白细胞计数及淋巴细胞亚群对肺炎支原体感染儿童病情判断价值

Valure of WBC count and lymphocyte subsets in judging the condition of children infected with Mycoplasma pneumoniae

目的探讨白细胞计数(WBC)及淋巴细胞亚群对肺炎支原体感染儿童的病情判断价值。方法选取2020年2月至2021年11月南京医科大学第四附属医院收治的296例肺炎支原体感染儿童作为观察组,根据其病情分为重症组(n=109)和轻症组(n=187),并选取同期来本院体检的健康儿童100名作为对照组,对其基本情况、血常规、淋巴细胞亚群资料进行收集,并分析与患儿病情相关的影响因素,采用ROC曲线分析其影响因素对患儿病情的诊断价值。结果白细胞计数:重症组>轻症组>对照组,差异有统计学意义(F=198.878,P<0.05)。CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、CD19^(+)水平:对照组>轻症组>重症组,差异有统计学意义(F=71.295、119.900、66.210、3.799、93.355,P<0.05)。各组的血红蛋白、血小板计数、NK细胞比较,差异无统计学意义(P>0.05)。多因素结果显示,白细胞计数、CD3^(+)、CD4^(+)、CD8^(+)、CD19^(+)是肺炎支原体感染儿童病情的影响因素(P<0.05)。Logistic回归模型预测方程为Y=1.213X1⁃0.894X2⁃1.062X3⁃0.875X4⁃-0.943X5+5.633,对肺炎支原体感染重症儿童预测的灵敏度为96.33%(105/109),特异度为86.10%(161/187),准确度为90.88%(269/296),构建ROC曲线AUC为0.889。结论联合检测白细胞计数、CD3^(+)、CD4^(+)、CD8^(+)、CD19^(+)水平对肺炎支原体感染儿童的病情判断具有很好的指导意义。

Objective To explore the value of white blood cell(WBC)and lymphocyte subsets in judging the condition of children infected with Mycoplasma pneumoniae.Methods 296 children with Mycoplasma pneumoniae infection treated in the Fourth Affiliated Hospital of Nanjing Medical University from February 2020 to November 2021 were selected as the observation group,and they were divided into the severe group(n=109)and the mild group(n=187)according to their condition.100 healthy children admitted to our hospital for physical examination in the same period were selected as the control group,and their basic condition,blood routine examination and lymphocyte subgroup data were collected,and the influencing factors related to their condition were analyzed,ROC curve was used to analyze the judgment value of its main influencing factors on the condition of children.Results White blood cell count:severe group>mild group>control group,the difference was statistically significant(F=198.878,P<0.05).The levels of CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),CD19^(+):control group>mild group>severe group,the difference was statistically significant(F=71.295,119.900,66.210,3.799,93.355,P<0.05).There was no significant difference in hemoglobin,platelet count and NK cells among the groups(P>0.05).The multi⁃factor results showed that white blood cell count,CD3^(+),CD4^(+),CD8^(+),CD19^(+)were the influencing factors of children infected with Mycoplasma pneumoniae(P<0.05).The multifactor results showed that leukocyte count,CD3^(+),CD4^(+),CD8^(+),CD19^(+)were the influencing factors of Mycoplasma pneumoniae infection in children(P<0.05).The prediction equation of logistic regression model is y=1.213 x 1⁃0.894 x 2⁃1.062 x 3⁃0.875 x 4⁃0.943 x 5+5.633.The sensitivity of prediction for children with severe Mycoplasma pneumoniae infection is 96.33%(105/109),the specificity is 86.10%(161/187),the accuracy is 90.88%(269/296),and the AUC of ROC curve is 0.889.Conclusion The combined detection of white blood cell count,CD3^(+),CD4^(+),CD8^(+),CD19^(+)levels has good guiding significance for the diagnosis of children with Mycoplasma pneumoniae infection.