Clinical significance of mycoplasma pneumoniae-DNA load detection in alveolar lavage fluid of children with refractory mycoplasma pneumoniae pneumonia
10.3760/cma.j.issn.1673-4912.2020.06.011
- VernacularTitle:难治性肺炎支原体肺炎患儿肺泡灌洗液中肺炎支原体-DNA载量检测在病情评估中的临床意义
- Author:
Yuhan LIU
1
;
Han ZHANG
;
Yunxiao SHANG
Author Information
1. 中国医科大学附属盛京医院儿内科，沈阳 110004
- From:
Chinese Pediatric Emergency Medicine
2020;27(6):447-451
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical significance of mycoplasm pneumoniae-DNA(MP-DNA) load detected in bronchoalveolar lavage fluid of children with refractory mycoplasma pneumoniae pneumonia(RMPP) in the assessment of the condition.Methods:A total number of 98 hospitalized children with RMPP diagnosed in the Department of Pediatric Respiratory of Shengjing Hospital of China Medical University from May to November in 2018 were selected as the subjects.Bronchoscopy was performed on each subject and the alveolar lavage fluid was collected to detect the MP-DNA load quantitatively.According to the test results, all children were divided into three groups: high-load group(>10 6/ml, 28 cases), medium-load group(10 3 to 10 6/ml, 54 cases), and low-load group(≤10 3/ml, 16 cases). The clinical manifestations, relevant laboratory data, imaging data, and bronchoscopy findings of the children in different load groups were compared. Results:Compared with the low-load group and medium-load groups, the level of C-reactive protein was the highest in the high-load group with statistical significance( P<0.05). The difference of lactate dehydrogenase levels among the three groups was statistically significant( P=0.001). The positive incidences of nodular protuberances, mucosal erosion and necrosis, bronchial inflammatory stenosis and mucus plugs occlusion in the high-load group were 35.7%, 32.1% and 64.3%, respectively, which were significantly higher than those in the medium-load group(13.0%, 5.6%, 38.95) and low-load group(0, 0, 12.5%), and the differences were statistically significant( P<0.05). The imaging manifestation of large areas consolidation/lung atelectasis and pleural effusion in the high-load group were 100% and 60.7%, respectively, which were significantly higher than those in the medium-load group(61.1%, 27.8%)and low-load group(25.0%, 12.5%), and the differences were statistically significant( P<0.05). Compared with the low-load group and medium-load group, the hospitalization days was the longest in the high-load group, and the fever clearance time after the application of macroclides was also the longest( P<0.05). Conclusion:The MP-DNA load of children with RMPP is closely related with the clinical features.The clinical manifestations of children with higher DNA-load are more serious.The level of local MP-DNA load can guide clinicians to use drugs rationally, better predicting the outcome of the disease.
