Application of D-dimer in diagnosis and prognosis of childhood Mycoplasma pneumoniae pneumonia
10.3760/cma.j.issn.2095-428X.2019.22.006
- VernacularTitle: D－二聚体在肺炎支原体肺炎患儿病情及预后判断中的应用
- Author:
Yixuan HE
1
;
Chunfeng ZHANG
2
;
Runhui WU
1
;
Ju YIN
2
;
Jun LIU
2
;
Yan GUO
2
;
Xiuyun LIU
2
Author Information
1. National Children′s Medical Center, Hematology Oncology Center, Beijing Children′s Hospital, Capital Medical University, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
2. National Children′s Medical Center, Department of Respiratory, Beijing Children′s Hospital, Capital Medical University, National Clinical Research Center for Res-piratory Diseases, Beijing 100045, China
- Publication Type:Journal Article
- Keywords:
D-dimer;
Child;
Mycoplasma pneumoniae;
Prognosis
- From:
Chinese Journal of Applied Clinical Pediatrics
2019;34(22):1702-1706
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the practical value of D-dimer in diseases condition judgment and prognosis evaluation of childhood Mycoplasma pneumoniae pneumonia (MPP).
Methods:Retrospective analysis was performed on clinical data of 606 MPP at Department of Respiratory, Beijing Children′s Hospital, Capital Medical University from January 2009 to July 2017, and the subjects were divided a severe group (298 cases) and a moderate group (308 cases) according to severity.By comparing clinical characteristics, laboratory tests and imaging findings, multivariate Logistic regression analysis for significant single factors was accomplished, which was to find out the independent factors affecting the severity of childhood MPP in acute phase.Receiver operating characteristic (ROC) curves were drawn in the area under the curve (AUC) and the diagnosis threshold value was calculated, which could be used to judge the predicators affecting the severity judgment of childhood MPP in acute phase.And the prognosis was judged according to the convalescent fiberoptic bronchoscopic indicators in recovery phase.
Results:The levels of white blood cells (WBC)[(10.25±3.76)×109/L], neutrophil(Neu)[(7.31±3.76)×109/L], platelet (PLT)[(334.66±143.80)×109/L], C-reactive protein(CRP)[(69.00±80.50) mg/L], erythrocyte sedimentation (ESR)[(39.38±26.29) mm/1h], lactate dehydrogenase (LDH)[(436.61±248.96) IU/L], fibrinogen(Fib)[(4.61±1.36) g/L] and D-dimer [(2.09±1.66) mg/L]in the severe group were higher than those in the moderate group[(7.55±3.14)×109/L, (4.77±2.54)×109/L, (291.60±109.19)×109/L, (23.40±42.50) mg/L, (30.25±16.18) mm/1 h, (318.05±116.97) IU/L, (4.18±0.88) g, (0.58±0.72) mg/L], and the differences were statistically significant (all P<0.01). The levels of Neu, PLT, CRP, LDH and D-dimer were independent and relevant factors for the severity of acute MPP.The area under each ROC curve was Neu 0.719, PLT 0.592, LDH 0.675, CRP 0.749, D-dimer 0.848, and each diagnostic threshold was 6.5× 109/L, 265.5×109/L, 417.5 IU/L, 28.9 mg/L, 0.73 mg/L, respectively.Obviously, D-dimer had the highest sensitivity and specificity for the severe MPP.There was a significant difference in D-dimer level between the endobronchial inflammation group and the subbronchial stenosis, poor ventilation and occlusion group of fiberoptic bronchoscopy [(1.11±0.26) mg/L vs.(2.14±1.84) mg/L, t=-5.870, P<0.05].
Conclusion:D-dimer levels can be used as one of the most sensitive indicator for determining the severity and prognosis of MPP.
