部分炎症反应指标在儿童难治性支原体肺炎早期评估中的评估价值

Value of partial inflammatory response indexes in early evaluating refractory mycoplasma pneumonia in children

目的探究炎症指数在儿童难治性支原体肺炎(RMPP)早期评估中的临床价值。方法肺炎支原体肺炎(MPP)患儿1000例纳入研究,根据患儿严重程度分为常规MPP组(MPP组)762例和RMPP组(RMPP组)238例,比较两组患儿入院后第1天时的炎症反应指标[C反应蛋白(CRP)、中性粒细胞、降钙素原(PCT)、血清淀粉样蛋白A(SAA)、红细胞沉降率(ESR)、丙氨酸转氨酶(ALT)、乳酸脱氢酶(LDH)α-羟基丁酸脱氢酶(HBDH)、D-二聚体(D-D)、铁蛋白]根据治疗效果;再将RMPP患者分为有效组和无效组,比较不同疗效RMPP患者治疗前后(入院后第1天、治疗1周后)的炎症反应指标及炎症反应指标与疗效相关性,通过ROC曲线分析炎症反应指标诊断RMPP的价值。结果与MPP组相比,RMPP组CRP、中性粒细胞、PCT、SAA、ESR、ALT、LDH、HBDH、D-D及铁蛋白均更高(P<0.05);RMPP组患儿治疗后显效48例,有效152例,总有效200例,占比84.03%,无效38例、占比15.97%;与治疗前比较,RMPP组患儿治疗后CRP、中性粒细胞、PCT、SAA、ESR、ALT、LDH、HBDH、D-D及铁蛋白均降低(P<0.05),且有效组低于无效组(P<0.05);Person相关分析显示,CRP、中性粒细胞、PCT、SAA、ESR、ALT、LDH、HBDH、D-D、铁蛋白与疗效呈负相关(P<0.05),ROC曲线分析显示这些指标对诊断RMPP均具有一定价值。结论基于炎症反应指标的炎症指数早期诊断早期诊断儿童RMPP具有较好价值,且与临床治疗疗效相关密切。

Objective To explore clinical value of inflammatory indexes in early evaluating refractory mycoplasma neumonia(RMPP)in children.Methods A total of 1000 children with mycoplasma pneumoniae pneumonia(MPP)were included in the study and divided into conventional MPP group(n=762)and RMPP group(n=238)based on their severity.Inflammatory response indexes[C-reactive protein(CRP),neutrophils,procalcitonin(PCT),serum amyloid A(SAA),erythrocyte sedimentation rate(ESR),alanine aminotransferase(ALT),lactate dehydrogenase(LDH),α-Hydroxybutyrate dehydrogenase(HBDH),D-dimer(D-D),and ferritin]on the first day after admission were compared between two groups.RMPP patients were divided into effective and ineffective groups based on treatment efficacy.Inflammatory response indexes and their correlation with therapeutic efficacy were compared among RMPP patients with different therapeutic effects before and after treatment(on the first day after admission,at one week after treatment).ROC curvea of inflammatory response indexes were used to analyze the value of diagnosing RMPP.Results CRP,neutrophils,PCT,SAA,ESR,ALT,LDH,HBDH,D-D,and ferritin were higher in RMPP group than those in MPP group(P<0.05).After treatment,RMPP group had 48 children showing significant improvement and 152 children showing effective improvement,and the total number of children showing effective was 200,accounting for 84.03%,with 38 children ineffective,accounting for 15.97%.When compared with before treatment,CRP,neutrophils,PCT,SAA,ESR,ALT,LDH,HBDH,D-D,and ferritin in RMPP group were decreased after treatment(P<0.05),and they were lower in effective group than those in ineffective group(P<0.05).Person correlation analysis showed that CRP,neutrophils,PCT,SAA,ESR,ALT,LDH,HBDH,D-D,and ferritin were negatively correlated with therapeutic efficacy(P<0.05).ROC curve analysis revealed that these indexes had certain values in diagnosing RMPP.Conclusion Inflammation indexes based on inflammatory response exhibit good values in early diagnosing RMPP in children.