乳酸脱氢酶与白蛋白比值和重症肺炎患儿预后的关系

Relationship Between Lactate Dehydrogenase and Albumin Ratio and Prognosis of Children with Severe Pneumonia

目的分析乳酸脱氢酶(LDH)与白蛋白(ALB)比值与重症肺炎患儿预后的关系。方法前瞻性纳入河南省直第三人民医院2020年10月至2022年11月收治的86例重症肺炎患儿,检测所有患儿治疗前LDH、ALB、C-反应蛋白(CRP)、D-二聚体、降钙素原(PCT)水平,并计算LDH/ALB值。患儿入院后随访1个月,观察并统计预后情况,根据预后情况将患儿分为存活组和病死组。比较两组患儿一般资料、LDH/ALB值,采用点二列相关性分析LDH/ALB值与预后的关系,采用受试者工作特征(ROC)曲线分析LDH/ALB值对重症肺炎患儿预后结局的预测价值。结果86例重症肺炎患儿入院1个月内,共有10例患儿病死,占比11.63%。两组性别、年龄、体重指数、就诊时发病时间、疾病类型、早产情况及ALB、D-二聚体、PCT水平比较,差异无统计学意义(P>0.05)。病死组LDH水平、LDH/ALB值、CRP水平高于存活组(P<0.05);经点二列相关性分析,LDH水平、LDH/ALB值与重症肺炎患儿预后情况呈正相关(r>0,P<0.05)。ROC曲线结果显示,LDH水平、LDH/ALB值预测重症肺炎患儿预后的曲线下面积(AUC)>0.7,具有一定预测价值。结论LDH/ALB值与重症肺炎患儿预后情况具有相关性,且LDH/ALB值对预后结局具有一定预测价值,LDH/ALB值越高,病死风险越大。

Objective To analyze the relationship between lactate dehydrogenase(LDH)and albumin(ALB)ratio and prognosis of children with severe pneumonia.Methods A total of 86 children with severe pneumonia admitted to Henan NO.3 Provincial People’s Hospital from October 2020 to November 2022 were prospectively included.All children were tested for LDH,ALB,C-reactive protein(CRP),D-dimer,procalcitonin(PCT)levels before treatment,and the LDH/ALB was calculated.Children were followed up for 1 month after admission to observe and count the prognosis.The children were divided into survival group and death group according to the prognosis.The baseline data and LDH/ALB were compared in both groups.The relationship between LDH/ALB and prognosis was analyzed by point binary correlation.The predictive value of LDH/ALB for the prognosis of children with severe pneumonia was analyzed using receiver operating characteristic(ROC)curve.Results Within one month after the admission of 86 children with severe pneumonia,10 children died,accounting for 11.63%.The difference was not statistically significant in both groups in gender,age,body mass index,number of days of onset,type of disease and premature delivery,and the levels of ALB,D-dimer and PCT(P>0.05).The LDH level,LDH/ALB and CRP level in the death group were higher than those in the survival group(P<0.05).By point binary correlation analysis,the LDH level and LDH/ALB were positively correlated with the prognosis of children with severe pneumonia(r>0,P<0.05).The ROC curve result showed that the area under the curve(AUC)of LDH level and LDH/ALB in predicting the prognosis of children with severe pneumonia was more than 0.7,which had certain predictive value.Conclusion The LDH/ALB is correlated with the prognosis of children with severe pneumonia,and the LDH/ALB has a certain predictive value for the prognosis.The higher the LDH/ALB,the greater the risk of death.