿D-二聚体、乳酸脱氢酶和CRP水平差异,并绘制三项指标对RMPP的评估价值ROC曲线,找到各预测指标诊断价值最大的cut off值并确定其灵敏度和特异度。结果RMPP组患儿的D二聚体、乳酸脱氢酶和CRP均高于GMPP组,差异有统计学意义(P<0.05)。ROC曲线显示D-二聚体、乳酸脱氢酶和CRP的AUC值分别为0.888、0.770和0.798;灵敏度分别为69.02%、66.71%和71.43%;特异度分别为98.73%、85.72%和87.01%。结论儿童外周血中D-二聚体、乳酸脱氢酶和CRP浓度对预测RMPP具有一定的价值。3项指标中灵敏度最佳和特异度最佳分别为CRP和D-二聚体。

Objective To explore the predictive value of D-dimer,lactate dehydrogenase and CRP in children with refractory mycoplasma pneumoniae pneumonia.Methods Forty-two cases of Refractory Mycoplasma pneumoniae pneumonia admitted to the Suqian Hospital of Nanjing Drum Tower Hospital Group from January 2020 to May 2022 were selected.Children with RMPP(RMPP group)and 77 children with general Mycoplasma pneumoniae pneumonia(GMPP group)were included in this study.The diff erence of D-dimer,lactate dehydrogenase and CRP concentration levels between the two groups was compared,and the ROC curve of the evaluation value of the three indicators for RMPP was drawn to fi nd the maximum cut off value of each predictor and determine its sensitivity and specifi city.Results The levels of D-dimer,lactate dehydrogenase and CRP in RMPP group were higher than those in GMPP group,and the diff erences were statistically signifi cant(P<0.05).ROC curve showed that the AUC values of D-dimer,lactate dehydrogenase and CRP were 0.888,0.770 and 0.798,respectively.The sensitivity was 69.02%,66.71%and 71.43%,respectively.The specificity was 98.73%,85.72%and 87.01%,respectively.Conclusion The concentrations of D-dimer,lactate dehydrogenase and CRP in peripheral blood of children have certain value in predicting RMPP.The best sensitivity and specifi city were CRP and D-dimer,respectively.