外周血白细胞分类和PCT、CRP、肺炎支原体抗体水平对儿童肺炎支原体合并细菌性感染肺炎的早期诊断价值

Early Diagnostic Value of Peripheral Blood Leukocyte Classification and Levels of PCT,CRP,and Mycoplasma Pneumoniae Antibodies in Children with Mycoplasma pneumoniae Complicated with Bacterial Infection Pneumonia

目的探究外周血白细胞分类和降钙素原(Procalcitonin,PCT)、C-反应蛋白(C-reaction protein,CRP)、肺炎支原体抗体水平对儿童肺炎支原体合并细菌性感染性肺炎的早期诊断价值。方法选取2020年7月—2023年3月于北京市昌平区中西医结合医院接受治疗的500例肺炎支原体合并细菌性感染肺炎患儿为研究组,另取同期于北京市昌平区中西医结合医院接受治疗的100例病毒感染性肺炎患儿为病例对照组,选择同期体格检查的100例健康儿童为对照组,分别检测其血样中PCT、CRP、肺炎支原体抗体IgM、外周血白细胞分类指标(白细胞计数、中性粒细胞百分数、淋巴细胞百分数、单核细胞百分数)水平,对比两组儿童上述指标差异,采用绘制受试者操作曲线(Receiver operating characteris,ROC)的方式分别计算上述指标对肺炎支原体合并细菌性感染肺炎的诊断价值,并计算其曲线下面积(area under curv,AUC)。结果研究组患儿的血样PCR、CRP以及肺炎支原体抗体IgM水平均显著高于病例对照组和对照组儿童(P<0.05);研究组患儿外周血白细胞计数、中性粒细胞百分数和单核细胞百分数均显著高于病例对照组和对照组儿童,淋巴细胞百分数显著低于对照组儿童(P<0.05);通过绘制ROC曲线并计算得知,PCT、CRP以及肺炎支原体抗体IgM对肺炎支原体合并细菌性感染肺炎的诊断曲线下面积(AUC)分别为0.934(95%CI=0.900~0.968,P<0.001)、0.928(95%CI=0.880~0.975,P<0.001)、0.780(95%CI=0.712~0.848,P<0.001);外周血白细胞分类中的白细胞计数、中性粒细胞百分数、淋巴细胞百分数以及单核细胞百分数对肺炎支原体合并细菌性感染肺炎的诊断AUC分别为0.957(95%CI=0.925~0.988,P<0.001)、0.768(95%CI=0.700~0.836,P<0.001)、0.670(95%CI=0.595~0.746,P<0.001)、0.765(95%CI=0.698~0.832,P<0.001)。结论肺炎支原体合并细菌性感染肺炎患儿血样PCT、CRP、肺炎支原体抗体IgM均较健康儿童出现显著升高,白细胞分类水平也出现明显变化,上述指标在肺炎支原体合并细菌性感染肺炎患儿早期诊断中具有较好的应用价值。

Objective To explore the early diagnostic value of the classification of peripheral blood leukocytes and the levels of Calcitonin(PCT),C-reaction protein(CRP),and Mycoplasma pneumoniae antibody in children with Mycoplasma pneumoniae complicated with bacterial infectious pneumonia.Methods 500 children with Mycoplasma pneumoniae complicated with bacterial pneumonia who received treatment at the Changping District Integrated Traditional Chinese and Western Medicine Hospital in Beijing from July 2020 to March 2023 were selected as the research group,and 100 children with viral pneumonia who received treatment at the same time at the Changping District Integrated Traditional Chinese and Western Medicine Hospital in Beijing were selected as the case control group.100 healthy children who underwent physical examination at the same time were selected as the control group,and their blood samples were tested for PCT,CRP,and The levels of Mycoplasma pneumoniae antibody IgM and peripheral blood leukocyte classification indicators(white blood cell count,neutrophil percentage,lymphocyte percentage,monocyte percentage)were compared between the two groups of children.The diagnostic value of the above indicators for Mycoplasma pneumoniae combined with bacterial infection pneumonia was calculated by drawing receiver operating characteristics(ROC)of the subjects,And calculate the area under curve(AUC).Results The blood PCR,CRP,and IgM levels of Mycoplasma pneumoniae antibodies in the study group were significantly higher than those in the case control group and control group children(P<0.05).The peripheral blood white blood cell count,neutrophil percentage,and monocyte percentage of children in the study group were significantly higher than those in the case control group and control group,while the lymphocyte percentage was significantly lower than those in the control group(P<0.05).By plotting ROC curves and calculating,it was found that the diagnostic AUCs for PCT,CRP,and IgM antibodies against Mycoplasma pneumoniae combined with bacterial pneumonia were 0.934(95%CI=0.900-0.968,P<0.001),0.928(95%CI=0.880-0.975,P<0.001),and 0.780(95%CI=0.712-0.848,P<0.001).The diagnostic AUCs of white blood cell count,neutrophil percentage,lymphocyte percentage,and monocyte percentage in peripheral blood white blood cell classification for Mycoplasma pneumoniae complicated with bacterial infection pneumonia were 0.957(95%CI=0.925-0.988,P<0.001),0.768(95%CI=0.700-0.836,P<0.001),0.670(95%CI=0.595-0.746,P<0.001),and 0.765(95%CI=0.698-0.832,P<0.001).Conclusion The blood PCT,CRP,and IgM of Mycoplasma pneumoniae antibodies in children with Mycoplasma pneumoniae combined with bacterial infection pneumonia significantly increased compared to healthy children,and the level of white blood cell classification also showed significant changes.The above indicators have good application value in the early diagnosis of Mycoplasma pneumoniae combined with bacterial infection pneumonia in children.