Study on early identification indicators of refractory Mycoplasma pneumoniae pneumonia in children
10.3969/j.issn.1673-9701.2024.17.003
- VernacularTitle:儿童难治性肺炎支原体肺炎早期识别指标的研究
- Author:
Xinsong XU
1
;
Chen YUAN
;
Gang LI
Author Information
1. 湖州市第一人民医院儿科,浙江湖州 313000
- Keywords:
Refractory;
Mycoplasma pneumoniae pneumonia;
D-dimer;
IFN-γ;
CRP
- From:
China Modern Doctor
2024;62(17):13-16
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effective early identification indicators of refractory mycoplasma pneumoniae pneumonia(RMPP)in children.Methods Thirty children admitted to Department of Pediatrics the First People's Hospital of Huzhou and diagnosed with RMPP from June 2021 to June 2023 were selected as the study group.Forty children with mycoplasma pneumoniae pneumonia(GMPP)were selected as the control group.Blood interferon(IFN)-γ,D-dimer,lactate dehydrogenase(LDH)and C-reactive protein(CRP)were detected in all children after admission.Pharynx samples were collected for detection of Mycoplasma pneumoniae nucleic acid and drug resistance sites.The expression of IFN-γ,D-dimer,LDH and CRP in the early stage of mycoplasma pneumoniae pneumonia was compared between the two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive effect of each index on RMPP.To analyze the correlation between macrolide resistance and RMPP.Results The expression levels of IFN-γ,D-dimer and CRP in the study group were significantly higher than those in the control group.The difference between the two groups was statistically significant(P＜0.05).There was no significant difference in LDH expression between the study group and the control group(P＞0.05).By comparing the area under the ROC curve(AUC).IFN-γ had the highest AUC of 0.908(95% CI:0.840-0.976,P＜0.001).CRP was 0.760(95% CI:0.637-0.883,P＜0.001).D-dimer was 0.698(95% CI:0.573-0.822,P=0.005).LDH was 0.575(95% CI:0.434-0.715,P=0.288).These results indicate that IFN-γ has better diagnostic effect on RMPP than other variables.The proportion of macrolide resistance in RMPP patients was significantly higher than that in GMPP group.Conclusion IFN-γ,CRP,D-dimer,macrolide resistance factors have certain efficacy in the early prediction of RMPP.RMPP had the best prediction effect when IFN-γ＞24pg/ml.Combined with drug resistance factors can be used as a good indicator to predict RMPP.
