乳酸脱氢酶、天冬氨酸转氨酶、C反应蛋白对小儿难治性肺炎支原体肺炎的早期诊断价值分析

Value of lactate dehydrogenase,aspartate aminotransferase and C⁃reactive protein in early diag⁃nosis of refractory Mycoplasma pneumonia in children

目的探讨乳酸脱氢酶(LDH)、天冬氨酸转氨酶(AST)、C反应蛋白(CRP)在小儿难治性肺炎支原体肺炎诊断中的作用。方法选取2017年10月至2020年10月在院治疗的小儿肺炎支原体肺炎283例(支原体肺炎组),其中难治性患儿80例,普通性患儿203例,同时选取健康儿童200例作为对照组,检测血清LDH、AST和CRP水平。结果支原体肺炎组血清LDH、AST和CRP分别为(359.39±30.03)IU/L、(34.93±5.20)U/L和(54.49±26.82)mg/L,高于对照组(P<0.05);难治性患儿血清LDH、AST和CRP分别为(390.41±38.48)IU/L、(48.49±13.10)U/L和(62.82±21.92)mg/L,高于普通性(P<0.05);血清LDH和CRP判断难治性肺炎支原体肺炎的ROC曲线下面积分别为0.847和0.598,P<0.05,截断值分别为370.74IU/L和60.85mg/L,灵敏度分别为71.30%和52.50%,特异度分别为83.25%和67.00%;血清AST判断难治性肺炎支原体肺炎的ROC曲线下面积为0.538,P>0.05。结论小儿肺炎支原体肺炎血清LDH、AST和CRP升高,尤其难治性患儿明显升高,其中血清LDH和CRP有助于难治性肺炎支原体肺炎的诊断。

Objective To explore the role of lactate dehydrogenase(LDH),aspartate aminotransferase(AST)and C⁃re⁃active protein(CRP)in the diagnosis of refractory Mycoplasma pneumonia in children.Methods 283 children with myco⁃plasma pneumonia treated in hospital from October 2017 to October2020(mycoplasma pneumonia group),including 80 re⁃fractory children and 203 normal children,200 healthy children were selected as control group,serum LDH,AST and CRP levels were measured.Results The serum LDH,AST and CRP in mycoplasma pneumonia group were(359.39±30.03)IU/L,(46.93±12.20)U/L and(54.49±26.82)mg/L,which were significantly higher than those in control group(P<0.05);The serum LDH,AST and CRP of refractory children were(390.41±38.48)IU/L,(48.49±13.10)U/L and(62.82±21.92)mg/L,which were significantly higher than those of normal children(P<0.05);Area under ROC curve of detection of refractory Mycoplasma Pneumonia by serum LDH and CRP were 0.847 and 0.598,P<0.05,the cut⁃off values were 370.74IU/L and 60.85mg/L,the sensitivity were 71.30%and 52.50%,and the specificity were 83.25%and 67.00%;The area under ROC curve of detection of refractory Mycoplasma pneumonia by AST showed that was 0.538,P>0.05.Conclusion Serum LDH,AST and CRP in children with Mycoplasma pneumoniae pneumonia are increased signifi⁃cantly,especially in children with refractory pneumonia,serum LDH and CRP are helpful in the diagnosis of refractory My⁃coplasma pneumonia.