血液流变学检测在小儿肺炎支原体肺炎病情判断中的应用

Application of Hemorheology in judging the condition of Mycoplasma pneumoniae pneumonia in children

目的:探讨血液流变学检测对小儿肺炎支原体肺炎(MPP)急性期病情轻重程度的判断价值。方法:选取2020年1月~2021年12月在深圳市南山区妇幼保健院儿科病房住院的MPP患儿112例,其中普通肺炎支原体肺炎组(GMPP)57例和重症肺炎支原体肺炎组(SMPP)55例,比较两组患儿的性别构成、年龄、体重指数及血液流变学指标的差异性,将有统计学意义的指标进行多因素Logistic回归分析,并绘制受试者工作特征(ROC)曲线,分析其对急性期MPP病情轻重的判断价值。结果:①两组患儿年龄、体重指数及性别构成差异均无统计学意义(P>0.05)。②SMPP组患儿的全血黏度(高、中、低切)、低切还原黏度、血浆黏度、红细胞聚集指数、红细胞电泳时间及红细胞压积均高于GMPP组患儿,而红细胞变形指数低于GMPP组患儿,差异均具有统计学意义(P<0.001)。③低切黏度(OR=1.537,95%CI:1.073~2.201)及血浆黏度(OR=1.568,95%CI:1.163~2.114)是急性期SMPP发生的独立危险因素(P<0.05)。④全血低切黏度>14.77 mPa·s、血浆黏度>2.00 mPa·s对于判断急性期SMPP有较高价值(AUC=0.87、0.86,P<0.001)。结论:SMPP患儿与GMPP血液流变学变化不同,全血低切黏度、血浆黏度可作为急性期MPP病情轻重程度的判断指标。

Objective To explore the value of Hemorheology in judging the severity of acute Mycoplasma pneumoniae pneumonia(MPP)in children.Method 112 children with MPP hospitalized in the pediatric ward of Shenzhen Nanshan maternal and Child Health Hospital from January 2020 to December 2021 were selected,including 57 cases in the general mycoplasma pneumonia group(GMPP)and 55 cases in the severe mycoplasma pneumonia group(SMPP).The differences of gender composition,age,body mass index and hemorheological indexes between the two groups were compared.The statistically significant indexes were analyzed by multivariate logistic regression.Draw the receiver operating characteristic curve(ROC)to analyze its value in judging the severity of acute MPP.Results①There was no significant difference in age,body mass index and gender composition between the two groups(P>0.05).②The whole blood viscosity(high,medium and low shear),low shear reduction viscosity,plasma viscosity,erythrocyte aggregation index,erythrocyte electrophoresis time and hematocrit of children in SMPP group were higher than those of children in GMPP group,while the erythrocyte deformation index was lower than that of children in GMPP group,with statistical significance(P<0.001).③Low shear viscosity(OR=1.537,95%CI:1.073~2.201)and plasma viscosity(OR=1.568,95%CI:1.163~2.114)were independent risk factors for SMPP in acute stage(P<0.05).④The whole blood low shear viscosity>14.77 mPa·s and plasma viscosity>2.00 mPa·s were of high value in judging SMPP in acute stage(AUC=0.87、0.86,P<0.001).Conclusion The changes of Hemorheology in SMPP children are different from those in GMPP.The whole blood low shear viscosity and plasma viscosity can be used as the indexes to judge the severity of MPP in the acute phase.