MPP进展为塑型性支气管炎患儿临床特征及血清PCT、D-D、NLR对进展的预测价值OA
Clinical Characteristics of Pediatric Patients with Mycoplasma Pneumoniae Pneumonia Progressing to Plastic Bronchitis and Predictive Value of Serum PCT,D-D and NLR for Disease Progression
目的 探讨肺炎支原体肺炎(MPP)患儿进展为塑型性支气管炎(PB)的临床特征以及血清降钙素原(PCT)、D-二聚体(D-D)、中性粒细胞/淋巴细胞比值(NLR)对进展风险的预测价值.方法 回顾性选取2024年4月至2025年10月山西省儿童医院收治的MPP进展为PB的患儿106例作为研究组,按照1∶1选取同期未进展的MPP患儿106例作为对照组.比较两组临床资料、入院后24 h内的实验室指标(白细胞计数、红细胞沉降率、血小板计数、C反应蛋白、乳酸脱氢酶、PCT、D-D、NLR)水平,分析血清PCT、D-D、NLR水平与MPP患儿进展为PB的相关性,通过多因素条件Logistic回归分析及受试者工作特征曲线评估相关指标对MPP患儿进展为PB的预测价值.结果 研究组住院时间、发热持续时间长于对照组(P<0.05),胸腔积液患儿比例高于对照组(P<0.05).研究组红细胞沉降率、C反应蛋白、乳酸脱氢酶、PCT、D-D、NLR水平均高于对照组(P<0.05).多因素条件Logistic回归分析显示,胸腔积液、血清PCT、D-D、NLR水平高是MPP患儿进展为PB的独立危险因素(均P<0.05).受试者工作特征曲线显示,血清PCT、D-D、NLR水平预测MPP患儿进展为PB的曲线下面积分别为0.830、0.862、0.779,3项指标联合诊断的曲线下面积为0.894,各指标及联合诊断均具有较高的预测效能.结论 胸腔积液、血清PCT、D-D、NLR水平与MPP患儿进展为PB存在显著相关性,且上述血清指标对MPP病情进展具有较高的预测价值.
Objective To analyze the clinical characteristics of children with Mycoplasma pneumoniae pneumonia(MPP)progressing to plastic bronchitis(PB)and the predictive value of serum procalcitonin(PCT),D-dimer(D-D)and neutrophil-to-lymphocyte ratio(NLR)for the progression risk.Methods One hundred and six children with MPP progressing to PB admitted to Shanxi Children's Hospital from April 2024 to October 2025 were retrospectively enrolled as the study group(n=106),and 106 children with MPP without progression during the same period were selected at a 1:1 ratio as the control group(n=106).Clinical data and laboratory indicators within 24 hours after admission,including white blood cell count,erythrocyte sedimentation rate,platelet count,C-reactive protein,lactate dehydrogenase,PCT,D-D and NLR,were compared between the two groups.The correlation between serum PCT,D-D and NLR levels and progression to PB in children with MPP was analyzed.Multivariate conditional Logistic regression analysis and receiver operating characteristic(ROC)curve analysis were performed to assess the predictive value of related indicators for progression to PB in children with MPP.Results The length of hospital stay and duration of fever in the study group were significantly longer than those in the control group(P<0.05),and the proportion of children with pleural effusion was significantly higher in the study group than in the control group(P<0.05).The levels of erythrocyte sedimentation rate,C-reactive protein,lactate dehydrogenase,PCT,D-D and NLR in the study group were significantly higher than those in the control group(P<0.05).Multivariate conditional Logistic regression analysis showed that pleural effusion and elevated serum levels of PCT,D-D and NLR were independent risk factors for progression to PB in children with MPP(all P<0.05).ROC curves revealed that the area under the curve(AUC)of serum PCT,D-D and NLR in predicting progression to PB in children with MPP was 0.830,0.862 and 0.779,respectively,and the AUC of the combined diagnosis of the three indicators was 0.894,indicating that each single indicator and the combined diagnosis had favorable predictive value.Conclusion Pleural effusion and serum levels of PCT,D-D and NLR are significantly correlated with progression to PB in children with MPP,and the above serum indicators have high predictive value for the disease progression of MPP.
陈慧婧;王芳;张润平;高吊清;李晓霞;聂晶;王荣华
山西省儿童医院(山西省妇幼保健院)急诊科,太原 030002山西省儿童医院(山西省妇幼保健院)检验科,太原 030002山西省儿童医院(山西省妇幼保健院)检验科,太原 030002山西省儿童医院(山西省妇幼保健院)儿内门诊,太原 030002山西省儿童医院(山西省妇幼保健院)急诊科,太原 030002山西省儿童医院(山西省妇幼保健院)急诊科,太原 030002山西省儿童医院(山西省妇幼保健院)儿童重症医学科,太原 030002
肺炎支原体肺炎塑型性支气管炎降钙素原D-二聚体中性粒细胞/淋巴细胞比值
mycoplasma pneumoniae pneumoniaplastic bronchitisprocalcitoninD-dimerneutrophil-to-lymphocyte ratio
《转化医学杂志》 2026 (8)
1279-1284,6
山西省应用基础研究计划项目(201901D111424)
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