Changes and clinical significance of D-dimer and hepatic enzymes in children with Mycoplasma pneumoniae pneumonia complicated by plastic bronchitis
10.3760/cma.j.issn.1673-4912.2025.06.009
- VernacularTitle:肺炎支原体肺炎合并塑型性支气管炎患儿D-二聚体和肝酶的变化及意义
- Author:
Ying XU
1
;
Kexing ZHONG
1
;
Xi LIU
1
;
Quanshan ZHANG
1
Author Information
1. 深圳市宝安区妇幼保健院儿科 518102
- Publication Type:Journal Article
- Keywords:
Mycoplasma pneumoniae pneumonia;
Plastic bronchitis;
Aspartic transaminase;
Respiratory support;
D-Dimer
- From:
Chinese Pediatric Emergency Medicine
2025;32(6):443-448
- CountryChina
- Language:Chinese
-
Abstract:
Objective:The characteristics of D-dimer（D-D），liver enzymes and clinical presentation in pediatric Mycoplasma pneumoniae pneumonia（MPP）complicated by plastic bronchitis（PB）were analyzed,and the predictive value of abnormal D-D and liver enzymes in MPP complicated by PB was discussed.Methods:Patients diagnosed with MPP who underwent bronchoscopy at the Pediatric Department of Shenzhen Baoan Women's and Children's Hospital in Shenzhen between March 2023 and March 2024 were enrolled. The participants were categorized into the PB group and the non-PB group based on the presence or absence of PB complications.The differences in clinical characteristics，treatment characteristics，laboratory results and imaging results between the two groups were compared.The nomogram prediction model of MPP combined with PB was established,and its effectiveness was evaluated.Results:A total of 225 pediatric patients were enrolled,including 52 cases in the PB group and 173 cases in the non-PB group. No statistically significant differences were observed between the two groups in baseline characteristics such as age, gender, and body weight ( P>0.05).The PB group had a higher proportion of respiratory distress, respiratory support, PICU admission, decreased of SpO 2, viral infection and bacterial infection. And neutrophil ratio, C-reactive protein,procalcitonin, coagulation index and liver enzyme index were significantly higher than those in non-PB group.The analysis of binary Logistic analysis showed that increased aspartic transaminase, increased D-D,and the need of respiratory support were independent risk factors for MPP combined with PB.The nomogram predictive model based on binary Logistic analysis showed that the area under curve for predicting MPP combined with PB was 0.800（95% CI 0.724-0.875， P<0.001）.The calibrate curve showed that the predicted probability of the model fit well with actual probability. Conclusion:Children with MPP complicated by PB have higher levels of aspartic transaminase and D-D,along with an increased proportion requiring repiratory support.The prediction model based on these indicators shows good clinical application value.
