外周血WBC、ESR、CRP水平对难治性肺炎支原体肺炎患儿并发肝损害的预测分析

Predictive values of peripheral blood WBC,ESR and CRP levels for liver damage in children with refractory Mycoplasma pneumoniae pneumonia

目的分析外周血白细胞计数(WBC)、红细胞沉降率(ESR)、C反应蛋白(CRP)水平对难治性肺炎支原体肺炎患儿并发肝损害的预测价值。方法选取2018年7月至2022年3月徐州医科大学附属徐州儿童医院收治的268例难治性肺炎支原体肺炎患儿设为研究组,另选取同期在该院体检的256例健康儿童设为对照组。检测并对比两组的外周血WBC、ESR、CRP水平。根据并发肝损害的情况将研究组患儿分为并发组和未并发组,对比两组外周血WBC、ESR、CRP水平。采用Logistic回归分析法分析难治性肺炎支原体肺炎患儿并发肝损害的影响因素,采用受试者工作特征(ROC)曲线分析外周血WBC、ESR、CRP水平对难治性肺炎支原体肺炎患儿并发肝损害的预测价值。结果研究组的外周血WBC、ESR、CRP水平高于对照组(P<0.05);难治性肺炎支原体肺炎患儿肝损害的发生率为14.93%,并发组的外周血WBC、ESR、CRP水平高于未并发组(P<0.05);热程、胸腔积液、心肌损害、D-二聚体水平以及外周血WBC、ESR、CRP水平均是难治性肺炎支原体肺炎患儿并发肝损害的影响因素(P<0.05);外周血WBC、ESR、CRP水平联合预测难治性肺炎支原体肺炎患儿并发肝损害的灵敏度、特异度、曲线下面积(AUC)分别是95.00%、78.51%、0.902,联合预测的灵敏度和AUC均高于单独预测(P<0.05),特异度与单独预测差异无统计学意义(P>0.05)。结论与健康儿童相比,难治性肺炎支原体肺炎患儿外周血WBC、ESR、CRP水平升高,而且这3项指标均为难治性肺炎支原体肺炎患儿并发肝损害的影响因素,对肝损害发生情况具有一定的预测价值,但3项指标联合预测价值更高。

Objective To analyze the predictive values of peripheral blood white blood cell count(WBC),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)levels for liver damage in children with refractory Mycoplasma pneumoniae pneumonia.Methods Totally 268 children with refractory Mycoplasma pneumoniae pneumonia admitted to the hospital from July 2018 to March 2022 were enrolled as the research group,and 256 healthy children who underwent health examination in the hospital during the same period were enrolled as the control group.The levels of peripheral blood WBC,ESR and CRP in the two groups were detected and compared.In addition,the children in the research group were divided into the concurrent group and the non-concurrent group according to the situation of liver damage,and the levels of peripheral blood WBC,ESR and CRP in the two groups were compared.Logistic regression analysis was used to analyze the influencing factors of liver damage in children with refractory Mycoplasma pneumoniae pneumonia,and the receiver operating characteristic(ROC)curve was used to analyze the predictive values of peripheral blood WBC,ESR and CRP levels on liver damage in children with refractory Mycoplasma pneumoniae pneumonia.Results The levels of peripheral blood WBC,ESR and CRP in the research group were higher than those in the control group(P<0.05).The incidence rate of liver damage in children with refractory Mycoplasma pneumoniae pneumonia was 14.93%,and the levels of peripheral blood WBC,ESR and CRP in the concurrent group were higher than those in the non-concurrent group(P<0.05).Fever process,pleural effusion,myocardial damage,D-dimer data and the levels of peripheral blood WBC,ESR and CRP were the influencing factors of liver damage in children with refractory Mycoplasma pneumoniae pneumonia(P<0.05).The sensitivity,specificity and area under curve(AUC)of the combined prediction of peripheral blood WBC,ESR and CRP levels for liver damage in children with refractory Mycoplasma pneumoniae pneumonia were 95.00%,78.51%and 0.902 respectively,and the sensitivity and AUC of the combined prediction were higher than those of the single prediction(P<0.05),but there was no significant difference in specificity between combined prediction and single prediction(P>0.05).Conclusion Compared with healthy children,the levels of peripheral blood WBC,ESR and CRP are higher in children with refractory Mycoplasma pneumoniae pneumonia,and they are the influencing factors of liver damage in children with refractory Mycoplasma pneumoniae pneumonia,and they have certain predictive value for the occurrence of liver damage,but the combined predictive value of the above three factors is more valuable.