基于决策曲线分析血清铁蛋白检测在肺炎支原体肺炎中的诊断价值

Diagnostic value of serum ferritin in Mycoplasma pneumoniae pneumonia was analyzed based on the decision curve

目的 基于决策曲线(DCA)和剂量反应关系分析血清铁蛋白(SF)在肺炎支原体肺炎(MPP)早期诊断中的价值。方法 选取2016年10月至2021年10月于泰州市人民医院就诊的MPP患者104例为MPP组,另选取同期于泰州市人民医院体检的健康成人90例为健康组。比较两组临床资料,筛选发生MPP的影响因素。分析SF对发生MPP的诊断价值,寻求最佳临界值,并评估SF对MPP的临床预测价值。结果 白细胞计数、C反应蛋白、肿瘤坏死因子-α、乳酸脱氢酶、SF是患者发生MPP的独立危险因素,25-羟维生素D是其保护因素(P<0.05)。剂量反应关系分析结果显示,SF的连续变化与MPP的关联强度呈非线性剂量反应关系(P<0.05),当SF>127.68 ng/mL时,随着SF水平的升高,MPP发生风险越大;DCA分析结果显示,SF对MPP早期预测有重要临床价值。结论 SF具有较高的MPP早期诊断价值,与MPP发生大致呈非线性剂量反应关系,当SF>127.68 ng/mL时,随着SF水平的升高,MPP发生风险越大。

Objective To analyze the value of serum ferritin(SF)in the early diagnosis of Mycoplasma pneumoniae pneumonia(MPP)based on decision curve analysis(DCA)and dose-response relationship.Methods A total of 104 MPP patients in Taizhou People's Hospital from October 2016 to October 2021 were selected as the MPP group,and 90 healthy adults who underwent physical examination in Taizhou People's Hospital during the same period were selected as the healthy group.The clinical data of the two groups were compared.The influencing factors of MPP in patients were screened.The diagnostic value of SF for MPP was analyzed,the best cut-off value was sought,and the clinical predictive value of SF for MPP was evaluated.Results White blood cell count,C-reactive protein,tumor necrosis factor-α,lactate dehydrogenase,SF were independent risk factors for MPP,and 25-hydroxyvitamin D was its protective factor(P<0.05).The dose-response relationship analysis showed that there was a nonlinear dose-response relationship between the continuous change of SF and MPP(P<0.05).When SF>127.68 ng/mL,the risk of MPP increased with the increase of SF level.DCA analysis showed that SF had important clinical value in the early prediction of MPP.Conclusion SF has a high value in the early diagnosis of MPP,and there is a nonlinear dose-response relationship between SF and MPP.When SF>127.68 ng/mL,the risk of MPP increases with the increase of SF level.