肺炎支原体肺炎患儿血清D-二聚体和C反应蛋白及降钙素原水平变化的临床意义

Clinical significance of changes in serum D-dimer,Creactive protein and procalcitonin levels in children with mycoplasma pneumoniae pneumonia

目的探讨肺炎支原体肺炎(MPP)患儿血清D-二聚体(D-D)、C反应蛋白(CRP)和降钙素原(PCT)水平变化的临床意义。方法选取2020年1月至2022年1月于清流县总医院就诊的120例MPP患儿作为MPP组,根据疾病严重程度分为轻症组(n=76)与重症组(n=44),并以同期50名门诊体检正常儿童作为对照组,比较各组及MPP组不同病程分期患儿血清D-D、CRP和PCT水平。分析D-D、CRP、PCT与MPP病情严重程度相关性,绘制ROC曲线分析D-D、CRP、PCT单一检测与联合检测对MPP的诊断价值。结果重症组和轻症组血清D-D、CRP和PCT水平均高于对照组,且重症组高于轻症组(P<0.05)。MPP组恢复期患儿的D-D、CRP、PCT水平均低于急性期(P<0.05)。Spearman相关性分析结果显示,血清D-D、CRP和PCT与MPP病情严重程度均呈正相关(r>0,P<0.05)。ROC曲线分析结果显示,血清D-D、CRP、PCT三者联合检测的AUC、灵敏度和特异度均明显高于D-D、CRP、PCT单一检测(P<0.05)。结论血清D-D、CRP和PCT水平与MPP病情严重程度呈正相关,其水平能反映MPP患儿病情变化,可作为MPP患儿疗效评估的重要指标,三种指标联合检测的诊断价值更高。

Objective To investigate the clinical significance of changes in serum D-dimer(D-D),C-reactive protein(CRP)and procalcitonin(PCT)levels in children with mycoplasma pneumoniae pneumonia(MPP).Methods 120 children with MPP treated in Qingliu County General Hos-pital from January 2020 to January 2022 were selected as the MPP group,and they were divided into the mild group(n=76)and the severe group(n=44)according to the severity of the disease,50 normal children in outpatient physical examination in the same period were taken as the control group,and the levels of serum D-D,CRP and PCT among each group and children in the different of course of disease in the MPP group were compared.The correlations of D-D,CRP and PCT levels with the severity of MPP was analyzed.The ROC was drawn to analyze the diagnostic value of single and combined detection of D-D,CRP and PCT for MPP.Results The levels of serum D-D,CRP and PCT in the severe group and the mild group were higher than those in the control group,and the severe group was higher than the mild group(P<0.05).The levels of D-D,CRP and PCT in re-covery stage of children in the MPP group were significantly lower than those in the acute stage(P<0.05).Spearman correlation showed that serum D-D,CRP and PCT were positively correlated with the severity of MPP(r>0,P<0.05).ROC curve analysis showed that the AUC,sensitivity and specificity of combined detection of serum D-D,CRP and PCT were significantly higher than those of single detection of D-D,CRP and PCT(P<0.05).Conclusion The levels of serum D-D,CRP and PCT are positively correlated with the severity of MPP,can reflect the changes of the condi-tion of children with MPP,and can be used as important indicators for the efficacy evaluation of children with MPP,the combined detection of the three indicators has higher diagnostic value.